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Risk Perceptions Among Participants Undergoing Lung Cancer Screening: Baseline Results from the National Lung Screening Trial

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Lung cancer screening could present a “teachable moment” for promoting smoking cessation and relapse prevention. Understanding the risk perceptions of older individuals who undergo screening will guide these efforts.

Purpose

This paper examines National Lung Screening Trial (NLST) participants' perceptions of risk for lung cancer and other smoking-related diseases. We investigated (1) whether risk perceptions of lung cancer screening participants differed between current and former smokers and (2) which factors (sociodemographic, smoking and medical history, cognitive, emotional, and knowledge) were associated with these risk perceptions.

Methods

We analyzed baseline data collected from 630 NLST participants prior to their initial screen. Participants were older (55–74 years), heavy (minimum 30 pack years) current or former smokers. A ten-item risk perception measure was developed to assess perceived lifetime risk of lung cancer and other smoking-related diseases.

Results

The risk perception measure had excellent internal consistency (alpha = 0.93). Former smokers had lower risk perceptions compared to current smokers. Factors independently associated with high risk perceptions among current smokers included having a personal history of a smoking-related disease, higher lifetime maximum number of cigarettes smoked daily, having lived with a smoker, high worry, high perceived severity of lung cancer and smoking-related diseases, and accurate knowledge of tenfold increased risk of lung cancer for a one pack per day smoker. Factors independently associated with high risk perceptions among former smokers included being White, past history of smoking within 30 min of waking, high worry, and accurate knowledge of tenfold increased risk of lung cancer for a one pack per day smoker.

Conclusions

Using a comprehensive risk perception measurement, we found that current and former smokers held different risk perceptions. Former and current smokers' smoking and medical history, race, emotional concerns, behavior change cognitions, and knowledge should be considered during a prescreening risk communication session. We highlight the theoretical and risk communication implications for former and current smokers undergoing lung cancer screening.

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Acknowledgements

This project was funded by a grant from the American Cancer Society's Mentored Research Scholar Award (MRSG-005-05-CPPB), the ACRIN/NLST Trial (U01 CA79778 S2), and a NHLBI Midcareer Investigator Award in Patient-Oriented Research (#K24-HL04440). The authors wish to thank Dr. Deni Aberle, without whose support the study would not have been possible. We are also appreciative of the efforts of ACRIN staff members Irene Mahon and Maria Oh, Brown University staff JoRean Sicks and Amanda Adams, and Dr. Park's research assistant Jennifer Pandiscio. Lastly, we are very grateful for the assistance and approval of the eight ACRIN/NLST participating Principal Investigators, site coordinators, and staff at the Brown University Center for Statistical Sciences.

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Authors and Affiliations

  1. Massachusetts General Hospital/Harvard Medical School, 50 Staniford Street, 9th Floor, Boston, MA, 02114, USA

    Elyse R. Park Ph.D., MPH & Nancy A. Rigotti M.D.

  2. Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th Floor, New York, NY, 10022, USA

    Jamie S. Ostroff Ph.D.

  3. Department of Community Health and Center for Gerontology and Health Care Research, Brown University, 121 South Main Street, 2nd Floor, Providence, RI, 02912, USA

    William Rakowski Ph.D.

  4. Center for Statistical Sciences, Brown University, Box G-S121-7, Providence, RI, 02912, USA

    Ilana F. Gareen Ph.D.

  5. Departments of Urology & Oncological Science, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1272, New York, NY, 10029, USA

    Michael A. Diefenbach Ph.D.

  6. Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA, 02114, USA

    Sandra Feibelmann MPH

Authors
  1. Elyse R. Park Ph.D., MPH
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  2. Jamie S. Ostroff Ph.D.
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  3. William Rakowski Ph.D.
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  4. Ilana F. Gareen Ph.D.
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  5. Michael A. Diefenbach Ph.D.
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  6. Sandra Feibelmann MPH
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  7. Nancy A. Rigotti M.D.
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Corresponding author

Correspondence to Elyse R. Park Ph.D., MPH.

Appendix

Appendix

PARTICIPATING STUDY SITES

Brown University, Providence, Rhode Island

The Cancer Institute of New Jersey, New Brunswick, New Jersey

Mayo Clinic, Rochester, Minnesota

Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire

St. Elizabeth Health Center, Youngstown, Ohio

Jewish Hospital Heart and Lung Institute, Louisville, Kentucky

Moffitt Cancer Center, Tampa, Florida

Johns Hopkins University, Baltimore, Maryland

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Park, E.R., Ostroff, J.S., Rakowski, W. et al. Risk Perceptions Among Participants Undergoing Lung Cancer Screening: Baseline Results from the National Lung Screening Trial. ann. behav. med. 37, 268–279 (2009). https://doi.org/10.1007/s12160-009-9112-9

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