There are still several fears and misconceptions among the French population regarding lung cancer, according a prospective survey conducted nationwide on perceptions about the disease. While the study was conducted in France alone, the results may in fact reveal perspectives about lung cancer that are in fact universal throughout the world. The authors, from the International Association for the Study of Lung Cancer (IASLC), revealed a need for intensifying public education efforts in order to spread information about the benefits of lung cancer screening, positive survival rates due to early-stage detection of the disease, and better outcomes from novel treatment strategies, such as targeted-therapies.
Even though treatment of lung cancer has improved in recent years due to the establishment of new techniques, including screening and new chemotherapies, improved surgical outcomes and radiotherapy results, maintenance therapy validation, and effective targeted therapies, information about the success of treating lung cancer is not fully recognized by the public. The IASLC survey revealed fears or misperceptions about lung cancer, which may in fact affect communication between physicians and patients and lead to poorer patient outcomes.
“The general population appears to be aware of the main risk factors of lung cancer but efforts should be made to convince them that passive smoking is a well-recognized risk factor,” noted the authors, which include Julien Mazières as first author, Bernard Milleron as senior author, and Jean-Louis Pujol and Elisabeth Quoix as co-authors. “The general population should be educated on the fact that lung cancer is not symptomatic at the early stages and that the best survival is observed for small asymptomatic tumors that can benefit from, and many times be cured by, surgery.”
The survey, the results of which were recently published at the official journal of the IASLC, the Journal of Thoracic Oncology, included 1469 participants. Even though 93% of the respondents recognized the importance of active tobacco smoking for the development of lung cancer, only 67% knew about passive smoking as a risk factor. Similarly, 83% of those questioned said that lung cancer is a severe disease, but 85% wrongly believe that the symptoms are present in most cases.
In addition, a third of the participants believe that the disease may be cured at any stage, which is an overestimation, but only half said it can be cured when diagnosed in early stages of disease, which is an underestimation. Regarding the treatment they were most aware about, the top answer was chemotherapy (91%), followed by surgery (71%) and the benefits of smoking cessation (90%). Less known among the population was the use of radiotherapy, only mentioned by 64%, and targeted therapies, mentioned by 15%.
Three-quarters of the respondents knew that the incidence of the disease had increased in the last 10 years among women, and 40% recognized that the incidence of the disease remains the same in men. Within the lexical analysis, the researchers noted that the most characteristics mentioned about lung cancer were being tobacco-induced, life-threatening, and that it requires heavy treatment, while a minority answered that it is environmentally-induced. When compared with breast cancer, the disease was characterized by respondents as being related to lifestyle habits, and as a result the fault of the patient.
“It is well known that the efficiency of a screening program is directly related to the public being aware that a diagnosis performed before the onset of symptoms is associated with better survival. Since the general population had poor knowledge on new treatment opportunities in radiotherapy and on targeted agents, educational and awareness campaigns in this area may help the enrollment of patients in clinical research programs evaluating therapeutics regimens using these new tools in the fight against lung cancer,” the authors added.
In addition to the lack of information, the researchers believe that the lack of communication may affect and delay lung cancer screening, diagnosis, or treatment. The survey was conducted because the association believes that assessing the population’s perception on the disease, and consequently determining the gaps in knowledge, may reduce potential obstacles and improve public education programs.
The survey was created by an interdisciplinary group of oncologists working in the management of lung cancer, as well as other chest physicians, general practitioners, and social psychologists. It was composed of both a questionnaire and lexical approaches, with questions meant to evaluate the perception and knowledge of 2200 healthy subjects older than 18 years living in France regarding etiology, epidemiology, diagnosis, therapeutic treatments and prognosis of lung cancer.