The underutilization of EUS-guided FNA in the lymph-node staging of non-small-cell lung cancer: perceptions of chest physicians in Wisconsin

Gastrointest Endosc. 2005 Oct;62(4):517-20. doi: 10.1016/j.gie.2005.04.054.

Abstract

Background: Recently, the American College of Chest Physicians (ACCP) published evidence-based guidelines for the invasive staging of non-small-cell lung cancer (NSCLC), which shows the potential value of transesophageal sampling by EUS-guided FNA (EUS-FNA). The objective of the study was to determine the perceptions and the clinical practice of chest physicians regarding EUS-FNA as a staging modality for NSCLC.

Methods: We mailed a questionnaire to all members of the ACCP in Wisconsin.

Results: Seventy-one of 173 members (41%) responded. Chest physicians were more likely to perceive positron emission tomography, transbronchial needle aspiration, transthoracic needle aspiration, and mediastinoscopy to be able to make a difference in managing patients with NSCLC instead of EUS-FNA (p=0.01). Of the 40 chest physicians who believed that EUS-FNA can change the management of NSCLC, only 8 (20%) have sent a patient for EUS-FNA in the past year. Our findings may not necessarily reflect the opinions of chest physicians in other areas of the United States.

Conclusions: Many of the chest physicians surveyed do not believe EUS-FNA impacts the management of NSCLC. This limited awareness may represent a barrier to successful utilization of EUS-FNA in lung-cancer staging.

Publication types

  • Comparative Study

MeSH terms

  • Biopsy, Fine-Needle / methods
  • Biopsy, Fine-Needle / statistics & numerical data
  • Carcinoma, Non-Small-Cell Lung / diagnostic imaging
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Carcinoma, Non-Small-Cell Lung / secondary
  • Endosonography / statistics & numerical data*
  • Humans
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / pathology*
  • Lymphatic Metastasis
  • Neoplasm Staging / methods
  • Practice Patterns, Physicians'*
  • Retrospective Studies
  • Surveys and Questionnaires
  • Wisconsin