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Clinical Investigations: LUNG CANCER |

Do Australian Family Physicians Screen Smokers for Lung Cancer?*

Michael J. Sladden, MB ChB, MAE; Jeanette E. Ward, MB BS, MHPEd, PhD
Author and Funding Information

*From the Division of Community and Rural Health (Dr. Sladden), University of Tasmania, Hobart, Australia; and the Needs Assessment and Health Outcomes Unit (Dr. Ward), Central Sydney Area Health Service, Sydney, Australia.



Chest. 1999;115(3):725-728. doi:10.1378/chest.115.3.725
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Study objectives: To determine family physicians’ perceptions of the effectiveness of chest radiographs (CXRs) in reducing premature mortality from lung cancer and their self-reported levels of screening asymptomatic heavy smokers.

Design: National postal survey of 1,271 family physicians, obtaining 855 completed questionnaires (67% response rate).

Setting and participants: Random sample of Australian family physicians.

Measurements and results: One in five (n = 169, 20%) indicated that an annual CXR was an effective screening test. Older physicians were significantly more likely to hold this view (p < 0.0001). Nearly 25% (n = 190, 22.5%) reported that they recommend an annual CXR as a screening test for asymptomatic heavy smokers. Three variables independently predicted such a practice: increasing physician age (p = 0.0085), being in solo practice (p = 0.0068), and the aforementioned belief in its effectiveness (p < 0.0001).

Conclusions: A substantial minority of family physicians recommends an annual CXR as a screening test despite contradictory evidence from randomized controlled trials. These significant variations in the absence of epidemiologic evidence invite further research to develop effective, efficient, and affordable preventive care in family practice.

Abbreviations:ACS = American Cancer Society; AMA = Australian Medical Association; CI = confidence interval; CXR = chest radiograph; df = degrees of freedom; RACGP = Royal Australian College of General Practitioners


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