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
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