October 7, 2003
Some patients delay seeking medical care or reject treatment because of mistaken beliefs among their ethnic and cultural groups. One such myth is that lung cancer tumors spread when exposed to air. It is a particularly widespread belief among African-Americans, according to a study published this week in the Annals of Internal Medicine.
This could help explain their lower survival rates for lung cancer compared with whites, says lead author Mitchell L. Margolis, of the Philadelphia Veterans Affairs Medical Center.
Margolis and colleagues surveyed 626 patients at five pulmonary or thoracic surgery practices in Los Angeles, Philadelphia and Charleston, S.C., for a geographic mix. They found that nearly 40 percent of people surveyed said they believed that exposure to air in surgery caused tumors to spread. The major predictor of that belief, the researchers found, was race:
- Sixty-one percent of African-Americans surveyed said they believed in the myth -- twice the percentage of whites. [See Figure http://www.annals.org/cgi/content-nw/full/139/7/558/F1.]
- Even more worrisome, Margolis said, 19 percent of African-Americans cited the belief as a reason to reject surgery, and 14 percent said a doctor could not convince them otherwise.
- The Philadelphia study found that education and income were also important factors in believing the myth, though race was the most important.
- Similar studies show the same myth is widespread among poor whites of Appalachia, according to Harold Freeman, director of the Center to Reduce Cancer Health Disparities.
People who believe in the myth are basing it on personal experiences that they misunderstood. Poorer people generally have less access to proper health care and less trust in it, or they do not see it as a priority, Freeman says. As a result, they are less likely to obtain early diagnoses.
Source: Anahad O'Connor, "Finding of Fact: Myth About Lung Cancer Can Be Deadly," New York Times, October 7, 2003; see Mitchell L. Margolis et al., "Racial Differences Pertaining to a Belief about Lung Cancer Surgery: Results of a Multicenter Survey," October 7, 2003, Annals of Internal Medicine.
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