Worry about Lung Cancer is Related to Numeracy and Risk Perception of Diseases Associated with Smoking

Diaz, Destiny; Fix, Brian V.; Caruso, Rosalie V.; Travers, Maansi Bansal; O’Connor, Richard J.

doi:10.1080/19325037.2019.1687364

Cited by 5 publications

(5 citation statements)

References 18 publications

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“…The probability that a given treatment will successfully eliminate the tumor, the probability of recurrence, the probability of surviving across a given period, the probability of treatment side effects or debilitating outcomes-these numbers should help to inform decisions among different treatment options. The task of comprehending and comparing these varied statistics is daunting, particularly under stress, and certainly there is evidence that better comprehension of these numbers does influence cancer decisions [55][56][57][58][59][60][61][62][63][64][65] and that decision aids that improve numeric comprehension do support decision processes. [66][67][68] Nevertheless, improving numeric comprehension has limited benefit because comprehension is not the only decision-making hurdle.…”

Section: Discussionmentioning

confidence: 99%

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Lacey

Dayal

et al. 2023

Med Decis Making

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Background Past studies have shown a commission bias for cancer treatment, a tendency to choose active treatment even when watchful waiting is less risky. This bias suggests motivations for action beyond mortality statistics, but recent evidence suggests that individuals differ in their emotional sensitivity to probabilities (ESP), the tendency to calibrate emotional reactions to probability. The current study aims to examine the role of ESP in the commission bias, specifically whether those higher in ESP are more likely to choose watchful waiting when risk probabilities align with that choice. Methods Participants ( N = 1,055) read a scenario describing a hypothetical cancer diagnosis and chose between surgery and watchful waiting, with random assignment between versions where the mortality rate was either lower for surgery or for watchful waiting. We modeled choice using the Possibility Probability Questionnaire (PPQ), a measure of ESP, and several other individual differences in a logistic regression. Results We observed a commission bias as in past studies with most participants choosing surgery both when surgery was optimal (71%) and when watchful waiting was optimal (58%). An ESP × Condition interaction indicated that the predictive role of ESP depended on condition. Those higher in ESP were more likely to choose surgery when probabilities favored surgery, β = 0.57, P < 0.001, but when probabilities favored watchful waiting, ESP had a near-zero relationship with choice, β = 0.05, P < 0.99. Conclusions The role of ESP in decision making is context specific. Higher levels of ESP predict choosing action when that action is warranted but do not predict a shift away from surgery when watchful waiting offers better chances of survival. ESP does not overcome the commission bias. Highlights Past studies have identified a “commission bias,” a tendency to choose active treatment over watchful waiting, even when mortality rate is lower for waiting. Evaluation of risk probabilities is related to individual differences in emotional sensitivity to probabilities (ESP) and has been shown to predict reactions to and decisions about health risk situations. ESP appears to be selectively factored into decision making. ESP was a robust predictor of choosing surgery when probability information supported surgery but did not predict decisions when probability information supported watchful waiting. Those who are most emotionally attuned to probabilities are just as susceptible to the commission bias as those who are less attuned.

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Section: Discussionmentioning

confidence: 99%

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Lacey

Dayal

et al. 2023

Med Decis Making

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“…There have been researches exploring the relationship between cognitive risk and affective risk. Diaz et al ’.s study showed that perceived risk has a positive association with lung cancer worry (Diaz et al ., 2020). Turner et al reported that individuals’ lung cancer risk perception correlated positively with calculated risk in a screening population (Turner et al ., 2021).…”

Section: Discussionmentioning

confidence: 99%

“…A study by Turner et al (Turner et al, 2021) showed that the recruitment for lung cancer screening may be influenced by risk perception. Current studies on risk perception in lung cancer (Park et al, 2009;Greillier et al, 2018;Diaz et al, 2020) have focused on the analysis of influencing factors, such as smoking, in which their study objects have been already involved in screening practices. There is a lack of studies that explore the relevant factors associated with screening participation in populations with high risk of lung cancer and comprehensively analyze their effects.…”

Section: Introductionmentioning

confidence: 99%

Impact of risk perception and disease cognition on the willingness to participate in screening for lung cancer in a high-risk population

Rong,

Shi,

et al. 2023

European Journal of Cancer Prevention

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Objective Risk perception and disease cognition may influence the efficiency of lung cancer screening by affecting the participation rate. There is still some uncertainty regarding the association between risk perception and disease cognition and how they affect participation in lung cancer screening. Therefore, we explored the influence of risk perception and disease cognition on the willingness to participate in screening among people at high risk of lung cancer. Methods Subjects with high-risk factors for lung cancer were recruited in Lu’an City, Anhui Province, China. Questionnaires were used to determine their demographic characteristics, risk perception, disease cognition, and willingness to engage in screening. Results Of the 1955 subjects with high risk factors for lung cancer, 1136 (58.12%) were willing to participate in lung cancer screening. Univariable and multivariable analyses showed that disease cognition (adjOR = 2.012, 95% CI: 1.528–2.649, P = 0.000), cognitive risk (adjOR = 7.661, 95% CI: 6.049–9.704, P = 0.000), and affective risk (adjOR = 5.964, 95% CI: 4.552–7.815, P = 0.000) were significant factors in promoting screening participation. For those with moderate risk perception, improving disease cognition was a key approach to increase screening participation. Conclusion This study elucidated the relationship between various factors and lung cancer screening participation and proposed a feasible route for the screening implementation, providing a theoretical basis to further improve the participation rate and efficiency of lung cancer screening.

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“…6 These results are consistent with other studies, as former smokers consistently exhibit less general cancer and lung cancer worry than current smokers. [18][19][20] The HINTS measures did not allow for deeper exploration of the association of perceived information gathering capacity with discussing screening with a provider, but it warrants future consideration. Taken together, the challenge for public health programs and health professionals aiming to increase uptake of lung cancer screening will be to increase the relevance of such screening for former smokers while affirming the health benefits of their long-term cessation.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Discussing Lung Cancer Screening with a Health Care Provider Among Current and Former Smokers in HINTS: A Secondary Data Analysis

et al. 2022

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Introduction Lung cancer screening is greatly underutilized among those who may benefit from early detection. Methods We analysed data from a subsample (n = 929) of the 2020 Health Information National Trends Survey. We tested multivariable logistic regression models of associations of cancer worry, information insufficiency, and perceived information gathering capacity with reports of having discussed lung cancer screening with a health care provider. Results Among former smokers, no factors were associated significantly with lung cancer screening information seeking. However, for current smokers, extreme cancer worry was positively and significantly associated with having discussed lung cancer screening with a health care provider (OR: 12.95; 95% CI: 2.11, 79.39). Conclusion To increase uptake of lung cancer screening, public health campaigns and healthcare providers will face the dual challenge of increasing perceived need for screening among former smokers while directing current smokers with high levels of worry to see the benefits of early detection.

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Worry about Lung Cancer is Related to Numeracy and Risk Perception of Diseases Associated with Smoking

Cited by 5 publications

References 18 publications

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Context Matters: Emotional Sensitivity to Probabilities and the Bias for Action in Cancer Treatment Decisions

Impact of risk perception and disease cognition on the willingness to participate in screening for lung cancer in a high-risk population

Predictors of Discussing Lung Cancer Screening with a Health Care Provider Among Current and Former Smokers in HINTS: A Secondary Data Analysis

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