Challenges to Educating Smokers About Lung Cancer Screening: a Qualitative Study of Decision Making Experiences in Primary Care

Journal of Cancer Education : the Official Journal of the American Association for Cancer Education
Preston A GreeneSteven B Zeliadt

Abstract

We sought to qualitatively explore how those at highest risk for lung cancer, current smokers, experienced, understood, and made decisions about participation in lung cancer screening (LCS) after being offered in the target setting for implementation, routine primary care visits. Thirty-seven current smokers were identified within 4 weeks of being offered LCS at seven sites participating in the Veterans Health Administration Clinical Demonstration Project and interviewed via telephone using semi-structured qualitative interviews. Transcripts were coded by two raters and analyzed thematically using iterative inductive content analysis. Five challenges to smokers' decision-making lead to overestimated benefits and minimized risks of LCS: fear of lung cancer fixated focus on inflated screening benefits; shame, regret, and low self-esteem stemming from continued smoking situated screening as less averse and more beneficial; screening was mistakenly believed to provide general evaluation of lungs and reassurance was sought about potential damage caused by smoking; decision-making was deferred to providers; and indifference about numerical educational information that was poorly understood. Biased understanding of risks and benefits ...Continue Reading

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Citations

Jan 10, 2020·Journal of Cancer Education : the Official Journal of the American Association for Cancer Education·Randi M WilliamsCheryl L Knott
Sep 18, 2020·American Journal of Men's Health·Karriem S WatsonPhoenix Matthews
Dec 24, 2020·Western Journal of Nursing Research·Elizabeth KinchenDavid Newman

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