High‐risk older smokers' perceptions, attitudes, and beliefs about lung cancer screening

Abstract

The US Preventive Services Task Force recommends that smokers aged 55–80 should be screened annually with low‐dose computed tomography (LDCT). This study identified demographics, smoking history, health risk perceptions, knowledge, and attitudes factors of older smokers (≥55 years) related to LDCT agreement. Using binary logistic regression, a predictive model of factors to explain LDCT agreement was produced. This is a cross‐sectional, national, online survey of 338 older smokers (≥55 years) with a ≥30 pack‐year smoking history. Over 82% of the sample believed that a person who continues to smoke after the age of 40 has at least a 25% chance of developing lung cancer and 77.3% would “agree to a LDCT today”. Using chi‐square analyses, six variables that were significant at the 0.10 level were selected for inclusion in model development. Four of the independent variables made a unique statistically significant contribution to the model: perceives accuracy of the LDCT as an important factor in the decision to have a LDCT scan; believes that early detection of LC will result in a good prognosis; believes that they are at high risk for lung cancer; and is not afraid of CT scans. Of note, only 10.9% believed that a negative CT scan result would mean that they could continue to smoke. Older smokers are aware of the risks of smoking, are interested in smoking cessation, and most are interested in and positive about LDCT. Cognitive aspects of participation in screening are key to increasing the uptake of lung cancer screening among high‐risk smokers.

“To know or not to know…?” Push and pull in ever smokers lung screening uptake decision‐making intentions

“…This aligns with others findings as did the reasons why some participants expressed a preference for screening (early diagnosis and potential reassurance) and some did not (lung cancer diagnosis fear and low levels of perceived personal benefit) . Other studies have also found that waiting for results and hospital attendance created anxiety and were participation barriers . However, there were differences with some of the literature.…”

“…Many participants in our study expressed keenness to be screened as this could result in finding lung cancer early and increase survival chances. This is more in line with Cataldo's findings and may relate to this study's more socioeconomically mixed sample or it is possible that as the researchers were NHS employed with study participation invitations arising from an NHS organization this may have reduced negative comments. This was mitigated through building rapport with participants, the topic guide and seeking alternative views; however, the researcher's influence cannot be discounted .…”

“…A further difference to the London study was in the anxiety expressed about screening tests, including the LDCT scan due to claustrophobia. Fear of having a CT scan was reported by Cataldo and fear of subsequent treatment by Carter‐Harris et al …”

“…Other studies have reported that current smokers more than ex‐smokers consider cancer a “death sentence” expect less benefit from early detection and have higher uptake barriers . Contrastingly, Cataldo reported that older smokers were receptive to lung screening and suggested that further understanding of smokers’ views was needed . Our understanding of the views of ever smokers about lung screening is currently limited in a UK nontrial context .…”

Age‐related common miRNA polymorphism associated with severe toxicity in lung cancer patients treated with platinum‐based chemotherapy

“…Lung cancer is the leading cause of death among cancer patients, that can be divided into non‐small‐cell lung cancer (NSCLC) and small‐cell lung cancer (SCLC). The occurrence of lung cancer is closely related to age and smoking . The standard chemotherapy regimens include platinum‐based chemotherapy (cisplatin, carboplatin) and other cytotoxic agents for lung cancer patients diagnosed at advance stage .…”