Perspectives of African Americans on Lung Cancer: A Qualitative Analysis

Abstract

Background. Disparities in incidence and mortality for lung cancer in African Americans are well documented; however, the extent to which disparities reflect differences in patient perceptions of tobacco and lung cancer treatment is unclear. The objective of this study was to explore African Americans’ knowledge of lung cancer, perceived risk, interest in smoking cessation, attitudes toward lung cancer treatment, and lung cancer diagnosis and treatment experiences. Patients and Methods. The cohort comprised 32 African‐American current and former smokers without a cancer diagnosis who participated in focus groups and 10 African Americans with lung cancer who participated in in‐depth interviews. Transcripts were analyzed using a modified grounded theory approach. Results. Participants without a cancer diagnosis were aware of the link between smoking and lung cancer, the common symptoms of the disease, and its poor prognosis. They desired specific, personalized smoking‐cessation information. If diagnosed, the majority reported, they would seek medical care. Most believed that insurance and socioeconomic factors were more likely to affect treatment access than racial discrimination. Participants with a cancer diagnosis were also aware of the relationship between smoking and lung cancer. They felt their treatment plans were appropriate and trusted their physicians. Most did not believe that race affected their care. Conclusion. This qualitative study suggests that African‐American smokers are aware of the relationship between smoking and lung cancer and are interested in smoking‐cessation treatment. These data also indicate that lung cancer disparities are unlikely to be associated with differential willingness to receive care but that African Americans may perceive financial and insurance barriers to lung cancer treatment.

Metastases with definitive pathological diagnosis but no detectable primary tumor: A surveillance epidemiology and end results‐based study

“…The survival analysis indicated that among patients with type 2 CUP originating from the lung, white individuals tend to have a better prognosis than other individuals, which is in agreement with the findings of a previous study . Reviews suggest that the reasons for the wide racial disparities in lung cancer survival are complex and multifactorial, with contributions from treatment‐related factors, such as physician‐patient encounters and decision‐making, and barriers to access to high‐quality care, such as lower patient income or insurance coverage limits …”

Lung cancer survival in the United States by race and stage (2001‐2009): Findings from the CONCORD‐2 study

“…2,17,27–29 Reviews suggest that the reasons for the wide racial disparities in lung cancer survival are complex and multifactorial, with contributions from treatment-related factors, such as physician-patient encounters and decision-making, and barriers to access to high-quality care, such as lower patient income or insurance coverage limits. 30–32 Unfortunately, although our study highlights 2 key determinants (race and stage) of survival differences between US states, it does not provide definite conclusions about all of the factors that may contribute to differences, because information on these factors is not available for all patients with cancer at a population-based level. It would be interesting to analyze the availability or receipt of optimal treatment by US state and race.…”

The lived experiences of smokers with lung cancer

“…These have been found to be related to low income, tobacco advertisement, limited education, negative consequences of the cancer experience, loss of control, fatigue, social isolation, and lack of knowledge about causes, characteristics, and prognosis of the disease. [16] As well, research interest has been focused on the stress that lung cancer patients experience with findings of high levels of distress due to poor prognosis, with an accompanying sense of responsibility for the cancer, and the stigma associated with their disease as an illness of smokers. [17] Lehto (2014) also identified stigma among friends, family, and health professionals for people with lung cancer because the disease is so closely connected with smoking.…”

“…[7] According to Cataldo et al, [18] stigma among lung cancer patients can lead to negative outcomes including increased level of depression and diminished QOL. Lathan et al (2015) [16] used a qualitative approach to interview lung cancer patients and identified that negative thoughts and emotions, such as guilt, self-blame, and self-deprecation are common in this population. Similarly, Raleigh [8] found smokers with a lung cancer diagnosis often feel depression and guilt because they think that they are a burden to their families and friends.…”