Understanding the decision to screen for lung cancer or not: A qualitative analysis

Claire Burke Draucker, Susan M. Rawl, Emilee Vode, Lisa Carter-Harris

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Although new screening programmes with low-dose computed tomography (LDCT) for lung cancer have been implemented throughout the United States, screening uptake remains low and screening-eligible persons' decisions to screen or not remain poorly understood. Objective: To describe how current and former long-term smokers explain their decisions regarding participation in lung cancer screening. Design: Phone interviews using a semi-structured interview guide were conducted to ask screening-eligible persons to describe their decisions regarding screening with LDCT. The interviews were transcribed and analysed with conventional content analytic techniques. Setting and participants: A subsample of 40 participants (20 who had screened and 20 who had not) were drawn from the sample of a survey study whose participants were recruited by Facebook targeted advertisements. Results: The sample was divided into the following five groups based on their decisions regarding lung cancer screening participation: Group 1: no intention to be screened, Group 2: no deliberate consideration but somewhat open to being screened, Group 3: deliberate consideration but no definitive decision to be screened, Group 4: intention to be screened and Group 5: had been screened. Reasons for screening participation decisions are described for each group. Across groups, data revealed that screening-eligible persons have a number of misconceptions regarding LDCT, including that a scan is needed only if one is symptomatic or has not had a chest x-ray. A physician recommendation was a key influence on decisions to screen. Discussion and conclusions: Education initiatives aimed at providers and long-term smokers regarding LDCT is needed. Quality patient/provider communication is most likely to improve screening rates.

Original languageEnglish (US)
Pages (from-to)1314-1321
Number of pages8
JournalHealth Expectations
Issue number6
StatePublished - Dec 1 2019


  • behaviour
  • long-term smokers
  • lung cancer screening
  • qualitative

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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