Old habits die hard: Chest radiography for screening purposes in primary care

Davide Mauri, Konstantinos Kamposioras, Anastasios Proiskos, Apostolos Xilomenos, Christina Peponi, Mario Dambrosio, Georgios Zacharias, Georgios Koukourakis, George Pentheroudakis, Nicholas Pavlidis

Research output: Contribution to journalArticlepeer-review


Objective: To assess whether the use of chest radiography for screening changes over time. Design: Systematic review. Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials, and handsearching of selected journals. Review Methods: We evaluated whether the proportion of primary care physicians using chest radiography to screen for (1) malignancy in the general asymptomatic population, (2) malignancy in a high-risk subgroup, (3) any disease in the general population, and (4) any disease in a high-risk subgroup changed over time, using random-effects meta-regression analysis. Adjustments for the availability of national guidelines were also performed. Results: Overall, 10% to 90% of primary care physicians reported using chest x-ray for screening. In unadjusted analyses, the proportion of physicians using chest radiography for cancer screening in the general population tended to increase by 0.9% per year (8 studies, n = 4313). The corresponding annual changes were -2.9% for cancer screening in high-risk subgroups (8 studies, n = 2784) and -0.4% regarding screening for any disease in the population (7 studies, n = 2627). No meta-regressions were run for outcome (4) (only 1 study). In the adjusted analyses, there was a decreasing nonsignificant trend for all outcomes. Conclusions: Despite formal recommendations, many physicians still use chest x-ray for screening, with their number decreasing slowly over time. This practice may be harmful because the positive predictive value of chest radiography is low, and further evaluation of false-positive findings might be associated with increased cost and risk from additional diagnostic or therapeutic interventions.

Original languageEnglish
Pages (from-to)650-656
Number of pages7
JournalAmerican Journal of Managed Care
Issue number11
Publication statusPublished - Oct 2006

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)
  • Health(social science)
  • Health Professions(all)


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