Shawn Nishi, M.D.
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Required pre-screening visits for lung cancer not happening

Required pre-screening visits for lung cancer not happening

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GALVESTON, Texas – Research from The University of Texas Medical Branch at Galveston, using Medicare data from 2015-2016, determined that only 9 percent of persons who received a low-dose computerized tomography screening for lung cancer discussed the process with their medical provider prior to the screening – a requirement known as a shared decision making.

The research findings were recently published in JAMA Internal Medicine.

Shared decision-making sessions for lung cancer screening have been required by the Center for Medicare and Medicaid Services since 2015 for individuals aged 55 to 77 years with a 30 pack-year or greater smoking history. It is the only health screening exam which has this unique requirement.

“Lung cancer screening is a complex process. There is a lot of conversation that needs to happen between a patient and health care provider,” said Dr. Shawn Nishi, a professor in UTMB’s Department of Internal Medicine and one of the study’s authors. “This goes beyond merely explaining facts, risks and benefits.”

According to Nishi, it is completely possible that a patient will come in for a lung cancer screening but after participating in a SDM session with their provider determine that screening is not right for them.

“Health care providers should work to understand what is important to an individual and then create an opportunity to deliberate the options, in order to make informed decisions. It is also an opportunity to counsel and treat modifiable risk factors, such as tobacco use,” said Nishi.

According to Nishi, the shared decision making sessions are not happening and that is simply not a good thing.

“We need to engage patients in these conversations. It is a key component of patient-centered health care that ensures decisions are aligned with patient preferences and values. This study shows we just aren’t doing good enough”.

The Cancer Prevention and Research Institute of Texas and the National Institutes of Health supported the research.

Other authors include UTMB’s James Goodwin, Jie Zhou and Yong-Fang Kuo.

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