The Effects of Health Disparities on Perceptions About Lung Cancer Screening: Results From a National Survey

Abstract

SESSION TITLE: Cultural Diversity and Palliative Care SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Health disparities are known to negatively impact participation in cancer screening programs. While this has previously been shown for colon and breast cancer screening, their impact upon lung cancer screening (LCS) has not been defined. We conducted a Web-based national survey to evaluate whether health disparities affect perceptions about LCS and therefore may have negative effects on particiption. We hypothesized that individuals of low socioeconomic status (SES) and minority racial and ethnic groups would differ in their responses to questions about susceptibility to lung cancer, benefits of LCS, and barriers to LCS compared to White or higher SES individuals. METHODS: A 96 question web-based survey was distributed nationally via SurveyMonkey and Cint databases to approximately 8700 current or former smokers aged 55-80 years. The survey included a modified version of the Champion Barrier Scale (CBS) (1), consisting of questions about susceptibility to lung cancer, benefits of LCS, and barriers to LCS. All individual items on the CBS were scored on a 4 point scale, ranging from 1 (very likely) to 4 (very unlikely). We created average scores for susceptibility, barriers, and benefits based on answers to category-specific items. Low SES was defined as either a household income less than $35,000 per year or educational attainment of high school diploma or less. We used analyses of variance to examine whether average scores for susceptibility, barriers and benefits differed by SES, educational level, household income level, or race (White, African-American, other). All analyses were performed with SAS 9.4. We used an alpha level of 0.05. RESULTS: A total of 756 responses were received (response rate 8.7%). 79.6% of respondents identified as White, 14.3% as African-American and 6.4% identified as Hispanic. 51.2% of respondents were female. 22.8% reported having the equivalent of a high school diploma or less. 41.7% reported annual household income less than $35,000. Half (51%) of our sample was low SES using the definition above. Mean scores for susceptibility and barriers did not differ significantly by race, income or educational status (p>0.05). Low SES individuals were more likely (p=0.02) to perceive benefits of screening, but the clinical importance of this difference in mean benefit scores between the two groups (1.9 for low SES vs 1.8 for others) is likely small. CONCLUSIONS: This national survey suggests that health disparities do not significantly impact perceptions of susceptibility to lung cancer, benefits of LCS or barriers to LCS. However, we must be cautious with generalization of these findings given the low survey response rate. CLINICAL IMPLICATIONS: Although our survey did not detect particular ethnic, racial or low socioeconomic status barriers to utilization of lung cancer screening, further studies may be helpful to ensure that appropriate outreach mechanisms can be instituted to facilitate screening across diverse populations. DISCLOSURE: The following authors have nothing to disclose: Sarah Ellen Stephens, Beverly Levine, Christina Bellinger No Product/Research Disclosure Information