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Published in: BMC Public Health 1/2006

Open Access 01-12-2006 | Research article

Screening chest radiography: results from a Greek cross-sectional survey

Authors: Konstantinos Kamposioras, Giovanni Casazza, Davide Mauri, Velisarios Lakiotis, Ivan Cortinovis, Apostolos Xilomenos, Christina Peponi, Vassilis Golfinopoulos, Athanasios Milousis, Dimitrios Kakaridis, Georgios Zacharias, Ioanna Karathanasi, Georgios Ferentinos, Anastasios Proiskos

Published in: BMC Public Health | Issue 1/2006

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Abstract

Background

Public health authorities worldwide discourage the use of chest radiography as a screening modality, as the diagnostic performance of chest radiography does not justify its application for screening and may even be harmful, since people with false positive results may experience anxiety and concern. Despite the accumulated evidence, various reports suggest that primary care physicians throughout the world still prescribe chest radiography for screening. We therefore set out to index the use of chest radiography for screening purposes among the healthy adult population and to analyze its relationship with possible trigger factors.

Methods

The study was designed as a cross-sectional survey. Five thousand four hundred and ninety-nine healthy adults, coming from 26 Greek provinces were surveyed for screening practice habits in the nationwide anticancer study. Data were obtained for the use of screening chest radiography. Impact of age, gender, tobacco exposure, family history positive for malignancies and professional-risk for lung diseases was further analyzed.

Results

we found that 20% (n = 1099) of the surveyed individuals underwent chest radiography for screening purposes for at least one time during the previous three years. Among those, 24% do so with a frequency equal or higher than once yearly, and 48% with a frequency equal or higher than every three years. Screening for chest radiography was more commonly adopted among males (OR 1.130, 95% CI 0.988–1.292), pensioners (OR 1.319, CI 1.093–1.593) and individuals with a positive family history for lung cancer (OR 1.251, CI 0.988–1.583). Multivariate analysis confirmed these results.

Conclusion

Despite formal recommendations, chest radiography for screening purposes was a common practice among the analyzed sample of Greek adults. This practice is of questionable value since the positive predictive value of chest radiography is low. The implementation of even a relatively inexpensive imaging study on a national scale would greatly burden health economics and the workload of radiology departments.
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Literature
1.
go back to reference Boyle P, Autier P, Bartelink H, Baselga J, Boffeta P, Burn J, Burns HJ, Christensen L, Denis L, Dicato M, Diehl V, Doll R, Franceschi S, Gillis CR, Gray N, Griciute L, Hackshaw A, Kasler M, Kogevinas M, Kvinnsland S, La Vecchia C, Levi F, McVie JG, Maisonneuve P, Martin-Moreno JM, Bishop JN, Oleari F, Perrin P, Quinn M, Richards M, Ringborg U, Scully C, Siracka E, Storm H, Tubiana M, Tursz T, Veronesi U, Wald N, Weber W, Zaridze DG, Zatonski W, zur Hausen H: European Code Against Cancer and scientific justification: third version. Ann Oncol. 2003, 14: 973-1005. 10.1093/annonc/mdg305.CrossRefPubMed Boyle P, Autier P, Bartelink H, Baselga J, Boffeta P, Burn J, Burns HJ, Christensen L, Denis L, Dicato M, Diehl V, Doll R, Franceschi S, Gillis CR, Gray N, Griciute L, Hackshaw A, Kasler M, Kogevinas M, Kvinnsland S, La Vecchia C, Levi F, McVie JG, Maisonneuve P, Martin-Moreno JM, Bishop JN, Oleari F, Perrin P, Quinn M, Richards M, Ringborg U, Scully C, Siracka E, Storm H, Tubiana M, Tursz T, Veronesi U, Wald N, Weber W, Zaridze DG, Zatonski W, zur Hausen H: European Code Against Cancer and scientific justification: third version. Ann Oncol. 2003, 14: 973-1005. 10.1093/annonc/mdg305.CrossRefPubMed
2.
go back to reference US Preventive Services Task Force Lung Cancer Screening: Recommendation Statement. Annals Inter Med. 2004, 140: 138-139. US Preventive Services Task Force Lung Cancer Screening: Recommendation Statement. Annals Inter Med. 2004, 140: 138-139.
4.
go back to reference Smith RA, Mettlin CJ, Davis KJ, Eyre H: American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2005, 50: 34-49.CrossRef Smith RA, Mettlin CJ, Davis KJ, Eyre H: American Cancer Society guidelines for the early detection of cancer. CA Cancer J Clin. 2005, 50: 34-49.CrossRef
6.
go back to reference Humphrey LL, Teutsch S, Johnson M, U.S. Preventive Services Task Force: Lung cancer screening with sputum cytologic examination, chest radiography, and computed tomography: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2004, 140: 740-753.CrossRefPubMed Humphrey LL, Teutsch S, Johnson M, U.S. Preventive Services Task Force: Lung cancer screening with sputum cytologic examination, chest radiography, and computed tomography: an update for the U.S. Preventive Services Task Force. Ann Intern Med. 2004, 140: 740-753.CrossRefPubMed
7.
go back to reference Manser RL, Irving LB, Stone C, Byrnes G, Abramson M, Campbell D: Screening for lung cancer. Cochrane Database Syst Rev. 2004, 1: Art No CD001991- Manser RL, Irving LB, Stone C, Byrnes G, Abramson M, Campbell D: Screening for lung cancer. Cochrane Database Syst Rev. 2004, 1: Art No CD001991-
8.
go back to reference Sladden MJ, Ward Do: Australian family physicians screen smokers for lung cancer?. Chest. 2004, 115: 725-728. 10.1378/chest.115.3.725.CrossRef Sladden MJ, Ward Do: Australian family physicians screen smokers for lung cancer?. Chest. 2004, 115: 725-728. 10.1378/chest.115.3.725.CrossRef
9.
go back to reference Ashford A, Gemson D, Sheinfeld Gorin SN, Bloch S, Lantigua R, Ahsan H, Neugut AI: Cancer screening and prevention practices of inner-city physicians. Am J Prev Med. 2000, 19: 59-62. 10.1016/S0749-3797(00)00152-5.CrossRefPubMed Ashford A, Gemson D, Sheinfeld Gorin SN, Bloch S, Lantigua R, Ahsan H, Neugut AI: Cancer screening and prevention practices of inner-city physicians. Am J Prev Med. 2000, 19: 59-62. 10.1016/S0749-3797(00)00152-5.CrossRefPubMed
10.
go back to reference Smith HE, Herbert CP: Preventive practice among primary care physicians in British Columbia: relation to recommendations of the Canadian Task Force on the Periodic Health Examination. CMAJ. 2003, 149: 1795-1800. Smith HE, Herbert CP: Preventive practice among primary care physicians in British Columbia: relation to recommendations of the Canadian Task Force on the Periodic Health Examination. CMAJ. 2003, 149: 1795-1800.
11.
go back to reference Beaulieu MD, Rivard M, Hudon E, Beaudoin C, Saucier D, Remondin M: Comparative trial of a short workshop designed to enhance appropriate use of screening tests by family physicians. CMAJ. 2002, 167: 1241-1246.PubMedPubMedCentral Beaulieu MD, Rivard M, Hudon E, Beaudoin C, Saucier D, Remondin M: Comparative trial of a short workshop designed to enhance appropriate use of screening tests by family physicians. CMAJ. 2002, 167: 1241-1246.PubMedPubMedCentral
12.
go back to reference Nakar S, Vinker S, Neuman S, Kitai E, Yaphe J: Baseline tests or screening: what tests do family physicians order routinely on their healthy patients?. J Med Screen. 2002, 9: 133-134. 10.1136/jms.9.3.133.CrossRefPubMed Nakar S, Vinker S, Neuman S, Kitai E, Yaphe J: Baseline tests or screening: what tests do family physicians order routinely on their healthy patients?. J Med Screen. 2002, 9: 133-134. 10.1136/jms.9.3.133.CrossRefPubMed
13.
go back to reference Lynch GR, Prout MN: Screening for cancer by residents in an internal medicine program. J Med Educ. 1986, 61: 387-393.PubMed Lynch GR, Prout MN: Screening for cancer by residents in an internal medicine program. J Med Educ. 1986, 61: 387-393.PubMed
14.
go back to reference ACS 1989 survey of physicians' attitudesand practices in early cancer detection. CA Cancer J Clin. 1990, 40: 77-101. ACS 1989 survey of physicians' attitudesand practices in early cancer detection. CA Cancer J Clin. 1990, 40: 77-101.
15.
go back to reference Proiskos A, Loukidou E, Kamposioras K, Bristianou M, Zina V, Pliadi O, Karakatsanis A, Alexiou G, Gkougkoutsi A, Mauri D: Screening chest radiography in primary care: an underestimate belief. Eur J Gen Pract. 2005, 11: 76-77.CrossRefPubMed Proiskos A, Loukidou E, Kamposioras K, Bristianou M, Zina V, Pliadi O, Karakatsanis A, Alexiou G, Gkougkoutsi A, Mauri D: Screening chest radiography in primary care: an underestimate belief. Eur J Gen Pract. 2005, 11: 76-77.CrossRefPubMed
16.
go back to reference Montano DE, Phillips WR: Cancer screening by primary care physicians: a comparison of rates obtained from physician self-report, patient survey, and chart audit. Am J Public Health. 2005, 85: 795-800.CrossRef Montano DE, Phillips WR: Cancer screening by primary care physicians: a comparison of rates obtained from physician self-report, patient survey, and chart audit. Am J Public Health. 2005, 85: 795-800.CrossRef
17.
go back to reference Woodward CA, Hutchison BG, Abelson J, Norman G: Do female primary care physicians practise preventive care differently from their male colleagues?. Can Fam Physician. 1996, 42: 2370-2379.PubMedPubMedCentral Woodward CA, Hutchison BG, Abelson J, Norman G: Do female primary care physicians practise preventive care differently from their male colleagues?. Can Fam Physician. 1996, 42: 2370-2379.PubMedPubMedCentral
18.
go back to reference Hutchison B, Woodward CA, Norman GR, Abelson J, Brown JA: Provision of preventive care to unannounced standardized patients. CMAJ. 1998, 158: 185-193.PubMedPubMedCentral Hutchison B, Woodward CA, Norman GR, Abelson J, Brown JA: Provision of preventive care to unannounced standardized patients. CMAJ. 1998, 158: 185-193.PubMedPubMedCentral
19.
go back to reference Mauri D, Pazarlis P, Mauri J, Altinoz H, Rivas Flores FJ, Karentzou I, Proiskos A, Lakiotis V, Maragkaki A, Terzoudi E, Dambrosio EM, Spiliopoulou A, Varsami A, Alexandropoulou P, Tolis C, Pavlidis N, Vittoraki A: Sesy Europe: a multi-language database dedicated to cancer screening monitoring. J Exp Clin Cancer Res. 2004, 23: 207-211. Mauri D, Pazarlis P, Mauri J, Altinoz H, Rivas Flores FJ, Karentzou I, Proiskos A, Lakiotis V, Maragkaki A, Terzoudi E, Dambrosio EM, Spiliopoulou A, Varsami A, Alexandropoulou P, Tolis C, Pavlidis N, Vittoraki A: Sesy Europe: a multi-language database dedicated to cancer screening monitoring. J Exp Clin Cancer Res. 2004, 23: 207-211.
20.
go back to reference Mauri J, Mauri D, Pazarlis P, Altinoz H, Rivas Flores FJ, Karentzou I, Priskos A, Lakiotis V, Alevizaki P, Terzoudi E, Dambrosio M, Spiliopoulou A, Alexandropoulou P, Kalogerakis D, Varsami A: PC 3 component database for community-based medical trials. A cost-effective solution for both voluntary associations and institutions of the Emerging World. Gazz Med Ital – Arch Sci Med. 2004, 163: 189-194. Mauri J, Mauri D, Pazarlis P, Altinoz H, Rivas Flores FJ, Karentzou I, Priskos A, Lakiotis V, Alevizaki P, Terzoudi E, Dambrosio M, Spiliopoulou A, Alexandropoulou P, Kalogerakis D, Varsami A: PC 3 component database for community-based medical trials. A cost-effective solution for both voluntary associations and institutions of the Emerging World. Gazz Med Ital – Arch Sci Med. 2004, 163: 189-194.
23.
go back to reference Diederich S, Lenzen H: Radiation exposure associated with imaging of the chest: comparison of different radiographic and computed tomography techniques. Cancer. 2000, 89 (Suppl 11): 2457-2460. 10.1002/1097-0142(20001201)89:11+<2457::AID-CNCR22>3.0.CO;2-7.CrossRefPubMed Diederich S, Lenzen H: Radiation exposure associated with imaging of the chest: comparison of different radiographic and computed tomography techniques. Cancer. 2000, 89 (Suppl 11): 2457-2460. 10.1002/1097-0142(20001201)89:11+<2457::AID-CNCR22>3.0.CO;2-7.CrossRefPubMed
24.
go back to reference Kubik A, Polak J: Lung cancer detection. Results of arandomized prospective study in Czechoslovakia. Cancer. 1986, 57: 2427-2437. 10.1002/1097-0142(19860615)57:12<2427::AID-CNCR2820571230>3.0.CO;2-M.CrossRefPubMed Kubik A, Polak J: Lung cancer detection. Results of arandomized prospective study in Czechoslovakia. Cancer. 1986, 57: 2427-2437. 10.1002/1097-0142(19860615)57:12<2427::AID-CNCR2820571230>3.0.CO;2-M.CrossRefPubMed
25.
go back to reference Frost JK, Ball WC, Levin ML, Tockman MS, Baker RR, Carter D, Eggleston JC, Erozan YS, Gupta PK, Khouri NF: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am RevRespir Dis. 1984, 130: 549-54. Frost JK, Ball WC, Levin ML, Tockman MS, Baker RR, Carter D, Eggleston JC, Erozan YS, Gupta PK, Khouri NF: Early lung cancer detection: results of the initial (prevalence) radiologic and cytologic screening in the Johns Hopkins study. Am RevRespir Dis. 1984, 130: 549-54.
Metadata
Title
Screening chest radiography: results from a Greek cross-sectional survey
Authors
Konstantinos Kamposioras
Giovanni Casazza
Davide Mauri
Velisarios Lakiotis
Ivan Cortinovis
Apostolos Xilomenos
Christina Peponi
Vassilis Golfinopoulos
Athanasios Milousis
Dimitrios Kakaridis
Georgios Zacharias
Ioanna Karathanasi
Georgios Ferentinos
Anastasios Proiskos
Publication date
01-12-2006
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2006
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-6-113

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