Qualitative findings from a survey on patient experiences and satisfaction with lung cancer screening

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.