Lung cancer screening decisional needs among African American smokers of lower socioeconomic status

Ethn Health. 2022 Apr;27(3):565-583. doi: 10.1080/13557858.2020.1771681. Epub 2020 Jun 5.

Abstract

Objectives: Adherence to most evidence-based cancer screenings is lower among African Americans due to system- and individual-level factors that contribute to persistent disparities. Given the recommendation for low-dose computed tomography (LDCT) screening among individuals at high risk for lung cancer, we sought to describe aspects of decision-making for LDCT among African Americans and to examine associations between select components of decision-making and screening-related intentions.

Design: African Americans (N = 119) with a long-term smoking history, aged 55-80 years, and without lung cancer were recruited to participate in a cross-sectional survey. We measured knowledge, awareness, decisional conflict, preferences, and values related to lung cancer screening.

Results: The majority of the study population was of lower socioeconomic status (67.2% had an annual income of ≤$20,000) and long-term current (79%) smokers. Participants had a median 20 pack-years smoking history. Most participants (65.8%) had not heard of LDCT and the total lung cancer screening knowledge score was M = 7.1/15.0 (SD = 1.8). Participants with higher scores on the importance of the pros and cons of screening expressed greater likelihood of talking with a doctor, family, and friends about screening (p's < .10).

Conclusions: Findings have implications for addressing the decisional needs of lower socioeconomic African American current and former smokers to promote informed decision-making for LDCT.

Keywords: African Americans; Lung cancer screening; informed decision-making; low-dose computed tomography.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Black or African American*
  • Cross-Sectional Studies
  • Early Detection of Cancer / methods
  • Humans
  • Lung Neoplasms* / diagnosis
  • Mass Screening / methods
  • Middle Aged
  • Smokers
  • Social Class