Patient Motivations for Non-Adherence to Lung Cancer Screening in a Military Population
Kenneth P. Seastedt.
Walter Reed National Military Medical Center, Bethesda, MD, USA.
OBJECTIVE: Lung cancer remains the leading cause of cancer deaths in the United States, and lung cancer screening has been shown to decrease this mortality rate. Adherence to lung cancer screening is paramount to realize the mortality benefit, and reported adherence rates vary widely. Few reports address causes of non-adherence to lung cancer screening, and our study sought to understand the behavior of non-compliant patients in our unique military population's screening program.
METHODS: Institutional Review Board approved retrospective review of patients enrolled in our lung cancer screening program from 2013 - 2019 identified patients who failed to obtain a subsequent screening CT scan within 15 months of their prior scan. Attempts were made to contact these patients and elucidate motivations for non-adherence via telephone interviews.
RESULTS: Of the 242 patients enrolled in our program, 168 (69.4%) are male, 140 (57.8%) Caucasian, 67 years old on average, and 3 (1.2%) lung cancers identified. 59 patients (24.3%) were non-adherent. 31 (52.5%) were contacted, and the most common reason for non-adherence was lack of contact to schedule a follow-up CT scan (40.7%). Of those contacted, 20 (64.5%) desired to be re-enrolled, either through our program or a local civilian program. The expressed preferred method of future contact was phone (45.2%) followed by email (41.9%).
CONCLUSIONS: Our study demonstrates that ensuring frequent follow-up contact with patients via multiple avenues of communication can improve overall adherence rates to lung cancer screening. By contacting patients who have become non-adherent, high rates of re-enrollment are achievable.
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