Higher perceived self-efficacy was associated with a 37% higher odds of lung cancer screening referral (P=0.002), whereas higher perceived barriers were associated with a 16% lower odds (P=0.01).
Observational (n=221)
No
Do patient health beliefs regarding lung cancer screening influence the likelihood of referral by primary care providers?
Higher perceived barriers and lower self-efficacy among patients are associated with a reduced likelihood of lung cancer screening referral by primary care providers.
Effect estimate: 37% higher odds (95% CI 12% - 67%)
p-value: p=0.002
Abstract Background Lung cancer screening (LCS) reduces mortality from the leading cause of cancer death in the United States. Patients’ beliefs about lung cancer and screening may vary by their race and ethnicity and may also influence whether primary care providers (PCPs) refer them for screening. Few studies have linked patient health beliefs directly to PCP referral behavior. Methods We recruited 221 primary care patients eligible for LCS and their PCPs (N = 119) between July 2022 and November 2025 at a Mid-Atlantic academic medical center as a part of an observational study on LCS. Patients completed sociodemographic and smoking history questionnaires before their appointment. Four dimensions of the Lung Cancer Screening Health Belief Scale (LCSHB) - perceived risk, benefits, barriers, and self-efficacy - were assessed. PCPs completed sociodemographic and practice questionnaires. After each appointment, patients reported whether their PCP referred them for LCS. To examine associations between race/ethnicity and LCSHB scores, we used a mixed effect linear regression controlling for patient and PCP characteristics. Logistic regression with generalized estimating equations assessed associations between LCSHB scores and LCS referral. Results Participants have a mean age of 64 years (SD = 7.5 years); 53.8% were women, 33.9% Hispanic, 35.7% non-Hispanic Black, and 5.0% as other. After adjustment, Black participants scored 0.96 points lower (95% CI: 1.79, 0.14, p = 0.02) on the Perceived Risk subscale and 1.52 points higher (95% CI: 0.49 - 2.54, p = 0.004) on the Perceived Benefit subscale than White participants. Each one point increase on the Perceived Barriers subscale was associated with a 16% lower odds of referral (95% CI: 4% - 27%; p = 0.01), whereas each one point increase on the Perceived Self-Efficacy subscale was associated with a 37% higher odds of referral (95% CI: 12% - 67%; p = 0.002) Conclusion Black participants perceived lower personal risk but greater benefits from screening than White participants. Higher perceived barriers and lower self-efficacy were associated with reduced likelihood of LCS referral. Addressing modifiable beliefs, particularly perceived barriers and self-efficacy may enhance equitable referral and screening uptake. Future research will examine how patient-provider communication shapes these belief-referral relationships. This abstract is funded by: NIH
Kale et al. (Fri,) conducted a observational in Lung cancer screening eligibility (n=221). Patient health beliefs (LCSHB scores) was evaluated on Lung cancer screening referral (37% higher odds, 95% CI 12% - 67%, p=0.002). Higher perceived self-efficacy was associated with a 37% higher odds of lung cancer screening referral (P=0.002), whereas higher perceived barriers were associated with a 16% lower odds (P=0.01).