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Racial disparities in lung cancer -- could attitudes be at play?

African-Americans have the highest incidence and death rates for lung cancer. As with many puzzling racial disparities in health, researchers don't know for sure why blacks are more likely than other racial groups to suffer from the disease. But a new study suggests blacks may hold mistaken and fatalistic perceptions toward lung cancer treatment which, coupled with a reluctance to visit the doctor, could attribute to the disparity.

Researchers at the Dana-Farber Cancer Institute in Boston wondered if perception of lung cancer among different races could explain some of the disparity. The study, appearing today CANCER, the journal of the American Cancer Society, surveyed 1,530 people from a National Cancer Institute 2005 study.

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Both blacks and whites underestimated how lethal lung cancer is, with many saying that the percentage of people who survive lung cancer past 5 years is 50 percent, when the actual figure is 15 percent. Lung cancer is the leading cause of cancer deaths in the U.S., killing 162,000 people each year.

But on other issues, blacks and whites had very different views. African-Americans were more likely than whites (53 percent vs. 37 percent) to say they were confused by too many recommendations on how to prevent lung cancer. Blacks were also less likely than whites to say the disease caused by lifestyle (i.e. smoking) --73 percent of blacks vs. 85 percent of whites.

And here's where it gets interesting: 22 percent of blacks said they would be reluctant to be checked for lung cancer symptoms because they're scared of getting a bad prognosis. That figure was just 9 percent for whites.

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The bottom line: these beliefs could be interfering with blacks' ability to prevent the disease and get prompt treatment, researchers said. And for that reason, the medical community must do a better job getting education and treatment messages out in black communities, they said.

“We really need to target out lung cancer education to communities of color,” said Dr. Christopher Lathan, the study's lead author in a statement. “And we need to deliver really clear messages: Stop smoking if you want to prevent lung cancer. You should go to see your doctor. And we should let people known that lung cancer is deadly – more deadly than breast, prostate and colon cancer combined."

Now, a few caveats: The study is based on just a small survey of people -- so how representative can it be of a race of people you might ask? Good question. We have the same reservations.

Researchers acknowledge that this is just one study of the issue and cannot alone explain the complexities of racial disparities. There are, of course, a host of other factors likely at play in racial health disparities, from patients lacking insurance to possible genetic differences to doctors' attitudes in treating patients.

Still, the take home message of better outreach to minority communities is needed, researchers said. 

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