LUNG CANCER

Attitudes towards screening for lung cancer among smokers and their non-smoking counterparts

Gerard A Silvestri¹, Paul J Nietert², James Zoller³, Cindy Carter⁴, David Bradford³

¹ Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
² Departments of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA
³ Departments of Health Administration and Policy, Medical University of South Carolina, Charleston, South Carolina, USA
⁴ Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA

Correspondence to:
Dr G A Silvestri
Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, PO Box 250630, Charleston, SC, USA; silvestri{at}musc.edu

Background: There has been resurgence of interest in lung cancer screening using low-dose computed tomography. The implications of directing a screening programme at smokers has been little explored.

Methods: A nationwide telephone survey was conducted. Demographics, certain clinical characteristics and attitudes about screening for lung cancer were ascertained. Responses of current, former and never smokers were compared.

Results: 2001 people from the US were interviewed. Smokers were significantly (p<0.05) more likely than never smokers to be male, non-white, less educated, and to report poor health status or having had cancer, and less likely to be able to identify a usual source of healthcare. Compared with never smokers, current smokers were less likely to believe that early detection would result in a good chance of survival (p<0.05). Smokers were less likely to be willing to consider computed tomography screening for lung cancer (71.2% (current smokers) v 87.6% (never smokers) odds ratio (OR) 0.48; 95% confidence interval (CI) 0.32 to 0.71). More never smokers as opposed to current smokers believed that the risk of disease (88% v 56%) and the accuracy of the test (92% v 71%) were important determinants in deciding whether to be screened (p<0.05). Only half of the current smokers would opt for surgery for a screen-diagnosed cancer.

Conclusion: The findings suggest that there may be substantial obstacles to the successful implementation of a mass-screening programme for lung cancer that will target cigarette smokers.

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