Lung Cancer Screening: Do Individual Health Beliefs Matter? Lisa Carter-Harris, PhD, RN, ANP-C1, James E. Slaven II, MS, MA2, Patrick O. Monahan, PhD2, & Susan M. Rawl, PhD, RN, FAAN1 1Indiana University School of Nursing, Indianapolis, IN 2Indiana University School of Medicine, Department of Biostatistics, Indianapolis, IN Background Results Results Lung cancer kills more people worldwide than any other cancer. Most die because they are diagnosed advanced with a 1% 5-year relative survival rate. Lung cancer screening with low-dose computed tomography is a recent USPSTF recommendation for high-risk smokers. New screening programs are being implemented, but factors that influence lung cancer screening participation in this population are unknown. Health beliefs (perceived risk, perceived benefits, perceived barriers, and self-efficacy) have predicted cancer screening participation in other types of cancer, and may be predictive of lung cancer screening. Table 1. Participant Sociodemographics Overall (N=496) Mean (SD) Stages 1-4 (n=350) Stages 5-7 (n=146) Age 62.8 (5.8) 62.8 (6.1) 62.7 (5.2) Pack-Years 50.5 (23.6) 49.9 (22.0) 52.1 (27.1) N (%) n (%) Education: Less than High School 20 ( 4.0) 17 ( 4.9) 3 ( 2.1) High School Graduate 135 (27.3) 101 (28.9) 34 (23.5) Some College 208 (42.0) 154 (44.0) 54 (37.2) College Graduate 132 (26.7) 78 (22.3) Race: White 384 (77.7) 272 (78.2) 112 (76.7) Black 103 (20.8) 72 (20.7) 31 (21.2) Gender: Male 191 (38.6) 127 (36.4) 64 (43.8) Female 305 (61.5) 223 (63.7) 82 (56.2) Income: Less than $25K 155 (31.5) 119 (34.3) 36 (24.8) $25K to $50K 227 (46.1) 161 (46.4) 66 (45.5) Greater than $50K 110 (22.4) 67 (19.3) 43 (29.7) Insurance Status: Government-Sponsored 283 (57.2) 202 (57.7) 81 (55.9) Private 192 (38.8) 134 (38.3) 58 (40.0) Uninsured 14 ( 4.0) 6 ( 4.1) Smoking Status: Current Smoker 238 (48.5) 171 (49.3) 67 (46.5) Former Smoker 254 (51.2) 179 (51.1) 79 (54.1)   Bivariable Model Multivariable Model Perceived Risk 1.01 (0.92, 1.11); p=0.8423 0.98 (0.89, 1.08); p=0.7706 Perceived Benefits 1.08 (1.03, 1.13); p=0.0018 1.07 (1.01, 1.13); p=0.0160 Perceived Barriers 0.98 (0.96, 0.99); p=0.0277 0.98 (0.96, 1.01); p=0.1201 Self-Efficacy 1.05 (1.02, 1.09); p=0.0034 1.03 (0.99, 1.08); p=0.1171 Outcomes are odds ratios (95% confidence intervals) for the odds of being in the Stage 5-7 group with p-value from logistic regression model. Bivariable models are with only one predictor on the stage outcome variable. Multivariable model uses all four predictors at once on the stage outcome. Conclusions Purpose Health beliefs have predicted cancer screening participation in other cancers like breast and colorectal cancer screening. Results from this study support the importance of health belief model variables in the context of lung cancer screening in current and former long-term smokers. Individuals who have an increased level of perceived benefit of and self-efficacy for lung cancer screening and decreased perceived barriers to lung cancer screening are more likely to screen for lung cancer. Research is needed to explore these relationships more fully and to test the pathways in the conceptual model for lung cancer screening participation. Identification of long-term current and former smokers who are more likely to screen for lung cancer will be useful for investigators interested in developing and testing interventions addressing health beliefs regarding lung cancer screening. Ultimately, interventions tailored to the individual at risk for the development of lung cancer will benefit from designs that take individual health beliefs into consideration. To examine the relationships between individual health beliefs (perceived risk of lung cancer, perceived benefits of, perceived barriers to, and self-efficacy for lung cancer screening) and lung cancer screening participation. Participants who intend to or have been screened for lung cancer had higher mean scores on perceived benefits and self-efficacy, and lower means scores on perceived barriers compared to participants who have not been screened for lung cancer with LDCT. Methods   Overall (n=496) Mean (Range) Stages 1-4 (n=350) Stages 5-7 (n=146) p-value Total Perceived Risk 6.52 (2.26); 6 (2-12) 6.51 (2.17); 6 (2-12) 6.55 (2.47); 6 (2-12) 0.8428 Total Perceived Benefits 17.09 (4.48); 18 (2-24) 16.68 (4.55); 18 (2-24) 18.07 (4.14); 18 (3-24) 0.0016* Total Perceived Barriers 34.44 (9.08); 35 (7-65) 35.03 (8.58); 36 (7-55) 33.05 (10.07); 34 (14-65) 0.0387* Total Self-Efficacy 29.10 (6.25); 30 (1-36) 28.55 (6.55); 29 (1-36) 30.38 (5.29); 32 (8-36) 0.0012* Descriptive, cross-sectional, correlational design using survey methodology. Convenience sample of long-term current and former smokers eligible for lung cancer screening. Conceptual Model   Acknowledgements This work was supported by Grant 5T32 NR007066 from the National Institute of Nursing Research Health Nursing and the Sigma Theta Tau International Iota Zeta Research Grant.