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Demographic, Social, and Behavioral Determinants of Lung Cancer Perceived Risk and Worries in a National Sample of American Adults; Does Lung Cancer Risk Matter?

1
Department of Radiology, Duke University Medical Center, Durham, NC 27705, USA
2
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205 USA
3
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48104, USA
4
Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Medicina 2018, 54(6), 97; https://doi.org/10.3390/medicina54060097
Received: 3 August 2018 / Revised: 20 November 2018 / Accepted: 29 November 2018 / Published: 3 December 2018
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Abstract

Background: Perceived risk and worries of developing cancer are important constructs for cancer prevention. Many studies have investigated the relationship between health behaviors and subjective risk perception. However, factors correlated with lung cancer risk perception and worries in individuals more susceptible to lung cancer have rarely been investigated. Objective: To determine demographic, social, and behavioral determinants of cancer perceived risk and worries and to explore heterogeneities in these associations by the level of lung cancer risk in a nationally representative sample of American adults. Methods: For this cross-sectional study, data came from the Health Information National Trends Survey (HINTS) 2017, which included a 2277 representative sample of American adults. Smoking status, cancer perceived risk, cancer worries, age, gender, race, education, income, and insurance status were measured. We ran structural equation models (SEMs) for data analysis. Results: “Ever smoker” status was associated with higher cancer perceived risk (b = 0.25; 95% CI = 0.05–0.44, p = 0.013) and worries (b = 0.34, 95% CI = 0.18–0.50, p < 0.001), suggesting that “ever smokers” experience higher levels of cancer perceived risk and worries regarding cancer, compared to “never smokers”. Other factors that correlate with cancer perceived risk and worries were race, age, income, and insurance status. Blacks demonstrated less cancer perceived risk and worry (b = −0.98, 95% CI = −1.37–0.60, p < 0.001) in both low and high risk lung cancer groups. However, the effects of social determinants (income and insurance status) and age were observed in low but not high risk group. Conclusions: Determinants of cancer perceived risk and worries vary in individuals depending on the level of lung cancer risk. These differences should be considered in clinical practice and policy makings with the goal of improving participation rates in lung cancer screening programs. View Full-Text
Keywords: perceived risk; worries; lung cancer screening; Health Information National Trends Survey (HINTS) perceived risk; worries; lung cancer screening; Health Information National Trends Survey (HINTS)
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Chalian, H.; Khoshpouri, P.; Assari, S. Demographic, Social, and Behavioral Determinants of Lung Cancer Perceived Risk and Worries in a National Sample of American Adults; Does Lung Cancer Risk Matter? Medicina 2018, 54, 97.

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