Lung cancer screening beliefs in Armenia

Nathan Chu; Haley Tupper; Tamara Galoyan; Armine Lulejian; James Dickhoner; Marine Hovhannisyan; Shant Shekherdimian

doi:10.3389/fonc.2023.1062690

Lung cancer screening beliefs in Armenia

Front Oncol. 2023 Jun 16:13:1062690. doi: 10.3389/fonc.2023.1062690. eCollection 2023.

Authors

Nathan Chu¹, Haley Tupper², Tamara Galoyan³, Armine Lulejian⁴, James Dickhoner⁵, Marine Hovhannisyan⁶, Shant Shekherdimian⁷

Affiliations

¹ Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, United States.
² Department of General Surgery, University of California, Los Angeles, Los Angeles, CA, United States.
³ School of Education, Drexel University, Philadelphia, PA, United States.
⁴ Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
⁵ Innovation Studio, Children's Hospital Los Angeles, Los Angeles, CA, United States.
⁶ Faculty of Public Health, Yerevan State Medical University, Yerevan, Armenia.
⁷ Department of Pediatric Surgery, University of California, Los Angeles, Los Angeles, CA, United States.

Abstract

Introduction: In Armenia, an upper-middle income country, 93% of deaths are from non-communicable diseases and over half of the male population smokes. Armenia has more than double the global lung cancer incidence. Over 80% of lung cancer is diagnosed at stages III or IV. However, there is a significant mortality benefit in detecting early-stage lung cancer via screening with low-dose computed tomography.

Methods: This study employed a rigorously-translated, previously-validated survey based on the Expanded Health Belief Model to understand how Armenian male smokers' beliefs would affect lung cancer screening participation.

Results: Survey responses highlighted key health beliefs that would mediate screening participation. Most respondents felt they were at risk for lung cancer, but over 50% also believed their cancer risk was equivalent to (or less than) non-smokers' risk. Respondents also overwhelmingly agreed a scan could help detect cancer earlier, but fewer agreed early detection could reduce cancer mortality. Important barriers included absence of symptoms and costs of screening and treatment.

Discussion: Overall, the potential to reduce lung cancer-related deaths in Armenia is high, but there are a number of central health beliefs and barriers that would limit screening uptake and effectiveness. Improved health education, careful consideration of socioeconomic screening barriers, and appropriate screening recommendations may be useful in overcoming these beliefs.

Keywords: Armenia; developing countries; health beliefs; health education (MeSH); lung cancer; screening; screening barriers; smoking.

Grants and funding

Funding was provided by a grant from the Promise Armenian Institute at UCLA.