Assessing Factors Associated With Patient-Provider Discussions About Lung Cancer Screening Using Andersen's Behavioral Model of Health Services Utilization.

Abstract

Background: Patient-provider shared decision-making discussions are an important component of lung cancer screening guidelines, but little is known about factors associated with these discussions among screening-eligible patients. We used Andersen's Behavioral Model of Health Services Utilization to examine factors associated with discussing LCS with a provider.

Patients: Data came from an online survey of N = 516 U.S. adults meeting United States Preventive Services Task Force LCS eligibility criteria (ie, were 50-80 years of age and had at least a 20-pack year history of tobacco use).

Methods: We used logistic regression to investigate whether having a LCS discussion was associated with predisposing factors (eg, chronic obstructive pulmonary disease [COPD] diagnosis), enabling factors (eg, having a primary care provider [PCP]), and need factors (eg, smoking history).

Results: About 36% participants had ever discussed LCS with a provider. Participants diagnosed with COPD (OR = 3.56, 95% CI, 1.90-6.67) and who had a first-degree relative with lung cancer (OR = 1.78, 95% CI, 1.02-3.09) had higher odds of LCS discussion than those without COPD and with no family history, respectively. Women had lower odds of LCS discussion than men (OR = 0.37, 95% CI, 0.24-0.58). Participants with an income of $30,000 to $59,999 had higher odds of LCS discussion compared to those earning < $30,000 (OR = 1.78, 95% CI, 1.06-2.98). Not having a PCP (OR = 0.39, 95% CI, 0.21-0.72) and currently smoking (OR = 0.38, 95% CI, 0.18-0.79) were associated with lower odds of LCS discussion.

Conclusions: Future interventions are needed to ensure all LCS-eligible individuals have access to provider discussions about LCS.