Table 2.
Barriers and perceptions | Total | Providers offer screening (n=47) | Providers do not offer screening or don’t know if screening is offered (n=63) | p-valuea |
---|---|---|---|---|
| ||||
Barriers to offering lung cancer screening, n, (% yes) | ||||
Lack of insurance coverage | 79 (71.8) | 33 (70.2) | 46 (73.0) | 0.75 |
Prior authorization by health insurance is required | 64 (58.2) | 27 (57.4) | 37 (58.7) | 0.89 |
Transportation challenges for patients | 60 (54.5) | 28 (59.6) | 32 (50.8) | 0.36 |
Difficult to refer certain patient populations | 43 (39.1) | 17 (36.2) | 26 (41.3) | 0.59 |
Coverage denials received | 33 (30.0) | 18 (38.3) | 15 (23.8) | 0.10 |
Services for non-English speaking patients are limited or unavailable | 32 (29.1) | 11 (23.4) | 21 (33.3) | 0.26 |
Other | 21 (19.1) | 6 (12.8) | 15 (23.8) | 0.15 |
We do not have any barriers to offering LDCT | 7 (6.4) | 3 (6.4) | 4 (6.3) | 0.99 |
Lung cancer screening perceptionsb, n, (% agree or strongly agree) | ||||
Evidence from randomized trials show that lung cancer screening with LDCT scans prevents lung cancer deaths | 73 (67.0) | 40 (85.1) | 33 (53.2) | <0.001 |
Available clinical evidence about lung cancer screening will be applicable to our patient population | 89 (81.7) | 40 (85.1) | 49 (79.0) | 0.42 |
Lung cancer is an important clinical concern for our patient population | 92 (84.4) | 42 (89.4) | 50 (80.6) | 0.21 |
Clinicians believe that other clinical priorities are more important than lung cancer screening for our patients | 37 (33.9) | 15 (31.9) | 22 (35.5) | 0.70 |
Senior leadership at our clinical site has made lung cancer screening a priority | 13 (11.9) | 7 (14.9) | 6 (9.7) | 0.40 |
Senior leadership at our clinical site has committed resources to support lung cancer screening | 13 (11.9) | 8 (17.0) | 5 (8.1) | 0.15 |
Our clinical site has adequate access to specialty providers to appropriately manage abnormal findings on lung cancer screening tests | 56 (51.4) | 29 (61.7) | 27 (43.5) | 0.06 |
Patients frequently ask for lung cancer screening | 2 (1.8) | 0 (0.0) | 2 (3.2) | 0.50 |
The benefits of lung cancer screening with LDCT outweigh the potential harms | 59 (54.1) | 36 (76.6) | 23 (37.1) | <0.001 |
Under-insured patients are less likely to be referred for lung cancer screening with LDCT | 66 (60.6) | 33 (70.2) | 33 (53.2) | 0.07 |
Out-of-pocket costs for follow-up procedures of suspicious screening findings will be a significant financial burden for our patients | 79 (72.5) | 35 (74.5) | 44 (71.0) | 0.68 |
Lung cancer screening may undermine smoking cessation efforts with our patient population | 10 (9.2) | 2 (4.3) | 8 (12.9) | 0.18 |
We need to provide lung cancer screening to be a leader in cancer prevention | 60 (55.0) | 31 (66.0) | 29 (46.8) | 0.05 |
Engaging patients in shared decision making for lung cancer screening is challenging | 55 (50.5) | 23 (48.9) | 32 (51.6) | 0.78 |
Notes: Boldface indicates statistical significance (p<0.05). Percentages may not add to 100 due to rounding.
Chi-square tests (or Fisher’s Exact Test if >20% of cells had expected count <5) were used to compare the proportion(s) across the LDCT groups (Yes and No/Don’t Know).
Due to missing data on perceptions for one site, Total N=109 and No LDCT or Don’t Know n=62.
FQHC, Federally Qualified Health Center; LDCT, Low-Dose Computed Tomography.