Attitudes and beliefs toward lung cancer screening among US Veterans

Lung cancer (LC) is the leading cause of cancer-related death for veterans cared for by the US Veterans Health Administration. The LC burden among veterans is almost double that of the general population. Before implementation of an LC screening program, we set out to assess the role of beliefs and attitudes toward LC screening among veterans.

Veterans presenting to the Ralph H. Johnson VA Medical Center were invited to complete a self-administered survey. The survey comprised questions about demographics, smoking status, health status, and knowledge about LC and willingness to be screened. Responses from veteran ever and never smokers were compared.

A total of 209 veterans completed the survey. Smokers were significantly (P < .05) more likely than never smokers to be less educated, have a lower income, and report poorer health. Smokers were more likely than never smokers to have two or more comorbidities, which trended toward significance (P = .062). Smokers were more likely to have been told by a physician that they were at high risk for LC and to believe that they were at risk. Nearly all veterans surveyed (92.8%) would have a CT scan for LC screening, and 92.4% would have surgery for a screen-detected LC.

Veterans are overwhelmingly willing to undergo screening for LC, and it seems that participation will not be a barrier to implementation of an LC screening program. The mortality benefit of LC screening, however, may not be generalizable to the veteran population because of a higher number of comorbid conditions.