Willingness for Lung Cancer Screening: Disparities Among Informed, Screening-Eligible Individuals

Lung cancer is the leading cause of cancer-related death. Although lung cancer screening has been shown to reduce mortality, only a small fraction of eligible people receive screening. This study briefly educated screening-eligible individuals about lung cancer risk, prevention, and screening recommendations. We then evaluated race and gender as predictors of willingness to be screened once participants were educated.

An online lung cancer screening learning module was created and distributed to convenience samples of screening-eligible White Americans (n = 173) and Black Americans (n = 52) between November 2022 and February 2023. Participants viewed short modules about lung cancer risks and screening. Thereafter, participants rated their willingness to consider future screening using theory of planned behavior measurement frameworks (attitudes, norms, perceived control, and intentions to screen), with higher scores indicating greater willingness. Participant demographics were recorded.

Black Americans reported higher perceived control over obtaining screening than White Americans (t ₂₂₃ = -3.10; P < .001; d = 1.28). We observed no other racial differences in willingness as Black Americans and White Americans reported similar attitudes, normative beliefs, and intentions. Women also showed more positive attitudes and greater intention to be screened than men did (t ₂₂₃ = -2.42; P = .02; d = 1.66).

Once informed about lung cancer risks, prevention, and screening recommendations, Black Americans may be as willing as White Americans to undergo screening, highlighting potential causal factors other than willingness for existing racial disparities in lung cancer screening uptake. Gender differences in willingness highlight a potential need for gender-targeted outreach and communication.