Project calls out lung cancer bias

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For many conditions, bias exists as a prominent symptom, whether it comes from within and/or all around. With lung cancer patients in particular, the effect and affect of biases seem especially strong, an assertion given even more bulk by the latest findings from The Lung Cancer Project.

The project — a study delving into the unconscious and conscious associations healthcare professionals, patients and the general public make regarding lung cancer — has found that some three out of four people carry with them a negative bias for the disease. This bias, according to Joan Schiller, MD, head of Hematology and Oncology at University of Texas Southwestern, president of the National Lung Cancer Partnership and lead investigator on the study, is harming patients both mentally and motivationally.

“Lung cancer patients suffer from this stigma associated with their disease,” Schiller told PhysBizTech. “If you suffer from this stigma, it brings shame and guilt, and if that happens there’s a concern that maybe lung cancer patients are not actively seeking the best care, they’re not being proactive. So the purpose of The Lung Cancer Project was to in fact document that and also to use that as a baseline going forward as we try to overcome those biases.”

By engaging Implicit Association Testing (IAT), Schiller and other project researchers were able to measure “both conscious and subconscious feelings about lung cancer.” Per the present outcomes, the study team posited that perhaps the undercurrent promoted by both subconscious and conscious grudges linking smoking to lung cancer has not only prevented patients from seeking the care they need, but physicians from delivering said care as well.

“Most of psychological literature would say that if somebody is experiencing negative emotions — guilt, shame — they’re less likely to be more outgoing and they’re less likely to be more proactive and I think that transfers over into them being less likely to be proactive in their care, to go online and seek out clinical trials for example,” said Schiller.

She continued: “And I think it’s the same on the physician side. I think physicians may be a little less likely to refer their patients for clinical trials or to give third line therapy for example. And not consciously, but subconsciously.”

But docs needn’t feel as if they cannot defeat such underlying bias. Schiller presented the following tips that may help in lessening the stigma:

  • Realize that “currently 50 percent of lung cancer occur in people who have quit smoking — so they’re already done the right thing. They’ve kind of realized the error of their ways, so to speak, so they can’t quit now; they’ve already done it.”
  • Acknowledge “that most people start smoking when they’re most vulnerable —  nowadays, for example, it’s teenagers, they’re really getting targeted by tobacco companies —  and most people start thinking they can stop whenever they want and then they can’t. It turns out smoking is very addicting, to some people more than others, and to many people it’s very, very difficult to stop. So I think [physicians] just have to have a little bit of sympathy for these folks who probably have stopped or have tried to stop or wish they had probably never gotten into it in the first place, but now they’re stuck.”
  • Abstain from “beating a lung cancer over the head with [smoking cessation] programs.”
  • Encourage patients to “become more angry about their disease rather than embarrassed about their disease.”
  • Measure you bias by partaking in the Lung Cancer Project IAT here.

Other efforts are underway by The Lung Cancer Partnership to uncover what the most effective bias intervention tactic is for patients, Schiller noted.

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