Willingness for Lung Cancer Screening: Disparities Among Informed, Screening-Eligible Individuals

Medical mistrust and receptivity to lung cancer screening among African American and white American smokers

Although medical mistrust is associated with lower cancer screening uptake among racial minorities, such as African Americans, potential impacts on cancer screening among White Americans are generally understudied. In this study, we examined links from medical mistrust to lung cancer screening among African American (N = 203) and White American (N = 201) smokers. Participants completed the Group-Based Medical Mistrust Scale and viewed a brief online educational module about lung cancer risks, etiology, and screening. Thereafter, participants reported their receptivity to lung cancer screening using a Theory of Planned Behavior (TPB) measurement framework (attitudes, normative beliefs, perceived control, and intentions). Medical mistrust predicted lower screening receptivity across all TPB measures for both racial groups. Although medical mistrust was higher among African Americans, there were no race differences in screening receptivity. However, there was some evidence that race moderates the relationship between medical mistrust and screening attitudes. While greater mistrust predicted more negative attitudes among both races, this effect was stronger among White Americans than African Americans. Findings suggest that group-based medical mistrust is a barrier to lung cancer screening for both African Americans and White Americans and illustrates the need to address medical mistrust as a barrier to screening for both racial minority and nonminority populations.