ABSTRACT
Background: In 2014, Moffitt Cancer Center (MCC) in Tampa, Florida launched a lung cancer screening program for high-risk individuals meeting USPSTF inclusion criteria. To reveal successes and potential limitations of this program, we conducted a survey to measure lung cancer screening patient experiences and satisfaction. Methods: In August 2020, a survey was mailed to 576 patients who completed one or more lung cancer screenings at MCC. The survey collected demographics and smoking history and measured patient satisfaction and experiences in 6 domains: the appointment process, clinical staff interactions, communication, visit with the provider, screening results and cost, and the clinic facility/overall satisfaction. There were also questions on the impact of the COVID-19 pandemic. A 5-point Likert scale was used to measure satisfaction with clinical staff and clinic facility/overall satisfaction (1= excellent to 5= poor) and other domains (1=strongly agree to 5=strongly disagree). Results were quantified using descriptive statistics. Results: Among the 160 patients that completed the survey, 96.3% were White, 93.1% were non-Hispanic, 46.9% were female, 78.1% were former smokers, and the mean age was 69 years. For the appointment process, 91.2% "strongly agreed/agreed" it was easy to make an appointment and 92.5% "strongly agreed/agreed" the clinic check-in process was efficient. Next, nearly 93% reported the courtesy of the clinical staff was "excellent/very good". For communication, while 90% "strongly agreed/agreed" that the lung cancer screening process was clearly explained, 63.2% "strongly agreed/agreed" that the potential harms and limitations were clearly explained and 71.2% "strongly agreed/agreed" that the process for follow-up screening was clearly explained. For the provider questions, 71.3% "strongly agreed/agreed" that the provider was willing to listen carefully and 66.3% "strongly agreed/agreed" that the instructions regarding follow-up were easy to understand. For results and costs, 79.4% "strongly agreed/agreed" the screening results were clearly explained and 70% "strongly agreed/agreed" that the cost of the screening was justified. Regarding overall satisfaction, 87.6% "strongly agreed/agreed" they would recommend lung cancer screening at MCC. Finally, 10.6% of patients were concerned about getting a lung cancer screening during the COVID-19 pandemic and only 8.1% reported that the COVID-19 pandemic prevented them from getting a lung cancer screening. Conclusion: Generally, for all 6 domains, patients reported favorable satisfaction and experience with lung cancer screening at MCC. However, higher rates of "neither agree/disagree" and "prefer not to answer" were observed for items related to communication and visit with the provider items suggesting improvements may be warranted, particularly related to future visits.
ABSTRACT
Background: In 2014, Moffitt Cancer Center initiated a lung cancer screening program for high-risk individuals who meet USPSTF inclusion criteria. As of January 2020, 576 patients have completed one or more lung cancer screenings. However, approximately 40% of lung cancer screening patients were noncompliant with their recommended follow-up. To understand reasons for lack of follow-up screening and to determine patient satisfaction and experiences, we conducted a survey with open-ended items to assess patient experiences and satisfaction among lung cancer screening patients. Methods: In this analysis, we report on findings from the qualitative portion of the survey. Six open-ended items elicited barriers related to returning for screening, experience with other cancer screenings, positive and negative experiences with the LDCT visit, as well as suggestions for improving the process of LDCT screening visits. Content analysis using the constant comparison method was applied to the text and coded based on the a priori codes of the open-ended questions. Results: As of November 2020, 190 people responded to the quantitative survey and 77 provided responses to one or more open-ended questions. Thirty-five respondents provided general positive comments about their lung cancer screening experience with typical responses of "positive" and "good experience". Twenty respondents mentioned that the staff was "caring", "knowledgeable", and "great staff". Ten respondents mentioned that they were "always treated well", "treated with respect", "high quality care". Negative comments were provided by 32 respondents in the areas of: "wanting more information on results" or "waiting too long for results" (N=7), "inefficient scheduling issues" (N=6), and billing issues (N=5). Additionally, six patients reported COVID-related issues impacted their lung cancer screening experience. Suggestion for improvements included: on-line appointments or text or email reminders (N = 10), lower costs (N=6), and uncertainty about remaining qualified for lung cancer screening due to age or current/prior medical conditions (N=5). Conclusion: Overall, findings provide insights about patient experiences and satisfaction for lung cancer screening. Suggestions for improvement centered on better scheduling systems and appointment reminders as well as the ability to speak to a clinician to better understand results and future eligibility. Ongoing patient-centered feedback may improve the lung cancer screening experience and increase follow-up screening rates.