Document Type


Publication Date



Maine Medical Center, Medical Education, Maine Medical Center Research Institute, Center for Outcomes Research & Evaluation

MeSH Headings

Attitude of Health Personnel, Early Detection of Cancer, Maine, Lung Neoplasms, Health Personnel, Primary Health Care


Context: Lung cancer screening is a relatively newly recommended preventive service. We have observed that involvement of primary care clinicians in lung cancer screening varied around the state. We wondered whether this variation might be partially due to the fact that the American Academy of Family Physicians (AAFP) has not endorsed lung cancer screening while the US Preventive Services Task Force (USPSTF) has. We surveyed primary care physicians in Maine to understand their knowledge, attitudes and current practices regarding lung cancer screening.

Objective: To understand the knowledge, attitudes and current practices of family physicians in Maine related to lung cancer screening using low dose CT (LDCT) scans.

Study Design: A cross-sectional survey was conducted using an online survey platform (REDCap™). Eligible participants were invited by email and provided an electronic link to the survey. Non-responders received three weekly email reminders.

Setting or Dataset: Statewide survey of primary care attending physicians and residents in Maine.

Population studied: Practicing attending physician members of three primary care organizations in Maine—Maine Academy of Family Physicians, Maine chapter of the American College of Physicians, and Maine Primary Care Association (consisting of primary care clinicians working in Federally Qualified Health Centers)—as well as residents at 4 family medicine residency programs in Maine (Central Maine FM Residency, Maine Medical Center FM Residency, Maine-Dartmouth FM Residency and Northern Light FM Residency) and one internal medicine residency program (Maine Medical Center). Intervention/instrument: Self-administered questionnaire utilizing both established and newly developed measures of several constructs.

Outcome measures: Knowledge of lung cancer screening using LDCT, including eligibility criteria and potential benefits and harms of screening; attitudes towards lung cancer screening and people who use tobacco; and current lung cancer screening practices including provision of shared decision making. Our results showed that respondents knew the eligibility criteria for screening but most were not familiar with the information about benefits and risks of the test. Knowledge, attitudes and current practices did not vary based on whether respondents endorsed the AAFP guideline or not. In general, PCP's endorsed an active role in all aspects of lung cancer screening, with the exception of following up on abnormal findings. PCP's wanted assistance from their specialist colleagues to make sure that people with abnormalities on screening ,especially more worrisome findings, got the appropriate follow up care. These data will help identify potential barriers to lung cancer screening among primary care physicians, as well as unmet educational needs. We will use the results to design interventions to better engage PCP's in lung cancer screening.


2020 Costas T. Lambrew Research Retreat