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Evaluation of Lung Cancer Screening Practices of Chest Physicians in Egypt: A Pilot National Survey FREE TO VIEW

Aliae Mohamed-Hussein, MD; Mohamed-Eltaher Ibrahim
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Assiut University Hospitals, Assiut, Egypt

Chest. 2014;146(4_MeetingAbstracts):603A. doi:10.1378/chest.1988633
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SESSION TITLE: Lung Cancer Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: In Egypt, lung cancer represented 4.5% of all cancers, accounting for 7.4% and 2.1% of male and female cancers respectively. Lung cancer ranked third in males and tenth in females (Egypt cancer National registry 2008). Despite periodic debate about the utility of screening patients for lung cancer, no randomized controlled trial has demonstrated that screening with chest radiograph or sputum cytology reduces mortality from lung cancer. No recent national survey of health care professionals has focused on lung cancer screening. In this study, we examined the lung cancer screening practices of Egyptian Chest Physician and characteristics of those who order lung cancer screening tests.

METHODS: We conducted a nationally representative pilot survey of chest physician in Egypt. Mailed questionnaires assessed the physicians’ knowledge of lung cancer screening guidelines, beliefs about the effectiveness of screening tests, and ordering of screening chest radiograph (CXR), low-dose spiral computed tomography (LDCT), or sputum cytology in the past 12 months. We also assessed the physicians’ intentions to screen asymptomatic 50-year-old patients with varying smoking histories for lung cancer.

RESULTS: A total of 92 Chest physicians, completed the questionnaires (response rate = 83.6%). Overall, 21.7% had ordered lung cancer screening tests; 19.5% had ordered CXR, 16.3% LDCT, and only 3.2% sputum cytology. In multivariate analysis, physicians had ordered lung cancer screening tests if they believed that expert groups recommend lung cancer screening or that screening tests are effective; if they are faculty members, MD or PhD, with > 20 years in practice, and would recommend screening for asymptomatic patients, males, > 50 years old, with substantial smoking and occupational exposure, COPD, with history of aero-digestive tumors and if their patients had asked them about screening.

CONCLUSIONS: Chest physicians in Egypt don’t frequently order lung cancer screening tests for asymptomatic patients, even though they are recommended by some expert groups.

CLINICAL IMPLICATIONS: Chest physicians and patients need more information about lung cancer screening’s evidence base, guidelines, potential benefits, and costs to avert inappropriate ordering or negligence of lung cancer screening.

DISCLOSURE: The following authors have nothing to disclose: Aliae Mohamed-Hussein, Mohamed-Eltaher Ibrahim

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