Lung cancer is a leading cause of cancer death in Latinos. In a telephone survey, we assessed perceptions about lung cancer and awareness of, interest in, and barriers to lung screening among older current and former smokers. We compared Latino and non-Latino responses adjusting for age, sex, education, and smoking status using logistic regression models. Of the 460 patients who completed the survey (51.5% response rate), 58.0% were women, 49.3% former smokers, 15.7% Latino, with mean age 63.6 years. More Latinos believed that lung cancer could be prevented compared to non-Latinos (74.6% vs. 48.2%, OR 3.07, CI 1.89–5.01), and less worried about developing lung cancer (34.8% vs. 50.3%, OR 0.44, CI 0.27–0.72). Most participants were not aware of lung screening (44.1% Latinos vs. 34.3% Non-Latinos, OR 1.24, CI 0.79–1.94), but when informed, more Latinos wanted to be screened (90.7% vs. 67%, OR 4.58, CI 2.31–9.05). Latinos reported fewer barriers to lung screening.
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Society AC. Cancer facts & figures for Hispanics/Latinos 2015–2017. Atlanta: American Cancer Society; 2015.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30. https://doi.org/10.3322/caac.21442.
Stern MC, Fejerman L, Das R, Setiawan VW, Cruz-Correa MR, Perez-Stable EJ, et al. Variability in cancer risk and outcomes Within US Latinos by national origin and genetic ancestry. Curr Epidemiol Rep. 2016;3:181–90. https://doi.org/10.1007/s40471-016-0083-7.
Siegel RL, Fedewa SA, Miller KD, Goding-Sauer A, Pinheiro PS, Martinez-Tyson D, et al. Cancer statistics for Hispanics/Latinos, 2015. CA Cancer J Clin. 2015;65(6):457–80. https://doi.org/10.3322/caac.21314.
Hong YR, Tauscher J, Cardel M. Distrust in health care and cultural factors are associated with uptake of colorectal cancer screening in Hispanic and Asian Americans. Cancer. 2017. https://doi.org/10.1002/cncr.31052.
Kadivar H, Kenzik KM, Dewalt DA, Huang IC. The association of English functional health literacy and the receipt of mammography among Hispanic women compared to non-Hispanic U.S.-born white women. PLoS ONE. 2016;11(10):e0164307. https://doi.org/10.1371/journal.pone.0164307.
Weksler B, Kosinski AS, Burfeind WR, Silvestry SC, Sullivan J, D’Amico TA. Racial and ethnic differences in lung cancer surgical stage: an STS database study. Thorac Cardiovasc Surg. 2015;63(7):538–43. https://doi.org/10.1055/s-0035-1546295.
Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409. https://doi.org/10.1056/NEJMoa1102873.
Humphrey LL, Deffebach M, Pappas M, Baumann C, Artis K, Mitchell JP, et al. Screening for lung cancer with low-dose computed tomography: a systematic review to update the US preventive services task force recommendation. Ann Intern Med. 2013;159(6):411–20. https://doi.org/10.7326/0003-4819-159-6-201309170-00690.
Force USPST. Lung cancer screening: summary of recommendations and evidence; 2015. https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/lung-cancer-screening. Accessed February 2017.
Jemal A, Fedewa SA. Lung cancer screening with low-dose computed tomography in the United States-2010 to 2015. JAMA Oncol. 2017. https://doi.org/10.1001/jamaoncol.2016.6416.
Ersek JL, Eberth JM, McDonnell KK, Strayer SM, Sercy E, Cartmell KB, et al. Knowledge of, attitudes toward, and use of low-dose computed tomography for lung cancer screening among family physicians. Cancer. 2016;122(15):2324–31. https://doi.org/10.1002/cncr.29944.
Duong DK, Shariff-Marco S, Cheng I, Naemi H, Moy LM, Haile R, et al. Patient and primary care provider attitudes and adherence towards lung cancer screening at an academic medical center. Prev Med Rep. 2017;6:17–22. https://doi.org/10.1016/j.pmedr.2017.01.012.
Kanodra NM, Pope C, Halbert CH, Silvestri GA, Rice LJ, Tanner NT. Primary care provider and patient perspectives on lung cancer screening. A qualitative study. Ann Am Thorac Soc. 2016;13(11):1977–82. https://doi.org/10.1513/AnnalsATS.201604-286OC.
Simmons VN, Gray JE, Schabath MB, Wilson LE, Quinn GP. High-risk community and primary care providers knowledge about and barriers to low-dose computed topography lung cancer screening. Lung Cancer. 2017;106:42–9. https://doi.org/10.1016/j.lungcan.2017.01.012.
Raz DJ, Wu GX, Consunji M, Nelson RA, Kim H, Sun CL, et al. The effect of primary care physician knowledge of lung cancer screening guidelines on perceptions and utilization of low-dose computed tomography. Clin Lung Cancer. 2017. https://doi.org/10.1016/j.cllc.2017.05.013.
Ali N, Lifford KJ, Carter B, McRonald F, Yadegarfar G, Baldwin DR, et al. Barriers to uptake among high-risk individuals declining participation in lung cancer screening: a mixed methods analysis of the UK Lung Cancer Screening (UKLS) trial. BMJ Open. 2015;5(7):e008254. https://doi.org/10.1136/bmjopen-2015-008254.
Quaife SL, Marlow LA, McEwen A, Janes SM, Wardle J. Attitudes towards lung cancer screening in socioeconomically deprived and heavy smoking communities: informing screening communication. Health Expect. 2016. https://doi.org/10.1111/hex.12481.
Delmerico J, Hyland A, Celestino P, Reid M, Cummings KM. Patient willingness and barriers to receiving a CT scan for lung cancer screening. Lung Cancer. 2014;84(3):307–9. https://doi.org/10.1016/j.lungcan.2014.03.003.
Jonnalagadda S, Bergamo C, Lin JJ, Lurslurchachai L, Diefenbach M, Smith C, et al. Beliefs and attitudes about lung cancer screening among smokers. Lung Cancer. 2012;77(3):526–31. https://doi.org/10.1016/j.lungcan.2012.05.095.
Byrd TL, Chavez R, Wilson KM. Barriers and facilitators of cervical cancer screening among Hispanic women. Ethn Dis. 2007;17(1):129–34.
Morgan C, Park E, Cortes DE. Beliefs, knowledge, and behavior about cancer among urban Hispanic women. J Natl Cancer Inst Monogr. 1995;18:57–63.
Tejeda S, Gallardo RI, Ferrans CE, Rauscher GH. Breast cancer delay in Latinas: the role of cultural beliefs and acculturation. J Behav Med. 2017;40(2):343–51. https://doi.org/10.1007/s10865-016-9789-8.
Hubbell FA, Chavez LR, Mishra SI, Valdez RB. Differing beliefs about breast cancer among Latinas and Anglo women. West J Med. 1996;164(5):405–9.
Schettino MR, Hernandez-Valero MA, Moguel R, Hajek RA, Jones LA. Assessing breast cancer knowledge, beliefs, and misconceptions among Latinas in Houston, Texas. J Cancer Educ. 2006;21(1 Suppl):42-6. https://doi.org/10.1207/s15430154jce2101s_9.
Perez-Stable EJ, Sabogal F, Otero-Sabogal R, Hiatt RA, McPhee SJ. Misconceptions about cancer among Latinos and Anglos. JAMA. 1992;268(22):3219–23.
Goldman RE, Diaz JA, Kim I. Perspectives of colorectal cancer risk and screening among Dominicans and Puerto Ricans: stigma and misperceptions. Qual Health Res. 2009;19(11):1559–68. https://doi.org/10.1177/1049732309349359.
Radiology ACo. NLST Decision Log 2010; 2017. https://www.acrin.org/PROTOCOLSUMMARYTABLE/PROTOCOL6654/6654DataForms.aspx. Accessed December 2017.
Saadi A, Bond B, Percac-Lima S. Perspectives on preventive health care and barriers to breast cancer screening among Iraqi women refugees. J Immigr Minor Health. 2012;14(4):633–9. https://doi.org/10.1007/s10903-011-9520-3.
Green AR, Peters-Lewis A, Percac-Lima S, Betancourt JR, Richter JM, Janairo MP, et al. Barriers to screening colonoscopy for low-income Latino and white patients in an urban community health center. J Gen Intern Med. 2008;23(6):834–40. https://doi.org/10.1007/s11606-008-0572-6.
Smiley MR, McMillan SC, Johnson S, Ojeda M. Comparison of Florida Hispanic and non-Hispanic Caucasian women in their health beliefs related to breast cancer and health locus of control. Oncol Nurs Forum. 2000;27(6):975–84.
Efuni E, DuHamel KN, Winkel G, Starr T, Jandorf L. Optimism and barriers to colonoscopy in low-income Latinos at average risk for colorectal cancer. Psychooncology. 2015;24(9):1138–44. https://doi.org/10.1002/pon.3733.
Cataldo JK. High-risk older smokers’ perceptions, attitudes, and beliefs about lung cancer screening. Cancer Med. 2016;5(4):753–9. https://doi.org/10.1002/cam4.617.
Carter-Harris L, Brandzel S, Wernli KJ, Roth JA, Buist DSM. A qualitative study exploring why individuals opt out of lung cancer screening. Fam Pract. 2017;34(2):239–44. https://doi.org/10.1093/fampra/cmw146.
Gressard L, DeGroff AS, Richards TB, Melillo S, Kish-Doto J, Heminger CL, et al. A qualitative analysis of smokers’ perceptions about lung cancer screening. BMC Public Health. 2017;17(1):589. https://doi.org/10.1186/s12889-017-4496-0.
Carter-Harris L, Ceppa DP, Hanna N, Rawl SM. Lung cancer screening: what do long-term smokers know and believe? Health Expect. 2015;20(1):59–68. https://doi.org/10.1111/hex.12433.
Wang J, Moehring J, Stuhr S, Krug M. Barriers to colorectal cancer screening in Hispanics in the United States: an integrative review. Appl Nurs Res. 2013;26(4):218–24. https://doi.org/10.1016/j.apnr.2013.08.005.
Brenner ATKL, Janz N, Gupta S, Inadomi J. Race/ethnicity and primary language: health beliefs about colorectal cancer screening in a diverse, low-income population. J Health Care Poor Underserved. 2015;26(3):824–38. https://doi.org/10.1353/hpu.2015.0075.
Jerome-D’Emilia B. A systematic review of barriers and facilitators to mammography in Hispanic women. J Transcult Nurs. 2015;26(1):73–82. https://doi.org/10.1177/1043659614530761.
Kobayashi LC, Wardle J, von Wagner C. Limited health literacy is a barrier to colorectal cancer screening in England: evidence from the English longitudinal study of Ageing. Prev Med. 2014;61:100–5. https://doi.org/10.1016/j.ypmed.2013.11.012.
Sentell T, Braun KL. Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California. J Health Commun. 2012;17(Suppl 3):82–99. https://doi.org/10.1080/10810730.2012.712621.
Sin MK, Ha A, Taylor V. Sociocultural barriers to lung cancer screening among Korean immigrant men. J Community Health. 2016;41(4):790–7. https://doi.org/10.1007/s10900-016-0154-1.
Moyer VA, Force USPST. Screening for lung cancer: U.S. preventive services task force recommendation statement. Ann Intern Med. 2014;160(5):330–8. https://doi.org/10.7326/M13-2771.
Patient Protection and Affordable Care Act, 42; 2010.
Services. CfMaM. Decision memo for screening for lung cancer with low dose computed tomography (LDCT) (CAG-00439N). 2017. https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=274.
Saadi A, Bond BE, Percac-Lima S, Bosnian. Iraqi, and Somali refugee women speak: a comparative qualitative study of refugee health beliefs on preventive health and breast cancer screening. Womens Health Issues. 2015;25(5):501–8. https://doi.org/10.1016/j.whi.2015.06.005.
Kinsinger LS, Anderson C, Kim J, Larson M, Chan SH, King HA, et al. Implementation of Lung cancer screening in the veterans health administration. JAMA Intern Med. 2017;177(3):399–406. https://doi.org/10.1001/jamainternmed.2016.9022.
This study was supported by American Cancer Society: Cancer Control Career Development Award for Primary Care Physicians, CCCDAA-14-012-01-CCCDA and Lazarex Cancer Foundation.
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Percac-Lima, S., Ashburner, J.M., Atlas, S.J. et al. Barriers to and Interest in Lung Cancer Screening Among Latino and Non-Latino Current and Former Smokers. J Immigrant Minority Health 21, 1313–1324 (2019). https://doi.org/10.1007/s10903-019-00860-2
- Lung cancer
- Cancer screening