IMPROVING KNOWLEDGE ABOUT LUNG CANCER SCREENING: EFFECT OF A DECISION AID VS. NCI WEBSITE

Purpose: Lung cancer screening (LCS) holds the potential for improving mortality rates for some high risk populations. However, both qualitative and quantitative research has shown that many individuals who may be candidates for screening are not well informed about the benefits or risks of screening. As a results, individuals may be making uninformed decisions about screening. This study assess the impact of a web-based LCS decision aid for improving knowledge (both subjective and objective) concerning LCS.

Methods: We conducted a randomized controlled trial (RCT)  of the Lung Cancer Screening (LuCaS) decision aid and the NCI website for LCS. As part of this study we assessed subjective (self-perceived) knowledge, as well as objective knowledge (including knowledge of screening effects, guidelines, and eligibility criteria for screening) for individuals participating in the study. Participants (n=50) were recruited from the Miami FL area and from rural areas in Kentucky. Measures were collected at baseline, 2 week follow up and 4 month follow up.

 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. Before viewing the DA or NCI website; only a minority of participants answered correctly on multiple choice questions concerning:

• Mortality reduction with LCS: 10%
• False positive rates of LCS: 6%
• Radiation levels of CT vs. X-ray: 16%
• Guidelines for eligibility for LCS: e.g., required pack years for screening 8%

At 2 week follow up, after opportunities for viewing the LCS DA or NCI website, correct responses increased (e.g., 33% of DA viewers and 20% of NCI website viewers answered correctly concerning mortality reduction), but the increases were not uniformly large.

Conclusions: The LuCaS Decision Aid for improving knowledge about LCS, and thus improving decision making about LCS shows some promise when compared with the NCI Lung Cancer Screening website. More information on the effect of the website and DA is needed, as well as research on the effects of knowledge on screening decisions.