Brief Original ReportFeasibility of a patient decision aid about lung cancer screening with low-dose computed tomography

- Screening with low-dose CT lowers lung cancer mortality in heavy smokers.
- Patients should be counseled about the benefits and harms of screening with CT.
- We field tested a video-based decision aid about lung cancer screening.
- Large gains in knowledge were observed; interest in screening increased.
- Decision aids prepare heavy smokers to make informed screening decisions.

ObjectiveNew clinical guidelines endorse the use of low-dose computed tomography (LDCT) for lung cancer screening among selected heavy smokers while recommending patients be counseled about the potential benefits and harms. We developed and field tested a brief, video-based patient decision aid about lung cancer screening.MethodsSmokers in a cancer center tobacco treatment program aged 45 to 75 years viewed the video online between November 2011 and September 2012. Acceptability, knowledge, and clarity of values related to the decision were assessed.ResultsFifty-two patients completed the study (mean age = 58.5 years; mean duration smoking = 34.8 years). Acceptability of the aid was high. Most patients (78.8%) indicated greater interest in screening after viewing the aid. Knowledge about lung cancer screening increased significantly as a result of viewing the aid (25.5% of questions answered correctly before the aid, and 74.8% after; P < .01) although understanding of screening eligibility remained poor. Patients reported being clear about which benefits and harms of screening mattered most to them (94.1% and 86.5%, respectively).ConclusionsPatients have high information needs related to lung cancer screening. A video-based decision aid may be helpful in promoting informed decision-making, but its impact on lung cancer screening decisions needs to be explored.