Shifting the Lens on Lung Cancer Screening Inequities
Menée aux Etats-Unis à partir notamment d'entretiens semi-structurés réalisés en ligne auprès de fumeurs ou anciens fumeurs âgés de 50 à 80 ans (âge moyen : 59,1 ans ; consommation tabagique : au moins 20 paquets par an), cette étude identifie les facteurs psychosociaux et environnementaux les influençant dans leur décision de participer à un dépistage du cancer du poumon
Disparities in lung cancer exist, with Black individuals in the US experiencing lung cancer disproportionately more compared with any other racial and ethnic group and having higher lung cancer incidence and mortality rates and lower survival rates compared with White individuals. Black individuals in the US have a poor prognosis, largely related to later stage at diagnosis, which is further worsened by the disparities seen in lung cancer screening. Over 14 million people in the US are eligible for lung cancer screening, and while screening uptake among eligible White individuals is a paltry 4.9%, it is even worse at 1.7% among eligible Black individuals. The study by Richmond and colleagues explored the decision to screen for lung cancer in the context of environmental and psychosocial factors, finding emergent themes that emphasized historical as well as present-day racism as a critical factor perpetuating medical mistrust and avoidance of cancer screening. At present, our understanding of the individual decision to screen or not for lung cancer has found that health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy) and psychosocial factors, such as stigma, medical mistrust, cancer fatalism, lung cancer worry, and lung cancer fear, are salient variables influencing lung cancer screening uptake. The study by Richmond et al offers a glimpse into the context of the sociocultural environment and its influences on critical factors that support why lung cancer screening inequities exist beyond an individual’s behavior.
JAMA Network Open , éditorial en libre accès, 2023