Understanding why lung cancer strikes African-Americans more than Caucasians

African Americans have a higher mortality rate from lung cancer than caucasians, a fact first discovered in the early 1980s. For decades, researchers have looked for differences in access to care, rates of surgery, and patient preferences to explain the disparity. Now it seems the answer may relate at least partly to the way African Americans think about lung cancer, according to a survey conducted by the Dana-Farber Cancer Institute.

Among the findings was that African Americans are more likely than whites, 53% vs 37%, to say they are confused by too many recommendations on how to prevent lung cancer.

“This is shocking,” says Dr. Christopher Lathan, an oncologist in the Dana-Farber division of population sciences and member of the research team. “There is only one recommendation to decrease the chance of getting lung cancer: stop smoking and avoid tobacco smoke.”

Lathan and colleagues surveyed 1530 individuals who had participated in the National Cancer Institute’s 2005 Health Information National Trends Survey. They uncovered several striking differences in the way blacks and whites view lung cancer.

When asked whether lung cancer is caused by lifestyle and behavior, 73% of blacks agreed compared with 85% of whites. When asked if they would be reluctant to be checked for lung cancer symptoms out of fear of receiving bad news, 22% of blacks said yes versus 9% of whites. Additionally, 51% of African Americans believed they would have symptoms before a diagnosis of lung cancer compared with 32% of whites.

While misperceptions may not be the only reason for differences in mortality between African Americans and whites, they could play a role, Lathan said.

“We really need to target lung cancer education to communities of color,” he said. “And we need to deliver really clear messages: Stop smoking if you want to prevent lung cancer. You should go to see your doctor.”

Prevention is the key, Lathan said. To drive home the point, the medical community must make it clear that lung cancer is deadly, “more deadly than breast, prostate, and colon cancer combined,” he said, a point that neither whites nor blacks adequately appreciate. Many of those surveyed, regardless of race, said they believed 50% of lung cancer patients survive five years or longer with treatment. The true percentage is 15%.