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. Author manuscript; available in PMC: 2021 Sep 30.
Published in final edited form as: Am J Prev Med. 2018 Feb 21;54(4):568–575. doi: 10.1016/j.amepre.2018.01.001

Table 2.

Perceptions Lung Cancer Screening and Barriers to Implementing Screening in FQHCs Stratified by Current Implementation of Screening (n=110)

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.

a

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).

b

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.