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Thorax 62:126-130 doi:10.1136/thx.2005.056036
  • Lung cancer

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

  1. Gerard A Silvestri1,
  2. Paul J Nietert2,
  3. James Zoller3,
  4. Cindy Carter4,
  5. David Bradford3
  1. 1Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
  2. 2Departments of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, South Carolina, USA
  3. 3Departments of Health Administration and Policy, Medical University of South Carolina, Charleston, South Carolina, USA
  4. 4Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina, USA
  1. 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
  • Received 18 November 2005
  • Accepted 29 September 2006
  • Published Online First 13 November 2006

Abstract

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.

Footnotes

  • Published Online First 13 November 2006

  • Funding: This work was supported by a grant from the Department of Defense.

  • Competing interests: None.