Feasibility of a patient decision aid about lung cancer screening with low-dose computed tomography

Abstract

Objective: New clinical guidelines endorse the use of low-dose computed tomography (LDCT) for lung cancer screening among selected heavy smokers while recommending patients be counseled about the potential benefits and harms. We developed and field tested a brief, video-based patient decision aid about lung cancer screening.

Methods: Smokers in a cancer center tobacco treatment program aged 45 to 75 years viewed the video online between November 2011 and September 2012. Acceptability, knowledge, and clarity of values related to the decision were assessed.

Results: Fifty-two patients completed the study (mean age=58.5 years; mean duration smoking=34.8 years). Acceptability of the aid was high. Most patients (78.8%) indicated greater interest in screening after viewing the aid. Knowledge about lung cancer screening increased significantly as a result of viewing the aid (25.5% of questions answered correctly before the aid, and 74.8% after; P<.01) although understanding of screening eligibility remained poor. Patients reported being clear about which benefits and harms of screening mattered most to them (94.1% and 86.5%, respectively).

Conclusions: Patients have high information needs related to lung cancer screening. A video-based decision aid may be helpful in promoting informed decision-making, but its impact on lung cancer screening decisions needs to be explored.

Keywords: Cancer; Decision making; Early detection of cancer; Lung neoplasms; Oncology.

Conflict of interest statement

CONFLICT OF INTEREST

The authors declare that there are no conflicts of interest.

Copyright © 2014 Elsevier Inc. All rights reserved.

Figures

Figure 1. Screen shots from the patient decision aid video

Clockwise from top left: LDCT image on a monitor; deaths due to lung cancer compared to other cancers; icon array showing likelihood of a positive LDCT result; and an LDCT scan procedure. Subjects were cancer center patients in a tobacco treatment program who participated in the study between November 2011 and September 2012.