Understanding the Attitudes and Perceptions Towards Lung Cancer Screening Amongst United States Veterans: A Qualitative Study

Introduction: Lung cancer is the leading cause of cancer mortality in the United States, with this rate disproportionately affecting the veteran population. Despite USPSTF recommendations, screening rates are low and underutilized. The purpose of this study is to understand veterans’ knowledge, attitudes and beliefs surrounding lung cancer and lung cancer screening to better address barriers to screening. Methods: Five interviews were conducted with veteran community members, and three were conducted with key informants for a current total of eight interviews. Key informants included Philadelphia community leaders who work with veterans. Interviews explored lung cancer screening knowledge, motivating factors and barriers to care, tobacco use, and potential educational strategies. Interviews were transcribed and coded through NVivo Pro 12 for direct content analysis. Results: Analysis revealed a lack of knowledge and awareness surrounding lung cancer screening amongst veterans. Cancer screening beliefs echoed themes of fatalism and personal experience. Multiple barriers to care were identified, including lack of concern, fear, and patient navigation. Despite these barriers, interviewees believed that screening is necessary. Smoking is highly prevalent in this community due to social, cultural, and habitual factors. Potential educational strategies include group classes with both medical providers and lung cancer survivors. Conclusion: This study provides insight into understanding veterans’ knowledge and beliefs surrounding lung cancer screening. Understanding these values are important in addressing barriers to care and reducing the disproportionate lung cancer burden. In the future, this knowledge can be utilized to facilitate the development of culturally and linguistically appropriate educational programs and materials