TY - JOUR
T1 - The complicated ‘Yes’
T2 - Decision-making processes and receptivity to lung cancer screening among head and neck cancer survivors
AU - Seaman, Aaron T.
AU - Dukes, Kimberly
AU - Hoffman, Richard M.
AU - Christensen, Alan J.
AU - Kendell, Nicholas
AU - Sussman, Andrew L.
AU - Veléz-Bermúdez, Miriam
AU - Volk, Robert J.
AU - Pagedar, Nitin A.
N1 - Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/10
Y1 - 2018/10
N2 - Objective: Shared decision making (SDM) is recommended when offering lung cancer screening (LCS)—which presents challenges with tobacco-related cancer survivors because they were excluded from clinical trials. Our objective was to characterize head and neck cancer (HNC) survivors’ knowledge, attitudes, and beliefs toward LCS and SDM. Methods: Between November 2017 and June 2018, we conducted semi-structured qualitative interviews with 19 HNC survivors, focusing on patients’ cancer and smoking history, receptivity to and perceptions of LCS, and decision-making preferences Results: Participants were receptive to LCS, referencing their successful HNC outcomes. They perceived that LCS might reduce uncertainty and emphasized the potential benefits of early diagnosis. Some expressed concern over costs or overdiagnosis, but most minimized potential harms, including false positives and radiation exposure. Participants preferred in-person LCS discussions, often ideally with their cancer specialist. Conclusion and Practice Implications: HNC survivors may have overly optimistic expectations for LCS, and clinicians need to account for this in SDM discussions. Supporting these patients in making informed decisions will be challenging because we lack clinical data on the potential benefits and harms of LCS for cancer survivors. While some patients prefer discussing LCS with their cancer specialists, the ability of specialists to support high-quality decision making is uncertain.
AB - Objective: Shared decision making (SDM) is recommended when offering lung cancer screening (LCS)—which presents challenges with tobacco-related cancer survivors because they were excluded from clinical trials. Our objective was to characterize head and neck cancer (HNC) survivors’ knowledge, attitudes, and beliefs toward LCS and SDM. Methods: Between November 2017 and June 2018, we conducted semi-structured qualitative interviews with 19 HNC survivors, focusing on patients’ cancer and smoking history, receptivity to and perceptions of LCS, and decision-making preferences Results: Participants were receptive to LCS, referencing their successful HNC outcomes. They perceived that LCS might reduce uncertainty and emphasized the potential benefits of early diagnosis. Some expressed concern over costs or overdiagnosis, but most minimized potential harms, including false positives and radiation exposure. Participants preferred in-person LCS discussions, often ideally with their cancer specialist. Conclusion and Practice Implications: HNC survivors may have overly optimistic expectations for LCS, and clinicians need to account for this in SDM discussions. Supporting these patients in making informed decisions will be challenging because we lack clinical data on the potential benefits and harms of LCS for cancer survivors. While some patients prefer discussing LCS with their cancer specialists, the ability of specialists to support high-quality decision making is uncertain.
KW - Attitudes
KW - Decision making
KW - Early detection of cancer
KW - Head and neck neoplasms
KW - Health knowledge
KW - Lung neoplasms
KW - Practices
KW - Qualitative research
KW - Shared
UR - http://www.scopus.com/inward/record.url?scp=85052213714&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85052213714&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2018.04.012
DO - 10.1016/j.pec.2018.04.012
M3 - Article
C2 - 29709410
AN - SCOPUS:85052213714
SN - 0738-3991
VL - 101
SP - 1741
EP - 1747
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 10
ER -