Barta 2021


Year: 2021

Title: Racial Differences in Lung Cancer Screening Beliefs and Screening Adherence

Country: United States

Age: Adult Only

Sex: All Sexes

Population: Black

Care Setting: Outpatient Ambulatory and Primary Care

Clinical Setting: Lung Cancer Screening

Data Level: Single Institution

Data Type: Private Survey

Data Source: Local data

Conclusion: Disparities In All Minority Groups

Health OutComes Reported: No

Mitigation: No

Free Text Conclusion: Racial differences in beliefs about lung cancer and LCS exist: African- Americans had greater lung cancer worries and reported more frequently that screening convenience, risk of disease, and cost were very important in making the decision to undergo LCS.

Abstract: Area: Lung cancer screening is a multistep process requiring adherence with annual or short-interval follow-up scans Overall result: Race, education, insurance, and barriers to screening were significantly associated with lung cancer screening adherence. General significance: Efforts to improve adherence with lung cancer screening should focus on overcoming modifiable barriers to the screening process, with an emphasis on vulnerable populations. Background: One challenge in high-quality lung cancer screening (LCS) is maintaining adherence with annual and short-interval follow-up screens among high-risk individuals who have undergone baseline low-dose CT (LDCT). This study aimed to characterize attitudes and beliefs toward lung cancer and LCS and to identify factors associated with LCS adherence. Methods: We administered a questionnaire to 269 LCS participants to assess attitudes and beliefs toward lung cancer and LCS. Clinical data including sociodemographics and screening adherence were obtained from the LCS Program Registry. Results: African- American individuals had significantly greater lung cancer worries compared with Whites (6.10 vs. 4.66, P<.001). In making the decision to undergo LCS, African- American participants described screening convenience and cost as very important factors significantly more frequently than Whites (60% vs. 26.8%, P<.001 and 58.4% vs. 37.8%, P=.001; respectively). African-American individuals with greater than high school education had significantly higher odds of LCS adherence (aOR 2.55; 95% CI, 1.14- 5.60) than Whites with less than high school education. Participants who described screening convenience and cost as "very important" had significantly lower odds of completing screening follow-up after adjusting for demographic and other factors (aOR 0.56; 95% CI, 0.33-0.97 and a OR 0.54; 95% CI, 0.33-0.91, respectively). Conclusion: Racial differences in beliefs about lung cancer and LCS exist among African-American and White individuals enrolled in an LCS program. Cost, convenience, and low educational attainment may be barriers to LCS adherence, specifically among African-American individuals. Impact: More research is needed on how barriers can be overcome to improve LCS adherence.