EFFECT OF A DECISION AID VS. NCI WEBSITE ON LUNG CANCER SCREENING DECISIONS AND BEHAVIOR

Purpose: Lung cancer screening (LCS) holds the potential for improving mortality rates for some high risk populations. However, the presence of negative physical, financial, and psychological consequences of LCS dictate that decisions about screening be well informed. This study assesses the impact of a web-based LCS decision aid on improving LCS decisions compared with the effect of the NCI LCS website.

 Methods: A pilot randomized controlled trial between the Lung Cancer Screening (LuCaS) decision aid  and the NCI website for LCS assessed decision making and LCS behavioral intentions prior to exposure to the DA or website, and at 2 weeks and 4 months follow up. Participants (n=50) were recruited from the Miami FL area and from rural areas in Kentucky. Measures collected at baseline and follow up included the Decisional Conflict Scale, Decision Satisfaction scale, and intentions for being screened.

Results: Fifty participants were recruited from the Miami Area (n=25) and rural Kentucky (n=25). All completed the baseline surveys, and thus far 35 individuals have completed the 2 week follow up. The average age of participants was 52.6 years (SD 5.1), and 77% of the participants were female. Participants were mostly White (63%) and Black (34%); and 16% were Hispanic or Latino; almost half were married.  Baseline levels on the Decisional Conflict Scale were not different between the DA and NCI groups overall of for the subscales (informed, values, support, and uncertainty). A lower percentage of individuals in the DA than the NCI group reported negative responses indicating uncertainty at the 2 week follow up. Preliminary results indicate lower decision satisfaction in the NCI group; but no differences in intentions for being screened.

 Conclusions: LCS holds promise for reducing the mortality and morbidity from lung cancer due to earlier detection. However, the potential negative consequences from screening must be recognized and steps taken to reduce them. The potential role for decision aids to improve decision making in LCS is very promising. Early results from a RCT of a decision aid for lung cancer screening indicates the promise of this intervention.