A new survey has found that African-Americans are more likely than whites to hold mistaken and fatalistic beliefs about lung cancer, as well as being more reluctant to consult a doctor about possible symptoms of the disease, according to researchers from Dana-Farber Cancer Institute and their collaborators.
These attitudes among blacks may help explain the puzzling racial disparities in lung cancer treatment outcomes that have been documented over the past 25 years, and highlight the need for clearer, more direct public health messages directed at African-Americans, say the scientists.
Christopher Lathan, MD, MPH, an oncologist in the Division of Population Sciences at Dana-Farber, is the first author of the report in the journal Cancer. Senior author is Gary Bennett, PhD, of Duke University's Global Health Institute.
Both whites and blacks in the survey "grossly underestimated" the bleak outlook associated with a diagnosis of lung cancer - only 15 percent of patients survive for five years. Lung cancer is the most lethal cancer in the United States, and among people diagnosed with the disease, African-American men have the highest incidence and mortality. Blacks tend to be diagnosed later than whites, when the disease is more advanced.
Federal data quoted in the paper say that the 2001-2005 incidence rate of lung cancer for white men was 79.3 per 100,000 vs. 107.6 per 100,000 for African-American men, and the mortality rate for white men with lung cancer is 71.3 per 100,000 vs. 93.1 per 100,000 for African-American men. This survival gap was first detected in the early 1980s, and continues today.
Previous studies have suggested that the disparity may be due in part to differences in access to care, rates of surgery, and patient preferences, Lathan says. The current study was undertaken to find out "if African-Americans think about lung cancer in a different way," explains Lathan.
Using a random-digit phone dialing method, the investigators queried patients who had been participants in the National Cancer Institute's 2005 Health Information National Trends Survey (HINTS).
Both black and white respondents greatly overestimated the percentage of lung cancer patients who survive 5 years or longer - many said 50 percent when the true number is 15 percent.