Heavy smokers' barriers to lung cancer screening: Results of a focus group study
Lung cancer is the leading cause of cancer-related death in the United States. In 2009, when this study was conducted, no professional organization recommended screening for lung cancer using low dose computerized tomography (LDCT) or chest X-ray. In 2011, results of the National Lung Screening Trial were published demonstrating a 20% reduction in mortality among a high risk group. The purpose of this analysis was to identify potential barriers to lung cancer screening among heavy smokers. In June 2009, a total of twelve two-hour focus groups were conducted with 105 current, heavy smokers (51 women, 54 men) in Charlotte, NC and Cincinnati, OH. Heavy smoker was defined as smoking the equivalent of at least 1 pack of cigarettes per day for 20 years. A semi-structured guide was used by professional moderators to facilitate discussion about lung cancer screening tests. Verbatim transcripts were produced and coded using a structured codebook. Inductive methods were used to identify key themes. We identified five barriers in addition to lack of knowledge and denial of risk for lung cancer (previously reported): cost, concerns about the screening procedure (LDCT), fatalistic beliefs, ambiguity of screening results, and distrust of the medical system. If LDCT screening for lung cancer increases, barriers to screening must be understood. Public health will have a role in educating patients about the benefits and risks of screening and promoting smoking cessation as an important component of lung cancer screening efforts. Initiatives to improve patient understanding will be needed for those at high risk.
Chronic disease management and prevention
Describe five barriers to lung cancer screening among persons at high risk.
Discuss the role of public health in educating patients about lung cancer screening.
Keyword(s): Cancer Screening, Public Health Education
Presenting author's disclosure statement:
Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on evaluation and research cancer prevention and control efforts. Among my scientific interests has been studying social and behavorial aspects of lung cancer screening, colorectal cancer screening, and breast and cervical cancer screening.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.