Abstract
BackgroundLung cancer is the leading cause of cancer death worldwide. Routine UK lung cancer screening is not yet available, thus understanding barriers to participation in lung screening could help maximize effectiveness if introduced.MethodsPopulation‐based survey of 1007 adults aged 16 and over in Wales using random quota sampling. Computer‐assisted face‐to‐face interviews included demographic variables (age, gender, smoking, social group), four lung cancer belief statements and three lung screening attitudinal items. Determinants of lung screening attitudes were examined using multivariable regression adjusted for age, gender, social group and previous exposure to lung campaign messages.ResultsAvoidance of lung screening due to fear of what might be found was statistically significantly associated with negative lung cancer beliefs including fatalism (aOR = 8.8, 95% CI = 5.6‐13.9, P ≤ 0.001), low perceived value of symptomatic presentation (aOR = 2.4, 95% CI = 1.5‐3.9, P ≤ 0.001) and low treatment efficacy (aOR = 0.3, CI = 0.2‐0.7, P ≤ 0.01).Low perceived effectiveness of lung screening was significantly associated with fatalism (aOR = 6.4, 95% CI = 3.5‐11.7, P ≤ 0.001), low perceived value of symptom presentation (aOR = 4.9, 95% CI = 2.7‐8.9, P ≤ 0.001) and low treatment efficacy (aOR = 0.1, 95% CI = 0.1‐0.3, P ≤ 0.001). In contrast, respondents who thought lung screening could reduce cancer deaths had positive beliefs about lung cancer (aOR = 0.4, 95% CI = 0.2‐0.7, P ≤ 0.001) and its treatment (aOR = 6.1, 95% CI = 3.0‐12.6, P ≤ 0.001).ConclusionPeople with negative beliefs about lung cancer may be more likely to avoid lung screening. Alongside the introduction of effective early detection strategies, interventions are needed to modify public perceptions of lung cancer, particularly for fatalism.
Highlights
Lung cancer is the leading cause of cancer-related death worldwide.[1]
Attitudes towards lung cancer screening were assessed using three items: “I would be so worried about what might be found at lung cancer screening that I would prefer not to go”; “I don’t think there is any point going for lung cancer screening because it won’t affect the outcome”; and “Lung screening could reduce my chances of dying from cancer.”
TA B L E 3 Frequencies and univariate analysis for lung screening attitude “I don’t think there is any point going for lung cancer screening because it won’t affect the outcome”
Summary
Lung cancer is the leading cause of cancer-related death worldwide.[1]. Five-year cancer survival rapidly decreases the later lung cancer is diagnosed, due to limited treatments options. Previous studies of attitudes towards lung cancer screening suggest that smokers from socio-economically deprived groups place lower value on the benefits of lung cancer screening, hold fatalistic beliefs about lung cancer as an untreatable disease or report stigma as a barrier to screening participation.[12,13] In addition, emotional barriers such as fear of lung cancer[14] and the belief that the lungs are an untreatable organ[12,15] were reported to deter participation in lung screening trials. It was anticipated that current smokers, respondents from the lowest socio-economic group and those with negative beliefs about lung cancer would have more negative attitudes towards lung cancer screening
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