Knowledge and Attitudes Towards Low Dose Computed Tomography Lung Cancer Screening and Smoking Among African Americans-a Mixed Method Study

Overview

Journal Transl Cancer Res

Specialty Oncology

Date 2022 Feb 4

PMID 35117119

Authors

Tung-Sung Tseng

Tyra Gross

Michael D Celestin

Wendy Dang

Lucretia Young

Yu-Hsiang Kao

Mirandy Li

David L Smith

Leonard R Bok

Jyotsna Fuloria

Sarah Moody-Thomas

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study is to investigate knowledge, attitudes, and smoking cessation needs for African Americans who receive low dose computed tomography (LDCT) in an effort to reduce the health burden of lung cancer.

Methods: A mixed method study was conducted among African Americans who received LDCT. Data were gathered using a self-administered questionnaire and structured in-depth interview. Descriptive statistics were used to provide summary information on knowledge, attitude and smoking behaviors. Thematic analysis was used to analyze interview data. The sample size for both the quantitative and qualitative approach was fifteen.

Results: The results showed that 73% of participants were male, the mean age was 61.8 (SD =4.6) years old, and 66.7% of participants had an income less than $20,000. Eighty percent had an education level of high school or below and 73.3% were overweight or obese. Smoking history was long (mean years =39 SD =14.9), but the number of cigarettes smoked per day was low (mean =9.2 SD =7.3), and 64% of the patients had a low nicotine dependence. Assessment of knowledge and attitudes towards LDCT revealed that participants had a moderate/lower knowledge score (mean =4.3 SD =2.6), and most had a positive attitude. All participants planned to quit smoking, with 73% planning to quit within the next 6 months. Similar findings were also observed in the qualitative analysis.

Conclusions: African Americans who receive LDCT lung cancer screening in this study have a moderate/lower knowledge score and positive attitude towards LDCT. Most were not heavy smokers and had a lower nicotine dependence. Understanding the factors associated with smoking cessation among at-risk African American smokers will help reduce disparities in lung cancer burden, and is important to improve health for medically underserved minority populations.

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References

Wiener R, Koppelman E, Bolton R, Lasser K, Borrelli B, Au D . Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study. J Gen Intern Med. 2018; 33(7):1035-1042. PMC: 6025674. DOI: 10.1007/s11606-018-4350-9. View

Roberts H, Walker-Dilks C, Sivjee K, Ung Y, Yasufuku K, Hey A . Screening high-risk populations for lung cancer: guideline recommendations. J Thorac Oncol. 2014; 8(10):1232-7. DOI: 10.1097/JTO.0b013e31829fd3d5. View

Patel D, Akporobaro A, Chinyanganya N, Hackshaw A, Seale C, Spiro S . Attitudes to participation in a lung cancer screening trial: a qualitative study. Thorax. 2011; 67(5):418-25. DOI: 10.1136/thoraxjnl-2011-200055. View

Silvestri G, Nietert P, Zoller J, Carter C, Bradford D . Attitudes towards screening for lung cancer among smokers and their non-smoking counterparts. Thorax. 2006; 62(2):126-30. PMC: 2111262. DOI: 10.1136/thx.2005.056036. View

de Koning H, Meza R, Plevritis S, Ten Haaf K, Munshi V, Jeon J . Benefits and harms of computed tomography lung cancer screening strategies: a comparative modeling study for the U.S. Preventive Services Task Force. Ann Intern Med. 2014; 160(5):311-20. PMC: 4116741. DOI: 10.7326/M13-2316. View

Borland R, Yong H, OConnor R, Hyland A, Thompson M . The reliability and predictive validity of the Heaviness of Smoking Index and its two components: findings from the International Tobacco Control Four Country study. Nicotine Tob Res. 2010; 12 Suppl:S45-50. PMC: 3307335. DOI: 10.1093/ntr/ntq038. View

Li J, Shi L, Liang H, Ding G, Xu L . Urban-rural disparities in health care utilization among Chinese adults from 1993 to 2011. BMC Health Serv Res. 2018; 18(1):102. PMC: 5807772. DOI: 10.1186/s12913-018-2905-4. View

Detterbeck F, Mazzone P, Naidich D, Bach P . Screening for lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013; 143(5 Suppl):e78S-e92S. PMC: 3749713. DOI: 10.1378/chest.12-2350. View

Jaklitsch M, Jacobson F, Austin J, Field J, Jett J, Keshavjee S . The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg. 2012; 144(1):33-8. DOI: 10.1016/j.jtcvs.2012.05.060. View

10.

Kanodra N, Pope C, Halbert C, Silvestri G, Rice L, Tanner N . Primary Care Provider and Patient Perspectives on Lung Cancer Screening. A Qualitative Study. Ann Am Thorac Soc. 2016; 13(11):1977-1982. DOI: 10.1513/AnnalsATS.201604-286OC. View

11.

Lewis J, Petty W, Tooze J, Miller D, Chiles C, Miller A . Low-Dose CT Lung Cancer Screening Practices and Attitudes among Primary Care Providers at an Academic Medical Center. Cancer Epidemiol Biomarkers Prev. 2015; 24(4):664-70. PMC: 4383689. DOI: 10.1158/1055-9965.EPI-14-1241. View

12.

Smith R, Manassaram-Baptiste D, Brooks D, Cokkinides V, Doroshenk M, Saslow D . Cancer screening in the United States, 2014: a review of current American Cancer Society guidelines and current issues in cancer screening. CA Cancer J Clin. 2014; 64(1):30-51. DOI: 10.3322/caac.21212. View

13.

May F, Almario C, Ponce N, Spiegel B . Racial minorities are more likely than whites to report lack of provider recommendation for colon cancer screening. Am J Gastroenterol. 2015; 110(10):1388-94. DOI: 10.1038/ajg.2015.138. View

14.

McBride C, Emmons K, Lipkus I . Understanding the potential of teachable moments: the case of smoking cessation. Health Educ Res. 2003; 18(2):156-70. DOI: 10.1093/her/18.2.156. View

15.

Li C, Matthews A, Rywant M, Hallgren E, Shah R . Racial disparities in eligibility for low-dose computed tomography lung cancer screening among older adults with a history of smoking. Cancer Causes Control. 2018; 30(3):235-240. DOI: 10.1007/s10552-018-1092-2. View

16.

Sin M . Lung cancer disparities and African-Americans. Public Health Nurs. 2017; 34(4):359-362. DOI: 10.1111/phn.12335. View

17.

Finney Rutten L, Blake K, Hesse B, Augustson E, Evans S . Illness representations of lung cancer, lung cancer worry, and perceptions of risk by smoking status. J Cancer Educ. 2011; 26(4):747-53. PMC: 4251766. DOI: 10.1007/s13187-011-0247-6. View

18.

Ryan B . Differential eligibility of African American and European American lung cancer cases using LDCT screening guidelines. BMJ Open Respir Res. 2016; 3(1):e000166. PMC: 5133421. DOI: 10.1136/bmjresp-2016-000166. View

19.

Duong D, Shariff-Marco S, Cheng I, Naemi H, Moy L, Haile R . Patient and primary care provider attitudes and adherence towards lung cancer screening at an academic medical center. Prev Med Rep. 2017; 6:17-22. PMC: 5304233. DOI: 10.1016/j.pmedr.2017.01.012. View

20.

Raz D, Wu G, Nelson R, Sun V, Wu S, Alem A . Perceptions and Utilization of Lung Cancer Screening Among Smokers Enrolled in a Tobacco Cessation Program. Clin Lung Cancer. 2018; 20(1):e115-e122. PMC: 8817898. DOI: 10.1016/j.cllc.2018.09.013. View