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The Use of CT for Screening: A National Survey of Radiologists' Activities and Attitudes¹

¹ From the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md (I.M.B., N.E.K.); Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Md (N.E.K.); American College of Radiology, Fairfax, Va (J.H.S.); and Department of Radiology, Johns Hopkins Hospital, Baltimore, Md (S.S.S.). From the 2006 RSNA Annual Meeting. Received August 1, 2007; revision requested October 2; revision received October 28; final version accepted December 15. I.M.B. supported by a National Research Service Award from the Agency for Healthcare Research and Quality. Address correspondence to I.M.B., 1233 York Ave, Apt 13-M, New York, NY 10021 (e-mail: ingrid.burger{at}gmail.com).

Purpose: To investigate the activities, motivations, and attitudes of radiologists regarding specific computed tomographic (CT) screening examinations by using a survey.

Materials and Methods: All study activities were approved by the institutional review board. A self-administered, mailed survey was used to collect data on the practices and attitudes of U.S. radiologists regarding three CT screening tests—coronary artery calcium scoring (CACS), lung cancer screening CT, and whole-body screening CT. The survey was sent to 1000 diagnostic radiologists who were randomly sampled from the American Medical Association Physician Masterfile.

Results: A total of 398 (41.4%) of 961 eligible radiologists completed the survey. Among respondents, 33.6% reported reading CT screening studies, the most common being CACS (26.7%), followed by lung screening (19.2%) and whole-body screening (9.5%). Among respondents, 34.1% supported CACS and 29.9% supported lung CT screening for particular patients, while 1.9% supported whole-body CT screening. The most common reasons reported for reading CT screening studies were responses to requests from physicians (83.3%) or patients (75.0%), while fewer (40.8%) cited patient benefit from screening as a reason.

Conclusion: A substantial proportion of a nationally representative sample of radiologists in the United States reads CT screening studies of the heart, lungs, and whole body and holds favorable attitudes toward CACS and lung CT screening. These attitudes may allow for the premature diffusion of new screening tests into practice before higher-level evidence demonstrates their benefits for population mortality.

© RSNA, 2008

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