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Lung Cancer Patients Get Blamed for Their Disease
Date:11/14/2008

Survey finds nearly two-thirds of Americans believe so, even though most victims don't smoke at diagnosis

FRIDAY, Nov. 14 (HealthDay News) -- A majority of Americans, including many health-care workers, believe that people who have lung cancer are at least partly to blame for their disease, a new survey finds.

In the poll of nearly 1,500 American adults, researchers found 59 percent of respondents agreeing with the notion that lung cancer patients helped bring on their diagnosis.

It's a bias that over time has led to fewer resources to investigate the number one cancer killer in the U.S, and added shame to the burden that lung cancer patients must carry, experts said.

"Sadly, the stigma has been used to justify underfunding, not only of research but also of programs for early detection and treatment," said Laurie Fenton Ambrose, president and CEO of Lung Cancer Alliance, a private organization providing support and advocacy for people with lung cancer.

Lung cancer is among the leading cause of cancer deaths in the United States. The American Lung Association estimates that more then 215,000 Americans will be diagnosed with lung cancer this year, and more than 161,000 will die of the disease. Between 10 percent and 15 percent of lung cancers are diagnosed in nonsmokers, the association estimates.

Too many people cast blame for lung cancer on the individual patient, due to the mistaken belief that all cases of the disease are caused by current smoking, Ambrose said. The truth is that "over 60 percent of people with lung cancer are former or never smokers," she noted. "No one deserves this disease. It is a public health epidemic, and you don't need to be a current smoker to be diagnosed with it."

But the prejudice against lung cancer patients is affecting patients. The Lung Cancer Alliance survey, which received some finding from drug maker Astra-Zeneca, also included 204 people with lung cancer. Fifty-four percent of these patients said they felt there was a stigma attached to the disease. Thirty-one percent felt that strangers or acquaintances had said or done things that showed they blamed the patient for their cancer, and 13 percent said that even members of their treatment team had done so.

Lung cancer continues to be a major public health threat. About 150,000 Americans are hospitalized with the disease each year, according to the U.S. Agency for Healthcare Research and Quality (AHRQ).

"What seems to be happening is that that there is a reduction in incidence, but the number of hospitalizations is holding fairly steady," said Anne Elixhauser, a senior research scientist at the AHRQ. "Patients may be living longer and may be admitted to the hospital more often, or they are getting more aggressive treatment that requires admission to the hospital."

The average hospital stay cost for lung cancer in 2006 cost $14,200, and the death rate was 13 percent, five times higher than the death rate for all hospitalized people.

However, a "blame the victim" mentality is helping to stymie efforts toward early detection and better treatment, the experts said.

"We need earlier disease detection," she said. "We need to understand at a molecular or genetic level what triggers lung cancer in people so it can be detected earlier. We need more treatment options for the earlier stages of the disease, when we have a chance for better outcomes."

Today, 70 percent of lung cancer cases are diagnosed at an advanced stage, Ambrose said, "which is why the survival rate has remained low for decades. Just as has happened in breast cancer, prostate cancer and colon cancer, a robust research pipeline can lead to a significant increase in survival."

But the situation is bleak: One survey of oncologists found nearly two-thirds saying they did not have adequate treatment options for people with advanced lung cancer. In contrast, only 15 percent of cancer specialists said they lacked adequate measures against advanced breast cancer.

In a separate report released Thursday, researchers at the U.S. National Heart, Lung, and Blood Institute found poor public awareness of another major pulmonary condition, chronic obstructive pulmonary disease (COPD), which affects an estimated 24 million Americans.

Only 64 percent of those surveyed had heard of COPD, and among those who knew of it, only 44 percent were aware of it as a leading cause of death. But those numbers were an improvement of results in a 2004 survey, when only 49 percent of those questioned said they were aware of COPD.

More information

There's more on lung cancer at the U.S. National Cancer Institute.



SOURCES: Laurie Fenton Ambrose, president and CEO, Lung Cancer Alliance, Washington D.C.; Anne Elixhauser, Ph.D, senior research scientist, U.S. Agency for Healthcare Research and Quality, Bethesda, Md.; news release, Nov. 13, 2008, U.S. National Heart, Lung, and Blood Institute; Nov. 12, 2008, news release, Lung Cancer Alliance


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