The following is a summary of “Lung cancer screening in rural primary care practices in Colorado: time for a more team-based approach?,” published in the March 2023 issue of Primary Care by Gomes et al.
Lung cancer is the second largest cause of mortality in the United States, yet many candidates for lung cancer screening (LCS) do not have the procedure. More study is required to comprehend the difficulties of LCS implementation in various contexts. This study aimed to understand better the factors that may influence rural primary care practices’ ability to encourage LCS use among their patients. This qualitative study included participants from 9 primary care practices (n=9 clinicians, n=12 clinical staff, n=5 administrators) and their patients (n=19). The practices ranged from federally qualified and rural health centers (n=3) to health system-owned (n=4) to private (n=2). Steps that could lead to a patient receiving LCS were discussed in interviews, along with their relative importance and feasibility.
Using thematic analysis with immersion crystallization, the RE-AIM implementation science framework was used to categorize and shed light on the data. While all parties acknowledged LCS’s significance, they also shared similar difficulties in implementing the strategy. For example, researchers inquired about the steps used in this direction since determining LCS eligibility includes reviewing a candidate’s smoking history. While some aspects of identifying eligibility and providing LCS were determined to be standard practice, others were not, including smoking assessment and support (including referral to programs).
Completing LCS was more difficult than screening for other types of cancer due to a lack of understanding about screening and coverage, patient stigma and resistance, and practical issues, including distance to LCS testing facilities. The low acceptance of LCS can be traced back to several interrelated problems that all compromise the reliability and precision of LCS’s actual application. Team-based ways of determining LCS eligibility and making joint decisions should be explored in future studies.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02003-x