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Chest. 2019 Jan;155(1):21-24. doi: 10.1016/j.chest.2018.10.013. Epub 2018 Oct 22.

Shared Decision-making and Lung Cancer Screening: Let's Get the Conversation Started.

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1
Health Equity and Rural Outreach Innovation Center (HEROIC), Ralph H. Johnson Veterans Affairs Hospital, Charleston, SC; Department of Medicine, Thoracic Oncology Research Group, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, SC. Electronic address: tripici@musc.edu.
2
Department of Medicine, Thoracic Oncology Research Group, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Medical University of South Carolina, Charleston, SC.

Abstract

Screening with low-dose CT scan has been shown to reduce mortality from lung cancer in those at risk based on age and smoking history. While lung cancer screening (LCS) is recommended by the United States Preventative Services Task Force and many professional societies, it has been recognized that the decision to be screened is complex due to a close balance of risk and benefit; therefore, shared decision-making is considered an essential component of effective LCS. The Centers for Medicare and Medicaid Services provides coverage for LCS following a mandated shared-decision making (SDM) visit. Here we review the concept of SDM, facilitators and barriers, evidence and knowledge gaps, and novel considerations for SDM within LCS.

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