Perspectives of African Americans on lung cancer: a qualitative analysis

Oncologist. 2015 Apr;20(4):393-9. doi: 10.1634/theoncologist.2014-0399. Epub 2015 Mar 20.

Abstract

Background: Disparities in incidence and mortality for lung cancer in African Americans are well documented; however, the extent to which disparities reflect differences in patient perceptions of tobacco and lung cancer treatment is unclear. The objective of this study was to explore African Americans' knowledge of lung cancer, perceived risk, interest in smoking cessation, attitudes toward lung cancer treatment, and lung cancer diagnosis and treatment experiences.

Patients and methods: The cohort comprised 32 African-American current and former smokers without a cancer diagnosis who participated in focus groups and 10 African Americans with lung cancer who participated in in-depth interviews. Transcripts were analyzed using a modified grounded theory approach.

Results: Participants without a cancer diagnosis were aware of the link between smoking and lung cancer, the common symptoms of the disease, and its poor prognosis. They desired specific, personalized smoking-cessation information. If diagnosed, the majority reported, they would seek medical care. Most believed that insurance and socioeconomic factors were more likely to affect treatment access than racial discrimination. Participants with a cancer diagnosis were also aware of the relationship between smoking and lung cancer. They felt their treatment plans were appropriate and trusted their physicians. Most did not believe that race affected their care.

Conclusion: This qualitative study suggests that African-American smokers are aware of the relationship between smoking and lung cancer and are interested in smoking-cessation treatment. These data also indicate that lung cancer disparities are unlikely to be associated with differential willingness to receive care but that African Americans may perceive financial and insurance barriers to lung cancer treatment.

Keywords: Black; Healthcare disparities; Lung neoplasms; Qualitative research; Smoking cessation.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Attitude to Health*
  • Black or African American*
  • Cohort Studies
  • Female
  • Healthcare Disparities
  • Humans
  • Lung Neoplasms / etiology*
  • Lung Neoplasms / psychology
  • Lung Neoplasms / therapy
  • Male
  • Massachusetts
  • Middle Aged
  • Risk Factors
  • Smoking / adverse effects
  • Smoking Cessation
  • Socioeconomic Factors