IU nurse researcher developing framework to help more individuals pursue lung cancer screening

INDIANAPOLIS -- Lung cancer kills more people in the U.S. than breast, colorectal, pancreatic and prostate cancers combined. Most fatalities occur because patients are diagnosed at an advanced stage, resulting in limited treatment options with a 1 to 5 percent five-year relative survival rate.

Cigarette smoking has been linked to 90 percent of all lung cancers in the U.S., putting long-term smokers at the highest level of risk for lung cancer. But this group is among the most reluctant to participate in screening.

Now, Indiana University School of Nursing researcher and assistant professor Lisa Carter-Harris is developing a new framework to understand lung cancer screening participation from the perspective of the individual. The National Institutes of Health has awarded Carter-Harris an R15 grant for the study. The $458,334 grant was made through the National Cancer Institute.

Carter-Harris' prior research has shown that psychological variables such as perceived stigma, medical mistrust, cancer fatalism, fear and worry seem to be uniquely relevant in lung cancer screening participation. Smokers experience stigma, battle an addiction to nicotine and feel blamed by others for the perceived self-infliction of tobacco-related diseases related to their lifestyle choice of smoking.

Carter-Harris' study "Lung Cancer Screening: Identifying Factors Associated with Participation" will inform future interventions tailored to individual patients by testing a model of factors related to screening.

This will be the first mixed-methods study to examine lung cancer screening behavior from the perspective of the person making the decision to screen -- or not -- for lung cancer. The study involves a sample of participants from an overall larger study. Its use of tailored interview guides developed specifically for an individual based on the way he or she answered the survey questions is highly innovative.

"This new study will provide critical insights into the variables that affect individual decision-making regarding lung cancer screening and will inform how we tailor intervention strategies in this area," Carter-Harris said.

"We're highlighting the patient voice in order to understand the survey findings more completely, which is critical in moving the science forward in improving both implementation as well as patient outcomes in lung cancer screening," she said.

Also participating in the study are Susan M. Rawl, professor, IU School of Nursing; Claire Burke Draucker, professor and Angela Barron McBride Endowed Professor, IU School of Nursing; Patrick Monahan, professor of biostatistics, IU Richard M. Fairbanks School of Public Health; and James E. Slaven, biostatistician, Department of Biostatistics, IU Richard M. Fairbanks School of Public Health.

Indiana University School of Nursing is ranked 14th among public schools and colleges of nursing for National Institutes of Health funding and has a robust program of research focused on quality of life in chronic illness, nursing education and behavioral oncology. Programs range from three undergraduate options, nine tracks in the master's program, post-master's options, a Ph.D. in nursing science, a leadership-focused Doctorate of Nursing Practice and continuing-education opportunities. U.S. News & World Report ranked the graduate programs No. 1 in the state of Indiana and among the top 20 public universities in the nation, according to the 2017 Best Graduate Schools rankings. Learn more about the IU School of Nursing online.

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