Explicit and implicit attitudes toward lung cancer (LC) relative to breast cancer (BC).

Lung Cancer - Non-Small Cell Metastatic
Session Type and Session Title: 
Poster Discussion Session, Lung Cancer - Non-small Cell Metastatic
Abstract Number: 
J Clin Oncol 31, 2013 (suppl; abstr 8017)
Joan H. Schiller, Chris J. Bowden, Jennifer Mills, Edward Lang, Holli Dickson, Heidi A Hamann, N. Sriram; The University of Texas Southwestern Medical Center, Dallas, TX; Genentech, Inc., South San Francisco, CA; University of Psychology, Department of Psychology, Charlottesville, VA

Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).

Abstract Disclosures


Background: Emerging research suggests that LC may be associated with greater levels of stigma, shame and hopelessness compared to other cancers. This study measured explicit, conscious attitudes (EAs) and used the Implicit Association Test (IAT) to assess implicit, unconscious attitudes (IAs) of LC relative to BC. Methods: To assess EAs, participants (Ps), [people with cancer (n=243), caregivers (n=677), healthcare providers (HCPs, n=142), and the general public (n=864)] were asked to rate their agreement, on a six-point scale, with statements about how people with LC and BC “do feel” (descriptive attitudes) or “ought to feel” (normative attitudes) about their disease. IAs were measured with three IATs that used LC or BC images with words representing good/bad; hope/despair; or suitable/shameful. An IAT D score indicated the strength of bias against LC relative to BC: >0.65 = strong bias; 0.35-0.65 = moderate bias; 0.15-0.35 = slight bias; -0.15 -+0.15 = no bias, and < -0.15 indicated bias against BC. Results: EAs and IAs were substantially more negative towards LC. Most Ps provided more negative ratings for LC than BC for both descriptive (70%vs.8%) and normative statements (56% vs. 3%). Ps had strong negative IAs towards LC compared to BC (bad: 74% vs. 10%; despair: 75% vs. 9%; shame: 67% vs. 17%). These trends were consistent across caregivers, patients, HCPs, and the public. EAs and IAs were uncorrelated. Conclusions: Ps had greater explicit and implicit negative bias against LC compared to BC.

Caregivers Patients HCPs General public
Negative descriptive
Negative normative
75%, 7%, 18%
59%, 3%, 38%
81%, 7%, 12%
64%, 2%, 34%
88%, 5%, 7%
65%, 3%, 32%
74%, 8%, 18%
56%, 3%, 41%
Bad D=0.43
73%, 12%, 15%
72%, 13%, 15%
63%, 17%, 20.0%
74%, 9%, 17%
Despair D=0.43
73%, 10%, 17%
76%, 5%, 19%
77%, 13%, 10%
77%, 8%, 15%
Shame D=0.32
65%, 18%, 17%
82%, 9%, 9%
72%, 11%, 17%
66%, 17%, 17%

Percentage order: LC bias%, BC bias%, No bias%. D=mean IAT score. All comparisons significant with ps<0.001.