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Consumer Research Looks at Patient Perspectives of Spiral CT for Lung Cancer

Laura Newman

Hoping to facilitate enrollment in a randomized trial of spiral CT, the National Cancer Institute conducted qualitative consumer research about what two high-risk groups (heavy smokers and recent quitters) think about spiral CT for early detection of lung cancer and how it should be evaluated.

A series of focus groups found that "high-risk individuals felt that evaluation of the technology was critical and the best way to ensure that insurance companies would be willing to pay for spiral CT," said Christine D. Berg, M.D., chief of the NCI Lung and Upper Aerodigestive Cancer Research Group.

If insurers would not pay for the spiral CT, most smokers and about half of the ex-smokers said that they would rather enter the clinical trial than pay for it out of pocket. Some people expressed "an incredible amount of pessimism" about the test— fearing it would open the door to illness when they felt fine, and worrying about the cascade of possible follow-up tests, and getting a death sentence.

Berg says that she was also impressed by the individuals’ altruism in considering participating in a randomized trial. Many said that they hoped participating would help others, such as their children and grandchildren.

Most focus group participants accepted all alternative control arms that were proposed, such as routine care or chest x-ray. The suggested study length of 3 to 5 years, or as much as 10 years, did not discourage most focus group participants, and despite learning of the risks of possible follow-up procedures, most said that they would stay in the trial until it ended.

Berg says that NCI is actively discussing a definitive randomized trial with a lung cancer mortality endpoint.

To receive a copy of the full focus group report by e-mail, contact Ellen Eisner at eisnere{at}mail.nih.gov.



             
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