Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening.
<h4>Background</h4>Individuals living with low income are more likely to smoke, have a higher risk of lung cancer, and are less likely to participate in preventative healthcare (i.e., low-dose computed tomography (LDCT) for lung cancer screening), leading to equity concerns. To inform th...
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Public Library of Science (PLoS)
2021
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oai:doaj.org-article:c66d524da4da4d7bb557e0bbe1357ab22021-11-25T06:19:18ZAdvancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening.1932-620310.1371/journal.pone.0251264https://doaj.org/article/c66d524da4da4d7bb557e0bbe1357ab22021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251264https://doaj.org/toc/1932-6203<h4>Background</h4>Individuals living with low income are more likely to smoke, have a higher risk of lung cancer, and are less likely to participate in preventative healthcare (i.e., low-dose computed tomography (LDCT) for lung cancer screening), leading to equity concerns. To inform the delivery of an organized pilot lung cancer screening program in Ontario, we sought to contextualize the lived experiences of poverty and the choice to participate in lung cancer screening.<h4>Methods</h4>At three Toronto academic primary-care clinics, high-risk screen-eligible patients who chose or declined LDCT screening were consented; sociodemographic data was collected. Qualitative interviews were conducted. Theoretical thematic analysis was used to organize, describe and interpret the data using the morphogenetic approach as a guiding theoretical lens.<h4>Results</h4>Eight participants chose to undergo screening; ten did not. From interviews, we identified three themes: Pathways of disadvantage (social trajectories of events that influence lung-cancer risk and health-seeking behaviour), lung-cancer risk and early detection (upstream factors that shape smoking behaviour and lung-cancer screening choices), and safe spaces of care (care that is free of bias, conflict, criticism, or potentially threatening actions, ideas or conversations). We illuminate how 'choice' is contextual to the availability of material resources such as income and housing, and how 'choice' is influenced by having access to spaces of care that are free of judgement and personal bias.<h4>Conclusion</h4>Underserved populations will require multiprong interventions that work at the individual, system and structural level to reduce inequities in lung-cancer risk and access to healthcare services such as cancer screening.Ambreen SayaniMandana VahabiMary Ann O'BrienGeoffrey LiuStephen HwangPeter SelbyErika NicholsonMeredith GiulianiLawson EngAisha LoftersPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0251264 (2021) |
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DOAJ |
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EN |
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Medicine R Science Q |
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Medicine R Science Q Ambreen Sayani Mandana Vahabi Mary Ann O'Brien Geoffrey Liu Stephen Hwang Peter Selby Erika Nicholson Meredith Giuliani Lawson Eng Aisha Lofters Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. |
| description |
<h4>Background</h4>Individuals living with low income are more likely to smoke, have a higher risk of lung cancer, and are less likely to participate in preventative healthcare (i.e., low-dose computed tomography (LDCT) for lung cancer screening), leading to equity concerns. To inform the delivery of an organized pilot lung cancer screening program in Ontario, we sought to contextualize the lived experiences of poverty and the choice to participate in lung cancer screening.<h4>Methods</h4>At three Toronto academic primary-care clinics, high-risk screen-eligible patients who chose or declined LDCT screening were consented; sociodemographic data was collected. Qualitative interviews were conducted. Theoretical thematic analysis was used to organize, describe and interpret the data using the morphogenetic approach as a guiding theoretical lens.<h4>Results</h4>Eight participants chose to undergo screening; ten did not. From interviews, we identified three themes: Pathways of disadvantage (social trajectories of events that influence lung-cancer risk and health-seeking behaviour), lung-cancer risk and early detection (upstream factors that shape smoking behaviour and lung-cancer screening choices), and safe spaces of care (care that is free of bias, conflict, criticism, or potentially threatening actions, ideas or conversations). We illuminate how 'choice' is contextual to the availability of material resources such as income and housing, and how 'choice' is influenced by having access to spaces of care that are free of judgement and personal bias.<h4>Conclusion</h4>Underserved populations will require multiprong interventions that work at the individual, system and structural level to reduce inequities in lung-cancer risk and access to healthcare services such as cancer screening. |
| format |
article |
| author |
Ambreen Sayani Mandana Vahabi Mary Ann O'Brien Geoffrey Liu Stephen Hwang Peter Selby Erika Nicholson Meredith Giuliani Lawson Eng Aisha Lofters |
| author_facet |
Ambreen Sayani Mandana Vahabi Mary Ann O'Brien Geoffrey Liu Stephen Hwang Peter Selby Erika Nicholson Meredith Giuliani Lawson Eng Aisha Lofters |
| author_sort |
Ambreen Sayani |
| title |
Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. |
| title_short |
Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. |
| title_full |
Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. |
| title_fullStr |
Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. |
| title_full_unstemmed |
Advancing health equity in cancer care: The lived experiences of poverty and access to lung cancer screening. |
| title_sort |
advancing health equity in cancer care: the lived experiences of poverty and access to lung cancer screening. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2021 |
| url |
https://doaj.org/article/c66d524da4da4d7bb557e0bbe1357ab2 |
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