Perspectives of family physicians towards access to lung cancer screening for individuals living with low income – a qualitative study

Individuals living with low income are less likely to participate in lung cancer screening (LCS) with low-dose computed tomography. In Canada, family physicians (FPs) are typically responsible for referring eligible patients to LCS. This study conducted semi-structured interviews with FPs to explore their  perspectives on access to lung cancer screening for individuals living with low income in order to improve equity in access to LCS. They found four main themes: (1) social disadvantage, where social disadvantage is related to increased health risks; (2) clinical encounter, where there is often a mismatch between the complex health needs of low income individuals and structure of health care appointments; (3) equity-oriented health care, where there is a lack of consideration for why someone may engage in health-risking behaviour; (4) improving health outcomes, including improving access to health care and their social wellbeing. These results suggest that a team-based approach to clinical care that addresses the social determinants of health and facilitates overall health and wellbeing can form the basis of an equity-informed way to enhance access to LCS. 

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