Significantly fewer blacks than whites thought lung cancer is caused by behavior or lifestyle (P=0.013), and significantly more expected symptoms prior to diagnosis (P=0.004), Christopher S. Lathan, MD, of Dana Farber Cancer Institute in Boston, and colleagues reported online in Cancer.
"Given the presentation of lung cancer, these beliefs could have an effect on prevention messages, seeking appropriate medical care for symptoms, and the physician-patient interaction with regard to seeking and accepting treatment," the researchers wrote.
Lung cancer is the leading cause of cancer deaths in U.S., with only 15% of patients surviving five years after their initial diagnosis.
Also, there are growing disparities in outcomes between black and white patients, Lathan and colleagues said. Blacks have the highest incidence of and mortality from the disease, but are less likely to receive treatment.
Researchers have long wondered whether potential differences in perception among racial and ethnic groups might play a role in such disparities.
So they assessed data from the 2005 Health Information National Trends Survey of 1,530 cancer-free patients, conducted via telephone interview.
They found that all participants underestimated the lethality of lung cancer, and few considered themselves at high risk for getting the disease.
On the other hand, the majority believed lung cancer was preventable through behavior or lifestyle modifications.
There were no differences in opinions based on sex, but many answers differed by race, the researchers said.
For instance, blacks were more likely than whites to believe that there were too many recommendations for preventing lung cancer (53% versus 37%, P=0.02), and in multivariate analyses blacks were twice as likely as whites to believe this (OR 2.05, 95% CI 1.19 to 3.53).
Blacks were also more reluctant than whites to be evaluated for lung cancer (22% versus 9%), and were three times as likely to avoid being evaluated in multivariate analyses (OR 3.32, 95% CI 1.84 to 5.98).
"There is no known screening mechanism for lung cancer, but reluctance to seek a physician for fear of a diagnosis of cancer is a grave concern because black patients present with later stage disease," the researchers wrote.
Blacks were also more likely to expect symptoms prior to diagnosis (51% versus 32%, P=0.004) and significantly less likely to believe that lung cancer is linked with behavior or lifestyle factors (73% versus 85%, P=0.013).
These findings suggest that beliefs may affect prevention and treatment of the disease, the researchers said.
"If patients doubt the link between smoking and lung cancer, then this may translate into difficulty with smoking cessation," they wrote. "If patients are reluctant to go to the physician for fear of diagnosing the disease, then this could lead to difficulty in accepting care for the disease."
The results also suggest that healthcare professionals need to do a better job of communicating information about lung cancer, they added.
The researchers noted that the study was limited by a relatively low response rate, and was skewed toward a higher income than expected.
Still, they wrote, "further efforts should involve discussion of the role of lung cancer in all communities, including communities of color, and addressing the knowledge gap."
Lathan is supported by grants from the National Cancer Institute.
- Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner