Risk Perception Among a Lung Cancer Screening Population

Abstract

BACKGROUND: A successful lung cancer screening program requires a patient cohort at sufficient risk of developing cancer who are willing to participate. Among other factors, a patient's lung cancer risk perception may inform their attitudes toward screening and smoking cessation programs.RESEARCH QUESTION: This study analyzed data from the Pan-Canadian Early Detection of Lung Cancer (PanCan) Study to address the following questions: Which factors are associated with the perception of lung cancer risk? Is there an association between risk perception for lung cancer and actual calculated risk? Is there an association between risk perception for lung cancer and the intent to quit smoking? Are there potential targets for lung cancer screening awareness?STUDY DESIGN AND METHODS: The PanCan study recruited current or former smokers aged 50 to 75 years who had at least a 2% risk of developing lung cancer over 6 years to undergo lowdose screening CT. Risk perception and worry about lung cancer were captured on a baseline questionnaire. Cumulative logistic regression analysis was used to assess the relationship between baseline risk variables and both lung cancer risk perception and worry.RESULTS: Among the 2,514 individuals analyzed, a higher perceived risk of lung cancer was positively associated with calculated risk (P ¼ .032). Younger age, being a former smoker, respiratory symptoms, lower FEV 1 , COPD, and a family history of lung cancer were associated with higher perceived risk. Conversely, a consistent relationship between calculated risk and worry was not identified. There was a positive association between risk perception and lung cancer worry and reported intent to quit smoking.INTERPRETATION: Individuals' lung cancer risk perception correlated positively with calculated risk in a screening population. Promotion of screening programs may benefit from focusing on factors associated with higher risk perception; conversely, harnessing worry seemingly holds less value.

Improved motivation and readiness to quit shortly after lung cancer screening: Evidence for a teachable moment

“…The heightened emotional response observed, as exhibited by high lung cancer worry, was consistent with the teachable moment heuristic. This finding supports previous research regarding the immediate heightened emotional response that may be caused by undergoing cancer screening 35,36 …”

“…Regarding perceived risk, compared with individuals who reported lower perceived risk, those who reported the same risk as well as higher risk were less likely to be ready to quit in the next 30 days at the postscreening assessment. This finding was counter to the conceptual framework guiding this work, that higher perceived risk is associated with being more ready to quit smoking 8,9,36 . However, prior research supports the link between higher perceived risk and lower self‐efficacy to quit smoking 21,37 because individuals who smoke may have high perceived risk for lung cancer while also holding a negative attitude toward quitting.…”

“…This finding supports previous research regarding the immediate heightened emotional response that may be caused by undergoing cancer screening. 35,36 Regarding perceived risk, compared with individuals who reported lower perceived risk, those who reported the same risk as well as higher risk were less likely to be ready to quit in the next 30 days at the postscreening assessment. This finding was counter to the conceptual framework guiding this work, that higher perceived risk is associated with being more ready to quit smoking.…”

“…This finding was counter to the conceptual framework guiding this work, that higher perceived risk is associated with being more ready to quit smoking. 8,9,36 However, prior research supports the link between higher perceived risk and lower self-efficacy to quit smoking 21,37 because individuals who smoke may have high perceived risk for lung cancer while also holding a negative attitude toward quitting. These results suggest that, among individuals undergoing lung screening, efforts to increase perceived risk for lung cancer may be counterproductive in increasing readiness and motivation to quit.…”

Expression Status and Prognostic Value of m6A RNA Methylation Regulators in Lung Adenocarcinoma

“…Lung cancer is the leading cause of cancer-related deaths worldwide [ 1 ]. There are many risk factors for lung cancer, with smoking and environmental and occupational exposure as the most common risk factors [ 2 ]. In the past few decades, medical technology has made great progress, but the treatment effect for lung cancer patients is not ideal.…”