Lung cancer screening: what do long-term smokers know and believe?

Lisa Carter-Harris, DuyKhanh Pham Ceppa, Nasser Hanna, Susan M Rawl, Lisa Carter-Harris, DuyKhanh Pham Ceppa, Nasser Hanna, Susan M Rawl

Abstract

Objective: To explore knowledge and beliefs of long-term smokers about lung cancer, associated risk factors and lung cancer screening.

Design: Qualitative study theoretically framed by the expanded Health Belief Model based on four focus group discussions. Content analysis was performed to identify themes of knowledge and beliefs about lung cancer, associated risk factors and lung cancer screening among long-term smokers' who had and had not been screened for lung cancer.

Methods: Twenty-six long-term smokers were recruited; two groups (n = 9; n = 3) had recently been screened and two groups (n = 7; n = 7) had never been screened.

Results: While most agreed lung cancer is deadly, confusion or inaccurate information exists regarding the causes and associated risk factors. Knowledge related to lung cancer screening and how it is performed was low; awareness of long-term smoking's association with lung cancer risk remains suboptimal. Perceived benefits of screening identified include: (i) finding lung cancer early; (ii) giving peace of mind; and (iii) motivation to quit smoking. Perceived barriers to screening identified include: (i) inconvenience; (ii) distrust; and (iii) stigma.

Conclusions: Perceived barriers to lung cancer screening, such as distrust and stigma, must be addressed as lung cancer screening becomes more widely implemented. Heightened levels of health-care system distrust may impact successful implementation of screening programmes. Perceived smoking-related stigma may lead to low levels of patient engagement with medical care and decreased cancer screening participation. It is also important to determine modifiable targets for intervention to enhance the shared decision-making process between health-care providers and their high-risk patients.

Keywords: health behaviours; health beliefs; lung cancer screening; primary care providers; smokers.

Conflict of interest statement

Conflict of interests The authors have no conflicts of interests to disclose.

©2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

References

    1. American Cancer Society Cancer Facts & Figures 2015. Atlanta, GA, 2015.
    1. Surveillance, Epidemiology, and End Results (SEER) Program () Research Data: National Cancer Institute, DCCPS, Surveillance Research Program, Surveillance Systems Branch, 2011.
    1. Jonnalagadda S, Bergamo C, Lin JJ et al Beliefs and attitudes about lung cancer screening among smokers. Lung Cancer, 2012; 77: 526–531.
    1. Wender R, Fontham ET, Barrera E Jr, Colditz GA, Church TR, Ettinger DS, et al American cancer society lung cancer screening guidelines. Cancer, 2013; 63: 107–117.
    1. United States Preventive Services Task Force Lung Cancer Screening Guidelines, 2013. Available at: , Accessed April 2, 2015.
    1. Jacobson FL, Austin JH, Field JK et al Development of The American Association for Thoracic Surgery guidelines for low‐dose computed tomography scans to screen for lung cancer in North America: Recommendations of The American Association for Thoracic Surgery Task Force for Lung Cancer Screening and Surveillance. Journal of Thoracic and Cardiovascular Surgery, 2012; 144: 25–32.
    1. Aberle DR, Adams AM, Berg CD et al Reduced lung‐cancer mortality with low‐dose computed tomographic screening. New England Journal of Medicine, 2011; 365: 395–409.
    1. Decision Memo for Screening for Lung Cancer with Low‐Dose Computed Tomography (LDCT): Centers for Medicare & Medicaid Services. Baltimore, MD: Centers for Medicare and Medicaid Services, 2015. Accessed April 2, 2015.
    1. Klabunde CN, Marcus PM, Silvestri GA et al U.S. primary care physicians' lung cancer screening beliefs and recommendations. American Journal of Preventive Medicine, 2010; 39: 411–420.
    1. Klabunde CN, Marcus PM, Han PK et al Lung cancer screening practices of primary care physicians: results from a national survey. Annals of Family Medicine, 2012; 10: 102–110.
    1. Doria‐Rose VP, White MC, Klabunde CN et al Use of lung cancer screening tests in the United States: results from the 2010 National Health Interview Survey. Cancer Epidemiology, Biomarkers & Prevention, 2012; 21: 1049–1059.
    1. Patel D, Akporobaro A, Chinyanganya N et al Attitudes to participation in a lung cancer screening trial: a qualitative study. Thorax, 2012; 67: 418–425.
    1. Mitka M. Chest physicians recommend CT screening for lung cancer only for older smokers. JAMA, 2013; 309: 2314.
    1. Lung Cancer Alliance Screening Centers of Excellence, MD: Baltimore, 2015. Available at: . Accessed August 26, 2015.
    1. Menon U, Belue R, Sugg Skinner C, Rothwell BE, Champion V. Perceptions of colon cancer screening by stage of screening test adoption. Cancer Nursing, 2007; 30: 178–185.
    1. Champion VL, Skinner CS. Differences in perceptions of risk, benefits, and barriers by stage of mammography adoption. Journal of Women's Health, 2003; 12: 277–286.
    1. Rawl S, Champion V, Menon U et al Differences on health beliefs by stage of readiness to screen for colorectal cancer among first‐degree relatives of affected individuals. Annals of Behavioral Medicine, 2001; 23: S202.
    1. Wang HL, Christy SM, Skinner CS et al Predictors of stage of adoption for colorectal cancer screening among African American primary care patients. Cancer Nursing, 2014; 37: 241–251.
    1. Menon U, Champion V, Monahan PO, Daggy J, Hui S, Skinner CS. Health belief model variables as predictors of progression in stage of mammography adoption. American Journal of Health Promotion, 2007; 21: 255–261.
    1. Bandura A. Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice‐Hall, 1986.
    1. Bandura A. Self‐efficacy: toward a unifying theory of behavior change. Psychological Review, 1977; 84: 191–215.
    1. Krueger R. Focus Groups: A Practical Guide for Applied Research. Thousand Oaks, CA: Sage Publications, 1988.
    1. Sofaer S. Qualitative methods: what are they and why use them? Health Services Research, 1999; 34: 1101–1118.
    1. Neuendorf KA. The Content Analysis Guidebook. Thousand Oaks, CA: Sage Publications, 2002.
    1. Patton M. Qualitative Research and Evaluation Methods. Thousand Oaks, CA: Sage, 2002.
    1. Faller H, Schilling S, Lang H. Causal attribution and adaptation among lung cancer patients. Journal of Psychosomatic Research, 1995; 39: 619–627.
    1. Salander P. Attributions of lung cancer: my own illness is hardly caused by smoking. Psychooncology, 2007; 16: 587–592.
    1. Weinstein NDMS, Moser RP. Smokers' unrealistic optimism about their risk. Tobacco Control, 2005; 14: 55–59.
    1. Carter‐Harris L, Hermann CP, Schreiber J, Weaver MT, Rawl SM. Lung cancer stigma predicts timing of medical help‐seeking. Oncology Nursing Forum, 2014; 41: E203–E210.
    1. Else‐Quest NM, LoConte NK, Schiller JH, Hyde JS. Perceived stigma, self‐blame, and adjustment among lung, breast and prostate cancer patients. Psychology & Health, 2009; 24: 949–964.

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