A qualitative analysis of smokers’ perceptions about lung cancer screening

Abstract

BackgroundIn 2013, the US Preventive Services Task Force (USPSTF) began recommending lung cancer screening for high risk smokers aged 55–80 years using low-dose computed tomography (CT) scan. In light of these updated recommendations, there is a need to understand smokers’ knowledge of and experiences with lung cancer screening in order to inform the design of patient education and tobacco cessation programs. The purpose of this study is to describe results of a qualitative study examining smokers’ perceptions around lung cancer screening tests.MethodsIn 2009, prior to the release of the updated USPSTF recommendations, we conducted 12 120-min, gender-specific focus groups with 105 current smokers in Charlotte, North Carolina and Cincinnati, Ohio. Focus group facilitators asked participants about their experience with three lung cancer screening tests, including CT scan, chest x-ray, and sputum cytology. Focus group transcripts were transcribed and qualitatively analyzed using constant comparative methods.ResultsParticipants were 41–67 years-old, with a mean smoking history of 38.9 pack-years. Overall, 34.3% would meet the USPSTF’s current eligibility criteria for screening. Most participants were unaware of all three lung cancer screening tests. The few participants who had been screened recalled limited information about the test. Nevertheless, many participants expressed a strong desire to pursue lung cancer screening. Using the social ecological model for health promotion, we identified potential barriers to lung cancer screening at the 1) health care system level (cost of procedure, confusion around results), 2) cultural level (fatalistic beliefs, distrust of medical system), and 3) individual level (lack of knowledge, denial of risk, concerns about the procedure). Although this study was conducted prior to the updated USPSTF recommendations, these findings provide a baseline for future studies examining smokers’ perceptions of lung cancer screening.ConclusionWe recommend clear and patient-friendly educational tools to improve patient understanding of screening risks and benefits and the use of best practices to help smokers quit. Further qualitative studies are needed to assess changes in smokers’ perceptions as lung cancer screening with CT scan becomes more widely used in community practice.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4496-0) contains supplementary material, which is available to authorized users.

Defining the information needs of lung cancer screening participants: a qualitative study

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Perceptions and Barriers to SNAP Utilization Among Asian and Pacific Islanders in Greater Los Angeles

“…After analysis of the data, themes and subthemes were organized under each level of the Social Ecological Model (SEM), a framework identified by Food and Nutrition Services for SNAP education and also used in other studies to address barriers to health. 23,24 The SEM addressed barriers that arose across themes and between the 4 communities collectively.…”

Progress in the Management of Early-Stage Non–Small Cell Lung Cancer in 2017

“…[29][30][31][32][33][34] With regard to patients, there are gaps in awareness of screening criteria and availability. 35 A pragmatic trial is currently underway to investigate the impact of patient navigation on screening adherence, patient-reported barriers, psychosocial concerns, and smoking cessation. 36 A European position statement on lung cancer screening was published in Lancet Oncology in 2017, and for European centers starting a screening program, specific recommendations related to surgical management were recently published by a task force of the European Society of Thoracic Surgeons.…”