An article published online today by JAMA Internal Medicine is very revealing about the misconceptions patients can have about screening, in this case lung cancer screening. This study was conducted at 7 VA sites launching a lung cancer screening program.  Participants underwent semi-structured qualitative interviews about health beliefs related to smoking and lung cancer screening. Participants had some interesting beliefs:

• Nearly all participants mentioned the belief that everyone who is screened will benefit in some way
• Many participants wanted to undergo screening to see “how much damage” they had done to their lungs
• Rather than being alarmed by identification of a nodule or suspicious findings requiring monitoring with future imaging, several participants expressed the belief that identification of the nodule meant their cancer had been found so early that it was currently harmless

Its important to educate our patients on what screening is and isn’t. They need to understand the role of screening. I like to ask patients what they expect to get out of screening. It can help you discover their misconceptions. They need to understand that they still need to change behaviors (in this case smoking) even if the screening test is negative. I think we all too often just order the screening test because a clinical reminder tells us to without thinking of how it could be interpreted by our patients.

Food for thought: What is the rate of false positive rate of CT scan for lung cancer screening?

Click here and read the results section of this abstract for the answer. Shocking isn’t it.