Evaluating beliefs associated with late-stage lung cancer presentation in minorities

Cara Bergamo, Jenny J. Lin, Cardinale Smith, Linda Lurslurchachai, Ethan A. Halm, Charles A. Powell, Andrew Berman, John S. Schicchi, Steven M. Keller, Howard Leventhal, Juan P. Wisnivesky

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Abstract

INTRODUCTION: Minority patients in the United States present with later stages of lung cancer and have poorer outcomes. Cultural factors, such as beliefs regarding lung cancer and discrimination experiences, may underlie this disparity. METHODS: Patients with a new diagnosis of lung cancer were recruited from four medical centers in New York City. A survey, using validated items, was conducted on the minority (black and Hispanic) and nonminority patients about their beliefs regarding lung cancer, fatalism, and medical mistrust. Univariate and logistic regression analyses were used to compare beliefs among minorities and nonminorities and to assess the association of these factors with late-stage (III and IV) presentation. RESULTS: Of the 357 lung cancer patients, 40% were black or Hispanic. Minorities were more likely to be diagnosed with advanced-stage lung cancer (53% versus 38%, p = 0.01). Although beliefs about lung cancer etiology, symptoms, and treatment were similar between groups (p > 0.05), fatalistic views and medical mistrust were more common among minorities and among late-stage lung cancer patients (p < 0.05, for all comparisons). Adjusting for age, sex, education, and insurance, minorities had increased odds of advanced-stage lung cancer (odds ratio: 1.79; 95% confidence interval, 1.04-3.08). After controlling for fatalism and medical mistrust, the association between minority status and advanced stage at diagnosis was attenuated and no longer statistically significant (odds ratio: 1.56; 95% confidence interval, 0.84-2.87). CONCLUSIONS: Fatalism and medical mistrust are more common among minorities and may partially explain the disparities in cancer stage at diagnosis. Addressing these factors may contribute to reducing disparities in lung cancer diagnosis and outcomes.

Original languageEnglish (US)
Pages (from-to)12-18
Number of pages7
JournalJournal of Thoracic Oncology
Volume8
Issue number1
DOIs
StatePublished - Jan 2013

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Lung Neoplasms
Hispanic Americans
Odds Ratio
Confidence Intervals
Sex Education
Insurance
Logistic Models
Regression Analysis

Keywords

  • Cultural differences
  • Health disparities
  • Lung cancer
  • Race and ethnicity

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Bergamo, C., Lin, J. J., Smith, C., Lurslurchachai, L., Halm, E. A., Powell, C. A., ... Wisnivesky, J. P. (2013). Evaluating beliefs associated with late-stage lung cancer presentation in minorities. Journal of Thoracic Oncology, 8(1), 12-18. https://doi.org/10.1097/JTO.0b013e3182762ce4

Evaluating beliefs associated with late-stage lung cancer presentation in minorities. / Bergamo, Cara; Lin, Jenny J.; Smith, Cardinale; Lurslurchachai, Linda; Halm, Ethan A.; Powell, Charles A.; Berman, Andrew; Schicchi, John S.; Keller, Steven M.; Leventhal, Howard; Wisnivesky, Juan P.

In: Journal of Thoracic Oncology, Vol. 8, No. 1, 01.2013, p. 12-18.

Research output: Contribution to journalArticle

Bergamo, C, Lin, JJ, Smith, C, Lurslurchachai, L, Halm, EA, Powell, CA, Berman, A, Schicchi, JS, Keller, SM, Leventhal, H & Wisnivesky, JP 2013, 'Evaluating beliefs associated with late-stage lung cancer presentation in minorities', Journal of Thoracic Oncology, vol. 8, no. 1, pp. 12-18. https://doi.org/10.1097/JTO.0b013e3182762ce4
Bergamo, Cara ; Lin, Jenny J. ; Smith, Cardinale ; Lurslurchachai, Linda ; Halm, Ethan A. ; Powell, Charles A. ; Berman, Andrew ; Schicchi, John S. ; Keller, Steven M. ; Leventhal, Howard ; Wisnivesky, Juan P. / Evaluating beliefs associated with late-stage lung cancer presentation in minorities. In: Journal of Thoracic Oncology. 2013 ; Vol. 8, No. 1. pp. 12-18.
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N2 - INTRODUCTION: Minority patients in the United States present with later stages of lung cancer and have poorer outcomes. Cultural factors, such as beliefs regarding lung cancer and discrimination experiences, may underlie this disparity. METHODS: Patients with a new diagnosis of lung cancer were recruited from four medical centers in New York City. A survey, using validated items, was conducted on the minority (black and Hispanic) and nonminority patients about their beliefs regarding lung cancer, fatalism, and medical mistrust. Univariate and logistic regression analyses were used to compare beliefs among minorities and nonminorities and to assess the association of these factors with late-stage (III and IV) presentation. RESULTS: Of the 357 lung cancer patients, 40% were black or Hispanic. Minorities were more likely to be diagnosed with advanced-stage lung cancer (53% versus 38%, p = 0.01). Although beliefs about lung cancer etiology, symptoms, and treatment were similar between groups (p > 0.05), fatalistic views and medical mistrust were more common among minorities and among late-stage lung cancer patients (p < 0.05, for all comparisons). Adjusting for age, sex, education, and insurance, minorities had increased odds of advanced-stage lung cancer (odds ratio: 1.79; 95% confidence interval, 1.04-3.08). After controlling for fatalism and medical mistrust, the association between minority status and advanced stage at diagnosis was attenuated and no longer statistically significant (odds ratio: 1.56; 95% confidence interval, 0.84-2.87). CONCLUSIONS: Fatalism and medical mistrust are more common among minorities and may partially explain the disparities in cancer stage at diagnosis. Addressing these factors may contribute to reducing disparities in lung cancer diagnosis and outcomes.

AB - INTRODUCTION: Minority patients in the United States present with later stages of lung cancer and have poorer outcomes. Cultural factors, such as beliefs regarding lung cancer and discrimination experiences, may underlie this disparity. METHODS: Patients with a new diagnosis of lung cancer were recruited from four medical centers in New York City. A survey, using validated items, was conducted on the minority (black and Hispanic) and nonminority patients about their beliefs regarding lung cancer, fatalism, and medical mistrust. Univariate and logistic regression analyses were used to compare beliefs among minorities and nonminorities and to assess the association of these factors with late-stage (III and IV) presentation. RESULTS: Of the 357 lung cancer patients, 40% were black or Hispanic. Minorities were more likely to be diagnosed with advanced-stage lung cancer (53% versus 38%, p = 0.01). Although beliefs about lung cancer etiology, symptoms, and treatment were similar between groups (p > 0.05), fatalistic views and medical mistrust were more common among minorities and among late-stage lung cancer patients (p < 0.05, for all comparisons). Adjusting for age, sex, education, and insurance, minorities had increased odds of advanced-stage lung cancer (odds ratio: 1.79; 95% confidence interval, 1.04-3.08). After controlling for fatalism and medical mistrust, the association between minority status and advanced stage at diagnosis was attenuated and no longer statistically significant (odds ratio: 1.56; 95% confidence interval, 0.84-2.87). CONCLUSIONS: Fatalism and medical mistrust are more common among minorities and may partially explain the disparities in cancer stage at diagnosis. Addressing these factors may contribute to reducing disparities in lung cancer diagnosis and outcomes.

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