Veteran Satisfaction With Lung Cancer Screening Care

OBJECTIVE: To assess differences in lung cancer screening care satisfaction among Veterans residing in rural and nonrural areas. METHODS: We identified Veterans screened for lung cancer from 2018-2021 at 10 Veterans Affairs Medical Centers and surveyed a sample using an adapted version of the Patient Satisfaction with Cancer Care (PSCC) scale. The primary analysis (t test) evaluated the association between rurality and care satisfaction in responder and population-weighted cohorts. Secondary analysis (linear regression) estimated the association of age, sex, race, ethnicity, smoking status, education attainment, and facility location with care satisfaction. The Fisher exact test evaluated the association of rurality and smoking status with individual PSCC item agreement. RESULTS: The response rate was 36.0% (n=689 complete surveys). The mean responder age was 68.3 years; 95.4% were male; 50.2% rural; 55.6% currently smoking. There was no significant difference in care satisfaction by rurality in the responder cohort [mean PSCC score 72.4 (SD=14.2), rural 72.4, non-rural 72.4, P=0.99] or population-weighted cohort [mean PSCC score 71.9 (SD=14.2), rural 72.1, non-rural 71.9, P=0.81]. "Currently smoking" status was negatively associated with care satisfaction [coefficient=-3.20 (-6.42,0.02)]. Individual PSCC items with the highest and lowest agreement were "I felt that I was treated with courtesy and respect" (93.6% agree); "I knew what the next step in my care would be" (65.2% agree). CONCLUSIONS: Veterans in rural and nonrural areas reported similar levels of satisfaction with lung cancer screening care. Veterans who currently smoke reported lower levels of satisfaction. Veterans identified limited understanding of lung cancer screening processes and poor communication as areas needing improvement.