Racial and ethnic differences in beliefs about lung cancer care.
BACKGROUND
Disparities in lung cancer treatment and palliative care are well documented. However,the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer.


METHODS
Patients were recruited from four medical centers in New York City and surveyed about their beliefs regarding lung cancer care, including disease-directed treatments, palliative and end-of-life care, and fatalistic and spiritual beliefs. We used univariate and multiple regression analyses to compare the distribution of beliefs among minority (black and Hispanic) and nonminority patients.


RESULTS
Of the 335 patients, 21% were black, 20% were Hispanic, and 59% were nonminority. Beliefs about chemotherapy and radiotherapy were similar across the three groups ( P > .05),whereas black patients were more likely to believe that surgery might cause lung cancer to spread( P =.008). Fatalistic beliefs potentially affecting cancer treatment were more common among both minority groups ( P ≤ .02). No signifi cant differences were found in attitudes toward clinician communication about cancer prognosis ( P > .05). However, both blacks and Hispanics were more likely to have misconceptions about advance directives and hospice care ( P ≤ .02).


CONCLUSIONS
Similarities and differences in beliefs about disease-directed treatment were observed between minority and nonminority patients with lung cancer. Minority patients hold more fatalistic views about the disease and misperceptions about advance care planning and hospice care. Further research is needed to assess the impact of these beliefs on decisions about lung cancer care and patient outcomes.
University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway, NJ.
Sirisha
S
Jonnalagadda
Division of General Internal Medicine, New York, NY.
Jenny J
JJ
Lin
Division of Pulmonary, Critical Care and Sleep Medicine, New York, NY; Hertzberg Palliative Care Institute, Brookdale Department of Geriatrics and Palliative Medicine, The Mount Sinai Hospital, New York, NY.
Judith E
JE
Nelson
Division of Pulmonary, Critical Care and Sleep Medicine, New York, NY.
Charles A
CA
Powell
Division of Pulmonary and Critical Care Medicine, Columbia University, New York, NY.
John
J
Salazar-Schicchi
Division of Pulmonary and Critical Care Medicine, University of Medicine and Dentistry of New Jersey, Newark, NJ.
Andrew R
AR
Berman
Department of Thoracic Surgery, Albert Einstein College of Medicine, Bronx, NY.
Steven M
SM
Keller
Division of Hematology and Oncology, Mount Sinai School of Medicine, New York, NY; Hertzberg Palliative Care Institute, Brookdale Department of Geriatrics and Palliative Medicine, The Mount Sinai Hospital, New York, NY.
Cardinale B
CB
Smith
Division of General Internal Medicine, New York, NY.
Linda
L
Lurslurchachai
Department of Medicine, University of Texas Southwestern, Dallas, TX.
Ethan A
EA
Halm
Department of Psychology, Rutgers University, New Brunswick, NJ.
Howard
H
Leventhal
Division of General Internal Medicine, New York, NY; Division of Pulmonary, Critical Care and Sleep Medicine, New York, NY. Electronic address: juan.wisnivesky@mssm.edu.
Juan P
JP
Wisnivesky
D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000704:Analysis of Variance; D001293:Attitude to Death / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D016009:Chi-Square Distribution; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008962:Models, Theoretical; D009519:New York City; D010166:Palliative Care; D012042:Registries; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D044465:White People / Q000523:psychology*