When someone is diagnosed with lung cancer, a common question many people have is, “did he or she smoke?” The implication is that lung cancer is a self-imposed illness, as opposed to the other cancers that may occur randomly or to people who are at high risk.
Some people say that it’s only reasonable to assume that someone with lung cancer may have smoked or has been a smoker at some point, because the illness is often smoking-related. It’s believed that more than 80% of lung cancer deaths are due to smoking. But does this automatic assumption come at a price? Are patients with lung cancer stigmatized? Could they be receiving a different—albeit subconscious—level of care compared to someone with breast cancer, for example? The authors of a study recently published in PLOS One think so.
The study, which evaluated explicit attitudes regarding both lung and breast cancer, included 1,778 participants (1,051 completed the entire process):
- Cancer patients: 243,
- Caregivers: 677,
- Healthcare providers: 142, and
- Members of the otherwise general public: 716.
The participants judged themselves as either being very knowledgeable, somewhat knowledgeable, or not at all knowledgeable about cancer. They also rated their agreement or disagreement with statements, such as:
- “Cancer is always fatal,”
- “Cancer is contagious,”
- “Lung cancer is always caused by smoking,”
- “Cancer medicines can help people live longer,” and
- “Early diagnosis can help people live longer.”
The results showed that more participants agreed more strongly with the negative statements when they were associated with lung cancer than with breast cancer. “Patients, caregivers, healthcare providers, and members of the general public had comparable levels of negative implicit attitudes toward lung cancer,” the authors wrote. “These results show that lung cancer was stigmatized by patients, caregivers, healthcare professionals, and the general public. Further research is needed to investigate whether implicit and explicit attitudes and stereotypes affect patient care.”
This is not the first study to look at the implications of lung cancer, quality of care, and quality of life (QOL). In one such study from 2014, researchers from the University of San Francisco studied the connection between the stigma of lung cancer and its relationship to QOL among 149 women who had been diagnosed with lung cancer. Only one had never smoked, the others were current or former smokers. The results showed that the majority of women showed a strong, negative relationship between QOL and anxiety, depression, and lung cancer stigma.
An opinion piece, published in The Lancet last year, also addressed this issue. The author wrote about a new lung cancer awareness campaign launched on August 1, 2015, called, “Honor, Unite, Inspire.” The campaign was developed to improve awareness of symptoms, screening options, and lesser-known risk factors for lung cancer. Importantly, the goal is to also increase awareness of nonsmoking causes of the disease.
“The public is not aware of the extent of non-smoking lung cancer, which represent the sixth leading cause of cancer deaths,” said Jennifer King, Lung Cancer Alliance, Washington, DC. “Up to 20% of lung cancers occur among never-smokers, a group defined as people who have smoked fewer than 100 cigarettes. A large population of young women with lung cancer are in the never-smoker group.”
The authors of the PLOS One article stressed that more research is needed so that we can better understand the attitudes and stereotypes associated with lung cancer and how they may affect patients as they undergo treatment.