Low-dose CT lung cancer screening has been a controversial topic in recent years — some studies make the case for it and other against it.

A new study published in CHEST found that structured counseling prior to screening, and visits with health care professionals, can help patients better understand the benefits and risks of lung cancer screening.

It has the potential to be a lifesaving test for high-risk patients, but it also comes along with radiation exposure and incidental findings. According to the study, patients don't fully understand these potential harms or even the eligibility criteria for screening.
The United States Preventive Services Task Force recommends lung cancer screening for individuals over age 55 who have smoked for more than the equivalent of 30 pack-years.

Studies have shown that the benefits of lung cancer screening for this population outweigh the risks, but the industry recognizes that its success hinges on how it's implemented.

For the study, the researchers designed a program that involves a counseling and shared decision-making visit with a health care practitioner to determine if lung cancer screening is appropriate.

The visits were divided into different educational sessions that informed patients about eligibility requirements, the benefits and harms of lung cancer screening and the personalized benefit and harms for each of them.

The patients completed surveys before their visits, which revealed that they had a very modest understanding of eligibility criteria and the benefits and harms. They filled out another survey after the visits that showed they had a better grasp on these topics.

Notably, the patients had a better understanding of the benefits of lung cancer screening compared to the harms and eligibility criteria. The researchers believe that's because physicians are more comfortable discussing benefits rather than the complexities of potential harm.

CMS requires a counseling and shared decision-making visit before lung cancer screening, but the effectiveness of these sessions have previously been unknown.

"This is the first study to show that this visit can improve a patient's understanding of lung cancer screening, allowing them to make a decision about participation that fits their values," Dr. Peter J. Mazzone, director of the Lung Cancer Screening Program at Cleveland Clinic and lead investigator of the study, said in a statement.

Mazzone and his team recommend these visits before each annual screening since patients forget this information over time. He added it would also provide an opportunity to reconfirm eligibility, offer additional smoking cessation counseling and build a stronger patient-physician relationship.

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