Abstract

Background: Perceived risk and worries of developing cancer are important constructs for cancer prevention. Many studies have investigated the relationship between health behaviors and subjective risk perception. However, factors correlated with lung cancer risk perception and worries in individuals more susceptible to lung cancer have rarely been investigated. Objective: To determine demographic, social, and behavioral determinants of cancer perceived risk and worries and to explore heterogeneities in these associations by the level of lung cancer risk in a nationally representative sample of American adults. Methods: For this cross-sectional study, data came from the Health Information National Trends Survey (HINTS) 2017, which included a 2277 representative sample of American adults. Smoking status, cancer perceived risk, cancer worries, age, gender, race, education, income, and insurance status were measured. We ran structural equation models (SEMs) for data analysis. Results: “Ever smoker” status was associated with higher cancer perceived risk (b = 0.25; 95% CI = 0.05–0.44, p = 0.013) and worries (b = 0.34, 95% CI = 0.18–0.50, p < 0.001), suggesting that “ever smokers” experience higher levels of cancer perceived risk and worries regarding cancer, compared to “never smokers”. Other factors that correlate with cancer perceived risk and worries were race, age, income, and insurance status. Blacks demonstrated less cancer perceived risk and worry (b = −0.98, 95% CI = −1.37–0.60, p < 0.001) in both low and high risk lung cancer groups. However, the effects of social determinants (income and insurance status) and age were observed in low but not high risk group. Conclusions: Determinants of cancer perceived risk and worries vary in individuals depending on the level of lung cancer risk. These differences should be considered in clinical practice and policy makings with the goal of improving participation rates in lung cancer screening programs.

Highlights

  • With an estimated 234,030 new cases and 154,050 cancer-related deaths in 2018, lung cancer is the leading cause of cancer death for both genders in the United States [1]

  • To investigate characteristics that might improve participation in lung cancer screening programs, we aimed to determine demographic, social, and behavioral factors correlated with the lung cancer perceived risk and worries in the American adult population

  • We found a negative age and cancer perceived risk and worries in the whole individuals in lung cancercorrelation screening between programs

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Summary

Introduction

With an estimated 234,030 new cases and 154,050 cancer-related deaths in 2018, lung cancer is the leading cause of cancer death for both genders in the United States [1]. The National Lung Cancer Screening Trial (NLST), a randomized clinical trial including more than 50,000 participants, showed a 20% decrease in lung cancer death and 6.7% decrease in all-cause mortality using annual low-dose computed tomography screening [3]. This important data and several other smaller reports shed light on the importance of lung cancer screening [4,5].

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