title: Racial differences pertaining to a belief about lung cancer surgery: results of a multicenter survey.
abstract: BACKGROUND
  Patients at the Philadelphia Veterans Affairs Medical Center frequently voice concern that air exposure during lung cancer surgery might cause tumor spread. Several African-American patients asserted that this belief was common in the African-American community.
  
  
  OBJECTIVE
  To assess the prevalence of the belief that air exposure during lung cancer surgery might cause tumor spread and gauge the influence of this belief on the willingness of African-American and white patients to have lung cancer surgery.
  
  
  METHODS
  Prospective questionnaire survey.
  
  
  METHODS
  Philadelphia Veterans Affairs Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania; Los Angeles Veterans Affairs Medical Center, Los Angeles, California; and Medical University of South Carolina, Charleston, South Carolina.
  
  
  METHODS
  626 consecutive patients in pulmonary and lung cancer clinics.
  
  
  METHODS
  None.
  
  
  RESULTS
  38% of patients (61% of whom were African American and 29% of whom were white) stated that they believe air exposure at surgery causes tumor spread. The most significant predictor of belief was African-American race (odds ratio, 3.5 [95% CI, 1.9 to 6.5]), even after controlling for other relevant variables in a multivariable analysis. Nineteen percent of African Americans stated that this belief was a reason for opposing surgery, and 14% would not accept their physicians' assertion that the belief is false. These rates were also statistically significantly higher among African-American than white patients.
  
  
  CONCLUSIONS
  Belief in accelerated tumor spread at surgery is prevalent among general pulmonary outpatients and lung cancer clinic patients facing lung surgery, particularly among African-American patients. Our findings may pertain to key racial disparities in lung cancer surgery and survival rates and suggest that culturally sensitive physician training or outreach programs directed at disparate beliefs and attitudes may help to address racial discrepancies in health care outcomes.
authors.affiliation: University of Pennsylvania and Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Mitchell L
authors.initials: ML
authors.lastname: Margolis
authors.forename: Jason D
authors.initials: JD
authors.lastname: Christie
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Silvestri
authors.forename: Larry
authors.initials: L
authors.lastname: Kaiser
authors.forename: Silverio
authors.initials: S
authors.lastname: Santiago
authors.forename: John
authors.initials: J
authors.lastname: Hansen-Flaschen
mesh_terms: D001741:Black or African American; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People