argumentative essay 6 to 8 page

lung_cancer.pdf

Home >English homework help >argumentative essay 6 to 8 page

180 April 2013 • Volume 17, Number 2 • Clinical Journal of Oncology Nursing

Pauline M. Green, PhD, RN, CNE, Suzy Guerrier-Adams, MSN, Priscilla O. Okunji, PhD, RN-BC, Deborah Schiavone, PhD, RN, PMHCNS-BC, CNE, and Joann E. Smith, PhD, RN, APHN-BC, CNE

Lung cancer is a leading cause of cancer-related deaths in the United States and globally. African Americans experience significant differences in lung cancer incidence and mortality. Smoking is the single greatest risk for lung cancer, making smoking cessation programs a potentially fruitful approach for reducing the risk of lung cancer. Despite clinical practice guidelines that prompt nurses to advise patients to quit smoking, only a small percentage of nurses do so. Minority patients are less likely than Whites to receive smoking cessation advice. This article discusses recent findings on the pathophysiol- ogy and risks for lung cancer. The literature on smoking cessation research is examined to determine the features of successful cessation interventions. Recommendations are offered for enhancing tobacco cessation efforts in nursing practice, education, and research.

Pauline M. Green, PhD, RN, CNE, is a professor, Suzy Guerrier-Adams, MSN, is an instructor and the interim director of the Office of Student Affairs, and Priscilla O. Okunji, PhD, RN-BC, is an instructor, all in the College of Nursing and Allied Health Sciences at Howard University in Washington, DC; Deborah Schiavone, PhD, RN, PMHCNS-BC, CNE, was an associate professor in the College of Nursing and Allied Health Sciences at Howard University at the time this article was written and currently is a faculty member in the College of Nursing at Stratford University in Falls Church, VA; and Joann E. Smith, PhD, RN, APHN-BC, CNE, is an associate professor in the College of Nursing and Allied Health Sciences at Howard University. The authors take full responsibility for the content of the article. The authors did not receive honoraria for this work. The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors, planners, independent peer reviewers, or editorial staff. Green can be reached at [email protected], with copy to editor at [email protected]. (Submitted June 2012. Revision submitted August 2012. Accepted for publication September 2, 2012.)

Digital Object Identifier:10.1188/13.CJON.180-186

n CNE Article

African American Health Disparities in Lung Cancer

G lobal statistics on lung cancer report 1.6 million new cases each year ( Jemal et al., 2011). Lung cancer is the most common cancer and the leading cause of cancer-related death in men worldwide (Jemal et al., 2011). In the United States, lung can-

cer is the second most common type of cancer among men and women, with more than 228,160 new cases estimated in 2013, and the leading cause of cancer-related death (Siegel, Naishad- ham, & Jemal, 2013). The incidence of lung cancer varies with age, peaking from age 70–79 years (Centers for Disease Control and Prevention [CDC], 2010a). African Americans experience a higher incidence and mortality from lung cancer than other ra- cial or ethnic groups. Smoking is a major contributor to the high incidence of lung cancer among African Americans, and tobacco smoking is the leading preventable cause of death (U.S. Depart- ment of Health and Human Services [USDHHS], 2006). Evidence exists to support the effectiveness of treatment of tobacco dependence (Fiore et al., 2008), and greater efforts are needed to prevent smoking and treat tobacco dependence. Smoking ces- sation is important even for those with a diagnosis of early-stage lung cancer as preliminary evidence indicates it may improve prognostic outcomes (Parsons, Daley, Begh, & Aveyard, 2010).

Lung cancer represents a public health burden and a research challenge, yet lung cancer research receives the lowest level

of funding of all prevalent cancers (American College of Chest Physicians, 2010). Recommendations from the latest clinical practice guidelines on treating tobacco dependence call for more research on treatment options among racial and ethnic mi- norities. However, the number of nurse researchers involved in the study of lung cancer remains limited (Sarna, 2012). In their roles as advocates, nurses support all efforts to promote health and reduce differences in cancer incidence, mortality, and health outcomes linked to race, ethnicity, and socioeconomics. Less than optimal research funding will reduce the number of studies focused on minorities and lung cancer, which, in turn, will widen existing inequalities. In that respect, lung cancer in African Americans is an area particularly ripe for nurses to examine the impact of health disparities and develop interven- tions aimed at prevention, treatment, and smoking cessation.

Background African Americans have a higher incidence of lung cancer

(76.1 per 100,000) compared to Whites (69.7 per 100,000) (CDC, 2010a). African Americans are more susceptible to smoking- induced lung cancer (Mechanic et al., 2007; Zhang et al., 2006) and have less access to healthcare services than do Whites (CDC, 2011c). Research using national data demonstrated racial and

or otherwise reuse any or all content from this article, e-mail [email protected]. To purchase high-quality reprints, e-mail [email protected].

Clinical Journal of Oncology Nursing • Volume 17, Number 2 • African American Health Disparities in Lung Cancer 181

regional disparities in lung cancer incidence. Incidence was highest among men (86.2 per 100,000), Blacks (73), people aged 70–79 years (431.1), and those living in the South (74.7) (Under- wood et al., 2011). Disparity in lung cancer incidence and mor- tality rates is evident by race and gender (Howlader et al., 2012) (see Table 1). Black men have much higher incidence and death rates than White men. White men experienced a steady decline in smoking prevalence since 1965, whereas smoking prevalence in Black men demonstrated a slower rate of decline (Burns et al., 1997; Garrett, Dube, Trsclair, Carabello, & Pechacek, 2011). Black men may not have known about the risks of smoking as early as White men, and smoking cessation efforts started later among Black men, resulting in greater smoking exposure (National Cancer Institute [NCI], 2008). Black women smoke less than their White counterparts (Burns et al., 1997) but have similar statistics for lung cancer incidence and death rate. Additional research is needed to identify the role other factors may play in lung cancer disparity for Black women, such as metabolism of tobacco smoke, susceptibility to tobacco-induced lung cancer, and socioeconomic status (CDC, 2010a). Greater efforts to im- prove early detection and treatment are essential to eliminate racial disparities in cancer mortality (DeLancey, Thun, Jemal, & Ward, 2008).

Pathophysiology Lung cancer is classified as small cell lung cancer or non-small

cell lung cancer (NSCLC). Eighty-five percent of all lung cancers are NSCLC (Herbst, Heymach, & Lippman, 2008). Smoking is the leading cause of lung cancer, with 80% of lung cancer deaths attributed to tobacco smoke, a carcinogen that causes changes in epithelial cells (American Cancer Society, 2013). Radon is the second leading cause of lung cancer and the leading cause of lung cancer in nonsmokers (NCI, 2012b, 2012c).

Epidemiologic studies have identified a number of factors that increase the risk for lung cancer. Modifiable, nonmodifiable, social, and cultural factors that increase risk are addressed in this article.

Modifiable Risk Factors

Smoking is the single greatest risk factor for lung cancer and is the largest preventable cause of death and disease (CDC, 2011c). The risk increases with the number of cigarettes smoked each day and the number of years of smoking (USDHHS, 2004). Quitting smoking can significantly lower one’s risk of develop- ing lung cancer (NCI, 2012c). Public health efforts to decrease smoking since the 1990s have resulted in an overall decrease in smoking prevalence (CDC, 2011c). African Americans have a smoking rate of 20%, which is similar to Whites (CDC, 2011c). However, African American men have higher incidence and mortality rates from lung cancer. Menthol cigarettes are used by African Americans more than other racial groups (Giovino et al., 2004); menthol was thought to mask airway irritation, allowing deeper inhalation and, therefore, in- creasing users’ exposure to carcinogens found in cigarette smoke. A review of evidence from

epidemiologic studies, however, did not support the preference for menthol cigarettes as a contributor to the high lung cancer rates in African American men (Lee, 2011). Genetic susceptibil- ity, environmental exposure, and socioeconomics may play an important role in the higher lung cancer incidence and mortal- ity rates among African Americans (American Lung Association, 2010; Haiman et al., 2006). Additional research is needed on the differential causes of lung cancers in African Americans.

Secondhand smoke is another major risk factor for lung cancer. Most exposures to secondhand smoke occur in the home and work place (USDHHS, 2006). An estimated 88 mil- lion nonsmokers were exposed to secondhand smoke from 2007–2008. Deaths related to smoking and secondhand smoke were estimated at 443,000 annually from 2000–2004 (CDC, 2008). Children, in particular, are at risk for exposure, with 54% of young children living with smokers in the home (CDC, 2010b). African American male workers in general, as well as construction workers, blue collar workers, and service work- ers, experience high levels of secondhand smoke exposure in the workplace (Arheart et al., 2008).

Residential and occupational exposures to chemical car- cinogens increase the risk for developing lung cancer. Radon gas exposure in the home is the leading cause of lung cancer in nonsmokers (Darby, Hill, & Doll, 2001; Frumkin & Samet, 2001). Occupational exposure to asbestos, arsenic, chromium, nickel, and tar also can increase the risk of developing lung cancer, particularly in smokers (NCI, 2012b). Although the combination of asbestos exposure and cigarette smoking is a strong risk factor for lung cancer, the exact relationship be- tween the two components remains uncertain (Frost, Darnton, & Harding, 2011).

Additional study is needed on the relationship between diet and lung cancer risk. Frequent consumption of foods high in cholesterol and drinking more than a moderate amount of alco- hol increase the risk of lung cancer (NCI, 2012a). The relation- ship between drinking and tobacco smoking is uncertain be- cause many people both smoke and drink alcohol (NCI, 2012a).

Nonmodifiable Risk Factors

Inherited genetic characteristics are the major nonmodifiable risk factors contributing to the development of lung cancer. The risk for lung cancer increases with age and family history of lung cancer. Risk is increased by smoking or living in a home where carcinogens such as radon are present (Etzel, Amos, & Spitz, 2003). Lung cancer is more prevalent in men and older adults than their female or younger counterparts. People with adeno- carcinomas of the lung often have mutations in the epidermal

TABLE 1. Lung Cancer Incidence and Death Rates 2005–2009

Variable All Races Black Men White Men Black Women White Women

Incidence 76.4 99.9 76.4 52.6 55.1

Death 65.7 82.6 65.3 38 40.8

Note. All numbers are per 100,000 people. Note. Based on information from Howlader et al., 2012.

182 April 2013 • Volume 17, Number 2 • Clinical Journal of Oncology Nursing

growth factor gene, which may serve as the initial step in the development of lung carcinoma (Herbst et al., 2008; Sun, Schil- ler, & Gazdar, 2007). The TP53 pathway contributes to tumor suppression after damage to DNA, and lung cancer in African Americans is associated with a genetic variation in the TP53 pathway (Mechanic et al., 2007; Zhang et al., 2006). Greater sus-

ceptibility of African Americans to carcinogenesis attributable to smoking may contribute to lung cancer disparity. Additional research is needed to explain the possible genetic susceptibility of African Americans to smoking-related lung cancer.

Hormonal influences may affect the development of lung cancer. Overexpression of the estrogen receptor beta mediator

TABLE 2. Selected Research Studies on Smoking Cessation Programs

Study Design Sample Intervention Outcome

Andrews et al., 2007 Quasiexperi- mental, repeat- ed measures

103 African Ameri- can women in public housing

Culturally tailored, nurse-led counseling and nicotine replace- ment therapy with community health workers for one hour weekly for six weeks

Six-month continuous smoking abstinence rate of 28% in intervention group and 6% in comparison group

Changes in social support and smoking self-efficacy over time predicted smoking abstinence.

Demonstrated support for community health workers in smoking abstinence efforts

Bryant et al., 2011 Review of 32 trials

Disadvantaged groups (homeless, prisoners, indig- enous populations, at-risk youth, low socioeconomic sta- tus, mental illness)

Behavioral smoking cessation programs

Majority of studies reviewed rated low on methodologic quality

Increased cessation rate in programs target- ed for low-income women at short-term follow-up and for individuals with mental illness at long-term follow-up

Chouinard & Robichaud- Ekstrand, 2005

Experimental 123 male and 45 fe- male cardiovascular inpatients

Tailored smoking cessation pro- gram with telephone follow-up; one hour of counseling and six follow-up calls for two months

42% cessation with follow-up tailored to individual stage of change compared to 30% with counseling alone; 20% cessa- tion with usual care

Rice & Stead, 2008 Review of 42 trials

Various Smoking cessation programs with follow-up of at least six months

Interventions significantly increased likeli- hood of quitting in 31 studies.

Rigotti et al., 1997 Randomized clinical trial

650 male inpatients Smoking cessation program; 5–10 minute bedside counseling; 1–3 follow-up phone calls

Increased smoking cessation rates at one month did not lead to long-term absti- nence.

Rigotti et al., 2008 Review of 33 trials

Inpatient Smoking cessation program, behavioral counseling, and/or pharmacotherapy

Increased cessation rate at 6 and 12 months with smoking counseling begun in hospital and contact for one month or more postdischarge

Adding nicotine replacement therapies increased odds of quitting.

Robles et al., 2008 Review of nine trials

African American, Hispanic, Native American, Alaskan Native

Smoking cessation pharmaco- therapy

Evidence supports use of nicotine patch and buproprion sustained release in non-White patients.

Smith et al., 2011 Randomized clinical trial

616 male inpatients Nurse-managed smoking cessa- tion: intensive versus brief; five minute bedside counseling with telephone follow-up over two months

Confirmed abstinence one year postinter- vention: 28% of those in the intensive group, 24% of those in the brief advice group

Tzelepis et al., 2011 Review of 24 trials

Various Proactive telephone counseling versus self-help materials or usual care

Proactive telephone counseling increased prolonged or continuous abstinence for actively and passively recruited smokers.

Wakefield et al., 2004 Experimental 137 male outpa- tients with cancer who are current smokers

Advice program telephone and in-person counseling; motiva- tional interviewing for three months

No difference in quit rates between groups. Intervention group more likely to report

attempts to quit

Clinical Journal of Oncology Nursing • Volume 17, Number 2 • African American Health Disparities in Lung Cancer 183

can promote the development of NSCLC (Motohashi, Okamoto, Yoshino, & Nakayama, 2011). The human papillomavirus may play an important role in the development of small cell lung cancer (Buonomo, Carraresi, Rossini, & Martinelli, 2011). In- fection with HIV is linked with a high risk for lung cancer, as well (NCI, 2012a).

Social and Cultural Risk Factors

Socioeconomic status: “Poverty and cancer are, too often, a lethal combination” (Freeman, 2004, p. 74). Poor cancer outcomes and survival rates in patients with early-stage lung cancer are associated with low socioeconomic status (Ou, Zell, Ziogos, & Anton-Culver, 2008). African Americans experience poverty at a higher rate (26%) than Whites (10%) (U.S. Census Bureau, 2012). Poverty is associated with an array of factors that promote health disparities, such as poor living conditions; risky lifestyle; and lack of education, information, and resources. Smoking prevalence is higher for those who live at or below the poverty line (CDC, 2011a).

Access to care: Access to care, critical for obtaining necessary health services, is associated with socioeconomic status and health insurance. Insurance coverage is strongly related to better health outcomes. Low socioeconomic status decreases the likeli- hood of having medical insurance, a regular health provider, and preventive services (CDC, 2011a). African Americans have higher uninsured rates compared to other racial groups (CDC, 2011b). People in the lowest income group are five times more likely to delay medical care and nine times more likely not to receive needed medical care (Adams, Martinez, & Vickerie, 2010). Lack of paid sick leave can act as a possible barrier to cancer screening (Peipins, Soman, Berkowitz, & White, 2012). Worry over lost in- come may act as a barrier to seeking care in the presence of symp- toms for low-income people with or without health insurance.

Racial inequality in access to curative surgery may help explain a portion of lung cancer disparity in survival and mor- tality rates. African Americans were found to have a lower rate of surgery for early-stage lung cancer when it was potentially curable (Bach, Cramer, Warren, & Begg, 1999). Other research found African Americans had lung cancer surgery less often than Whites, even if they had health insurance. African Ameri- cans were more likely to receive a negative recommendation for NSCLC surgery and more likely to refuse surgery than their White counterparts (Lathan, Neville, & Earle, 2006).

Beliefs: Trust in the medical system is necessary for deciding to seek health care and complying with treatment. Mistrust of health professionals can negatively affect African Americans’ care seeking for symptoms of lung cancer, as well as prevent participation in clinical trials from which they may benefit. African Americans’ mistrust of healthcare providers, which has its origin in past discrimination, mistreatment, and exploita- tion, has resulted in a fear of medicine and medical institutions (Gamble, 1997). That sentiment was intensified with respect to medical research following the unethical treatment of Black men in the Tuskegee study (Gamble, 1997). Researchers found African Americans were more likely than Whites not to trust physicians and suggested that the perception of advocacy may be particularly important to African Americans (Corbie-Smith, Thomas, & St. George, 2002).

Low levels of healthcare use by African Americans also have been associated with fatalism related to a cancer diagnosis. Fa- talism and fear may continue to play a role in African Americans’ willingness to participate in preventive services and acceptance of surgery for treatment, leading to a later stage of lung cancer at time of diagnosis and further contributing to lung cancer disparity (Phillips, Cohen, & Moses, 1999; Powe, 1996).

Research Studies on Smoking Cessation Several studies have reported results indicating smoking ces-

sation programs as a possible approach for interventions and research by nurses (see Table 2). Few of the publications cited in the table focus on African Americans and smoking cessation, indicating a need for future study by nurse researchers. Bryant, Bonevski, Paul, McElduff, and Attia (2011) reviewed 32 trials on smoking cessation for disadvantaged groups (e.g., low-income women, those with mental illness) and rated the studies low on the quality of research methods used. Numerous meta-analyses demonstrated support for offering smoking cessation programs to hospitalized patients. High-intensity programs that began while patients were hospitalized and provided supportive contact for more than one month after discharge increased cessation rates (Rigotti, Munafo, & Stead, 2008). Prior to that study, Rigotti et al. (1997) found increased smoking cessation rates at one month were not maintained over time. Similarly, a meta-analysis by Rice and Stead (2008) found interventions that offered hospitalized patients advice and support for smoking cessation increased the likelihood of quitting smoking. Follow- up counseling by telephone or in person increased smoking ces- sation rates (Rigotti et al., 2008; Tzelepis, Paul, Walsh, McElduff, & Knight, 2011). The efficacy of pharmacotherapy for smoking cessation in non-White populations also was supported (Robles, Singh-Franco, & Ghin, 2008).

Nurse researchers have made important contributions to knowledge of smoking cessation. A nursing intervention study

Implications for Practice

u Nurses in oncology and other fields should assess patients for smoking behaviors and recommend smoking cessation resources such as quit-lines, brochures, and Web sites.

u Nurses should educate African Americans about the risks of smoking behaviors and their greater susceptibility to smoking- induced lung cancer compared to other groups.

u Culturally tailored smoking cessation programs for African Americans should include plans for follow-up support for ef- forts to quit, with attention to individuals’ social support needs.

Exploration on the Go

Advancing Oncology Nursing Science includes more informa- tion about lung cancer and cancer-related disparities. To access, open a barcode scanner on your smartphone, take a photo of the code, and your phone will link automatically. Or,

visit http://esource.ons.org/ProductDetails.aspx?sku=INPU0576.

184 April 2013 • Volume 17, Number 2 • Clinical Journal of Oncology Nursing

conducted by nurse case managers that compared intensive versus brief tobacco cessation interventions confirmed abstinence rates of 28% for those in the intensive program and 24% in the brief program (Smith, Corso, Brown, & Cameron, 2011). An- other nursing intervention study used a stages-of-change model to tailor interventions according to the patient’s readiness to quit smoking. The authors found a higher rate of smoking absti- nence with inpatient counseling plus telephone follow-up (42%) compared to inpatient counseling alone (30%) or usual care (20%). Participants’ stages of readiness to quit, established at baseline, predicted smoking status at six months follow-up (Chouinard & Robichaud-Ekstrand, 2005). A novel approach by nurse counselors using community health workers and a cultur- ally tailored cessation program for African American women demonstrated a significant difference in abstinence rates in the intervention group (Andrews, Felton, Wewers, Waller, & Tingen, 2007). Wakefield, Olver, Whitford, and Rosenfeld (2004) found no difference in smoking cessation rates between

groups using motivational interviewing (i.e., support, empathy, reflective listening, and feedback) for patients with cancer compared to a control group receiving advice to quit smoking, a quit-smoking brochure, and quit-line service information. Participants who succeeded in quitting smoking at six months, however, were more likely to have had a smoking-related cancer diagnosis, made more attempts to quit before the trial began, and were less likely to have had radiation therapy.

Despite evidence supporting smoking cessation interven- tions by healthcare personnel, a recent national survey found only 10% of nurses recommended quit lines to patients who smoke (Sarna et al., 2009). A National Health Interview Survey showed that Black smokers had lower odds of being asked about tobacco use, being advised to quit smoking, and receiving smoking cessation aids (Cokkinides, Halpern, Barbeau, Ward, & Thun, 2005).

Implications for Nursing Practice Oncology nurses and those in other fields can readily lever-

age their access to patients in hospital settings by implementing the current practice guidelines for smoking cessation. Nurses should recognize the potential benefits of incorporating routine inquiry about smoking behavior during admission assessments and provide patient education resources for quitting smoking (see Figure 1). Smoking cessation advice provided in inpatient or outpatient settings that provides frequent follow-up support for efforts to quit will require new policy initiatives along with administrative support. Nurses need to be mindful of the prin- ciples of smoking cessation when planning patient education. Every effort by patients to quit smoking should be reinforced positively. Nurses should understand that several attempts may be needed before successfully quitting.

Conclusions Greater efforts are needed to screen for and promote smoking

cessation among African Americans who experience significant differences in lung cancer incidence and mortality. To ensure an ongoing cadre of prepared nurses, nursing curricula should include principles of smoking cessation, resources for smoking cessation, and incorporation of both in clinical practice. The nurse’s role in preventing initiation of smoking in youth and young adults should be presented in health promotion courses and include resources for community outreach activities. In- deed, preventing young people from beginning to smoke is a powerful strategy for reducing tobacco use and achieving the ultimate goal of decreasing lung cancer incidence.

Scant literature focuses on smoking cessation interventions with African Americans. More studies are needed to describe the process of attempting to quit smoking, barriers encoun- tered, and achieving success in smoking cessation. Additional research is needed to evaluate which culturally adapted pro- grams are most helpful for African Americans who desire to stop smoking. For that reason, researchers should ensure recruitment and inclusion of African Americans in their stud- ies. African Americans should be encouraged to participate in clinical trials on smoking prevention and cessation. The goal of

Agency for Healthcare Research and Quality u Treating Tobacco Use and Dependence: 2008 Update

www.ahrq.gov/path/tobacco.htm u Tips for healthy men on quitting or preparing to quit

www.ahrq.gov/healthymen/quitsmoking.htm

American Cancer Society u Smoking education, prevention, and cessation information

www.cancer.org/healthy/stayawayfromtobacco/index

Centers for Disease Control and Prevention u General tobacco control and use information

www.cdc.gov/tobacco u Youth tobacco prevention

www.cdc.gov/tobacco/youth/index.htm u Smoking and Health Resource Library Database

nccd.cdc.gov/shrl/QuickSearch.aspx

Legacy u Culturally tailored youth smoking prevention and cessation (e.g.,

African American, Asian American, Latino, Native American, les- bian, bisexual, gay, transgender, low socioeconomic status) www.legacyforhealth.org

National Cancer Institute u Lung cancer prevention

www.cancer.gov/cancertopics/pdq/prevention/lung/Health Professional

u Fast stats: Cancer statistics by race or ethnicity http://seer.cancer.gov/faststats/selections.php?series=race

Oncology Nursing Society u Oncology Nursing Society Position on Nursing Leadership in

Global and Domestic Tobacco Control www.ons.org/Publications/Positions/Tobacco

QuitNet u Online smoking cessation program

http://quitnet.com

Tobacco Free Nurses u Help for nurses and patients to quit smoking, as well as tobacco

control efforts within nursing organizations www.tobaccofreenurses.org

FIGURE 1. Resources for Smoking Prevention and Cessation

Clinical Journal of Oncology Nursing • Volume 17, Number 2 • African American Health Disparities in Lung Cancer 185

reducing the burden of lung cancer in African Americans can best be achieved by developing evidence-based interventions aimed at preventing smoking initiation and successful smoking cessation.

References Adams, P.F., Martinez, M.E., & Vickerie, J.L. (2010). Summary health

statistics for the U.S. population: National Health Interview Survey,

2009. Vital Health Statistics, Series 10, 248, 1–115.

American Cancer Society. (2013). Cigarette smoking. Retrieved

from http://w w w.cancer.org /acs /groups /cid /documents /

webcontent/002967-pdf.pdf

American College of Chest Physicians. (2010). Lung cancer: Large

impact, little funding [Press release]. Retrieved from http://www

.chestnet.org/accp/article/lung-cancer-large-impact-little-funding

American Lung Association. (2010). Too many cases, too many

deaths: Lung cancer in African Americans. Retrieved from

http://w w w.lung.org/assets/documents/publications/lung

-disease-data/ala-lung-cancer-in-african.pdf

Andrews, J.O., Felton, G., Wewers, M.E., Waller, J., & Tingen, M.

(2007). The effect of a multicomponent smoking cessation in-

tervention in African American women residing in public hous-

ing. Research in Nursing and Health, 30, 45–60. doi:10.1002/

nur.20174

Arheart, K.L., Lee, D.J., Dietz, N.A., Wilkinson, J.D., Clark, J.D.,

LeBlanc, W.G., . . . Fleming, L.E. (2008). Declining trends in se-

rum cotinine levels in U.S. worker groups: The power of policy.

Journal of Occupational and Environmental Medicine, 50(1),

57–63. doi:10.1097/JOM.0b013e318158a486

Bach, P.B., Cramer, L.D., Warren, J.L., & Begg, C.B. (1999). Racial

differences in the treatment of early-stage lung cancer. New

England Journal of Medicine, 341, 1198–1205. doi:10.1056/

NEJM199910143411606

Bryant, J., Bonevski, B., Paul, C., McElduff, P., & Attia, J. (2011). A

systematic review and meta-analysis of the effectiveness of behav-

ioural smoking cessation interventions in selected disadvantaged

groups. Addiction, 106, 1568–1585.

Buonomo, T., Carraresi, L., Rossini, M., & Martinelli, R. (2011).

Involvement of aryl hydrocarbon receptor signaling in the devel-

opment of small cell lung cancer induced by HPV E6/E7 oncopro-

teins. Journal of Translational Medicine, 9, 2. doi:10.1186/1479

-5876-9-2

Burns, D.M., Lee, L., Shen, L.Z., Gilpin, E., Tolley, H.D., Vaughan, J.,

& Shanks, T.G. (1997). Cigarette smoking behavior in the United

States. In National Cancer Institute, Changes in cigarette-related

disease risks and their implications for prevention and control

(NIH Pub. No. 97-4213, pp. 30–35). Retrieved from http://cancer

control.cancer.gov/tcrb/monographs/8/m8_2.pdf

Centers for Disease Control and Prevention. (2008). Smoking-

attributable mortality, years of potential life lost, and productiv-

ity losses—United States, 2000–2004. Morbidity and Mortality

Weekly Report, 57, 1226–1228.

Centers for Disease Control and Prevention. (2010a). Racial/

ethnic disparities and geographic differences in lung cancer

incidence—38 states and the District of Columbia, 1998–2006.

Morbidity and Mortality Weekly Report, 59, 1434–1438.

Centers for Disease Control and Prevention. (2010b). Vital signs: Non-

smokers’ exposure to secondhand smoke—United States, 1999–

2008. Morbidity and Mortality Weekly Report, 59, 1141–1146.

Centers for Disease Control and Prevention. (2011a). Health dis-

parities and inequalities report—United States, 2011. Retrieved

from http://www.cdc.gov/minorityhealth/reports/CHDIR11/

ExecutiveSummary.pdf

Centers for Disease Control and Prevention. (2011b). Health dis-

parities in health insurance coverage. Retrieved from http://

www.cdc.gov/minorityhealth/reports/CHDIR11/FactSheets/

Insurance.pdf

Centers for Disease Control and Prevention. (2011c). Vital signs:

Current cigarette smoking among adults aged ≥ 18 years—United States, 2005–2010. Morbidity and Mortality Weekly Report, 60,

1207–1212.

Chouinard, M.C., & Robichaud-Ekstrand, S. (2005). The effectiveness

of a nursing inpatient smoking cessation program in individuals

with cardiovascular disease. Nursing Research, 54, 243–254.

doi:10.1097/00006199-200507000-00006

Cokkinides, V.E., Halpern, M.T., Barbeau, E.M., Ward, E., & Thun,

M.J. (2005). Racial and ethnic disparities in smoking-cessation

interventions: Analysis of the 2005 National Health Interview

Survey. American Journal of Preventive Medicine, 34, 404–412.

doi:10.1016/j.amepre.2008.02.003

Corbie-Smith, G., Thomas, S.B., & St. George, D.M. (2002). Dis-

trust, race, and research. Archives of Internal Medicine, 162,

2458–2463.

Darby, S., Hill, D., & Doll, R. (2001). Radon: A likely carcinogen at all

exposures. Annals of Oncology, 12, 1341–1351.

DeLancey, J.O., Thun, M.J., Jemal, A., & Ward, E.M. (2008). Recent

trends in Black-White disparities in cancer mortality. Cancer Epi-

demiology, Biomarkers and Prevention, 17, 2908–2912.

Etzel, C.J., Amos, C.I., & Spitz, M.R. (2003). Risk for smoking-related

cancer among relatives of lung cancer patients. Cancer Research,

63, 8531–8535.

Fiore, M.C., Jaén, C.R., Baker, T.B., Bailey, W.C., Benowitz, N.L., Curry,

S.J., . . . Wewers, M.E. (2008). Treating tobacco use and depen-

dence: 2008 update. Rockville, MD: U.S. Department of Health

and Human Services.

Freeman, H.P. (2004). Poverty, culture, and social justice: Determi-

nants of cancer disparities. CA: A Cancer Journal for Clinicians,

54, 72–75. doi:10.3322/canjclin.54.2.72

Frost, G., Darnton, A., & Harding, A.H. (2011). The effect of smok-

ing on the risk of lung cancer mortality for asbestos workers in

Great Britain (1971–2005). Annals of Occupational Hygiene, 55,

239–247. doi:10.1093/annhyg/meq089

Frumkin, H., & Samet, J.M. (2001). Radon. CA: A Cancer Journal for

Clinicians, 51, 337–344. doi:10.3322/canjclin.51.6.337

Gamble, V.N. (1997). Under the shadow of Tuskegee: African Ameri-

cans and health care. American Journal of Public Health, 87,

1773–1778. doi:10.2105/AJPH.87.11.1773

Garrett, B.E., Dube, S.R., Trsclair, A., Carabello, R.S., & Pechacek, T.F.

(2011). Cigarette smoking—United States, 1965–2008. Morbidity

and Mortality Weekly Report, 60, 109; 113.

Giovino, G.A., Sidney, S., Gfroerer, J.C., O’Malley, P.M., Allen, J.A.,

Richter, P.A., & Cummings, K.M. (2004). Epidemiology of men-

thol cigarette use. Nicotine and Tobacco Research, 6(Suppl. 1),

S67–S81. doi:10.1080/14622203710001649696

Haiman, C.A., Stram, D.O., Wilkens, L.R., Pike, M.C., Kolonel, L.N.,

Henderson, B.E., & Le Marchand, L. (2006). Ethnic and racial dif-

ferences in the smoking-related risk of lung cancer. New England

Journal of Medicine, 354, 333–342. doi:10.1056/NEJMoa033250

Herbst, R.S., Heymach, J.V., & Lippman, S.M. (2008). Lung cancer.

New England Journal of Medicine, 359, 1367–1380. doi:10.1056/

NEJMra0802714

Howlader, N., Noone, A.M., Krapcho, M., Neyman, N., Aminou, R.,

186 April 2013 • Volume 17, Number 2 • Clinical Journal of Oncology Nursing

Altekruse, S.F., . . . Cronin, K.A. (2012). SEER cancer statistics

review, 1975–2009 (Vintage 2009 populations). Retrieved from

http://seer.cancer.gov/csr/1975_2009_pops09/index.html

Jemal, A., Bray, F., Center, M.M., Ferlay, J., Ward, E., & Forman, D.

(2011). Global cancer statistics. CA: A Cancer Journal for Clini-

cians, 61, 69–90. doi:10.3322/caac.20107

Lathan, C.S., Neville, B.A., & Earle, C.C. (2006). The effect of race on

invasive staging and surgery in non-small-cell lung cancer. Journal

of Clinical Oncology, 24, 413–417. doi:10.1200/JCO.2005.02.1758

Lee, P.N. (2011). Systematic review of the epidemiological evidence

comparing lung cancer risk in smokers of mentholated and unm-

entholated cigarettes. BMC Pulmonary Medicine, 11(18), 1–28.

Mechanic, L.E., Bowman, E.D., Welsh, J.A., Khan, M.A., Hagiwara,

N., Enewold, L., . . . Harris, C.C. (2007). Common genetic varia-

tion in TP53 is associated with lung cancer risk and prognosis in

African Americans and somatic mutations in lung tumors. Can-

cer Epidemiology, Biomarkers and Prevention, 16, 214–222.

doi:10.1158/1055-9965.EPI-06-0790

Motohashi, S., Okamoto, Y., Yoshino, I., & Nakayama, T. (2011).

Anti-tumor immune responses induced by iNKT cell-based im-

munotherapy for lung cancer and head and neck cancer. Clinical

Immunology, 140, 167–176. doi:10.1016/j.clim.2011.01.009

National Cancer Institute. (2008). Smoking prevalence and lung

cancer death rates. Strategies to control tobacco use in the

United States: A blueprint for public health action in the 1990’s

update (NIH Pub. No. 07-6242; pp. 85–86). Retrieved from http://

cancercontrol.cancer.gov/tcrb/monographs/1/m1_3.pdf

National Cancer Institute. (2012a). Lung cancer prevention (PDQ®):

Health professional version. Retrieved from http://www.cancer

.gov/cancertopics/pdq/prevention/lung/HealthProfessional

National Cancer Institute. (2012b). Lung cancer prevention (PDQ®):

Patient version. Retrieved from http://www.cancer.gov/cancertop

ics/pdq/prevention/lung/Patient/page1/AllPages

National Cancer Institute. (2012c). What you need to know about

lung cancer: Types of lung cancer. Retrieved from http://www

.cancer.gov/cancertopics/wyntk/lung/page4

Ou, S.H., Zell, J.A., Ziogos, A., & Anton-Culver, H. (2008). Low

socioeconomic status is a poor prognostic factor for survival in

stage I nonsmall cell lung cancer and is independent of surgi-

cal treatment, race, and marital status. Cancer, 112, 2011–2020.

doi:10.1002/cncr.23397

Parsons, A., Daley, A., Begh, R., & Aveyard, P. (2010). Influence of

smoking cessation after diagnosis of early stage lung cancer on

prognosis: Systematic review of observational studies with meta-

analysis. BMJ, 340, b5569. doi:10.1136/bmj.b5569

Peipins, L.A., Soman, A., Berkowitz, Z., & White, M.C. (2012). The

lack of paid sick leave as a barrier to cancer screening and medical

care-seeking: Results from the National Health Interview Survey.

BMC Public Health, 12, 520. doi:10.1186/1471-2458-12-520

Phillips, J.M., Cohen, M.Z., & Moses, G. (1999). Breast cancer screen-

ing and African American women: Fear, fatalism, and silence.

Oncology Nursing Forum, 26, 561–571.

Powe, B.D. (1996). Cancer fatalism among African Americans: A

review of the literature. Nursing Outlook, 44(1), 18–21.

Rice, V.H., & Stead, L.F. (2008). Nursing interventions for smok-

ing cessation. Cochrane Database of Systematic Reviews, 1,

CD001188. doi:10.1002/14651858.CD001188.pub3

Rigotti, N.A., Arnsten, J.H., McKool, K.M., Wood-Reid, K.M., Paster-

nak, R.C., & Singer, D.E. (1997). Efficacy of a smoking cessation

program for hospital patients. Archives of Internal Medicine, 157,

2653–2660. doi:10.1001/archinte.1997.00440430135016

Rigotti, N.A., Munafo, M.R., & Stead, L.F. (2008). Smoking cessa-

Receive Continuing Nursing Education Credits

Receive free continuing nursing education credit* for reading this article and taking a brief quiz online. To access the test for this and other articles, visit http://evaluationcenter.ons.org/Login.aspx. Af- ter entering your Oncology Nursing Society profile username and password, select CNE Tests and Evals from the left-hand menu. Scroll down to Clinical Journal of Oncology Nursing and choose the test(s) you would like to take.

* The Oncology Nursing Society is accredited as a provider of continuing nursing education by the American Nurses Credential- ing Center’s COA.

tion interventions for hospitalized smokers: A systematic review.

Archives of Internal Medicine, 168, 1950–1960. doi:10.1001/

archinte.168.18.1950

Robles, G.I., Singh-Franco, D., & Ghin, H.L. (2008). A review of the

efficacy of smoking-cessation pharmacotherapies in nonwhite

populations. Clinical Therapeutics, 30, 800–812. doi:10.1016/j

.clinthera.2008.05.010

Sarna, L. (2012). Carpe diem. Nursing Research, 61(1), 1–2. doi:10.1097/

NNR.0b013e31824101a1

Sarna, L., Bialous, S.A., Wells, M., Kotlerman, J., Wewers, M.E., &

Froelicher, E.S. (2009). Frequency of nurses’ smoking cessation

interventions: Report from a national survey. Journal of Clinical

Nursing, 18, 2066–2077. doi:10.1111/j.1365-2702.2009.02796.x

Siegel, R., Naishadham, D., & Jemal, A. (2013). Cancer statistics, 2013.

CA: A Cancer Journal for Clinicians, 63, 11–30. doi:10.3322/

caac.21166

Smith, P.M., Corso, L., Brown, K.S., & Cameron, R. (2011). Nurse

case-managed tobacco cessation interventions for general hospital

patients: Results of a randomized clinical trial. Canadian Journal

of Nursing Research, 43(1), 98–117.

Sun, S., Schiller, J.H., & Gazdar, A.F. (2007). Lung cancer in never

smokers—A different disease. Nature Reviews. Cancer, 7, 778–

790. doi:10.1038/nrc2190

Tzelepis, F., Paul, C.L., Walsh, R.A., McElduff, P., & Knight, J. (2011). Pro-

active telephone counseling for smoking cessation: Meta-analyses

by recruitment channel and methodological quality. Journal of

National Cancer Institute, 103, 922–941. doi:10.1093/jnci/djr169

Underwood, J.M., Townsend, J.S., Tai, E., Davis, S.P., Stewart, S.L.,

White, A., . . . Fairley, T.L. (2011). Racial and regional disparities

in lung cancer incidence. Cancer, 118, 1910–1918.

U.S. Census Bureau. (2012). Poverty: Overview/highlights. Retrieved

from http://www.census.gov/hhes/www/poverty/about/over

view/index.html

U.S. Department of Health and Human Services. (2004). The health

consequences of smoking: A report of the surgeon general.

Atlanta, GA: Author.

U.S. Department of Health and Human Services. (2006). The health

consequences of involuntary exposure to tobacco smoke: A

report of the surgeon general. Atlanta, GA: Author.

Wakefield, M., Olver, I., Whitford, H., & Rosenfeld, E. (2004).

Motivational interviewing as a smoking cessation intervention

for patients with cancer: Randomized controlled trial. Nursing

Research, 53, 396–405. doi:10.1097/00006199-200411000-00008

Zhang, X., Miao, X., Guo, Y., Tan, W., Zhou, Y., Sun, T., . . . Lin, D.

(2006). Genetic polymorphisms in cell cycle regulatory genes

MDM2 and TP53 are associated with susceptibility to lung cancer.

Human Mutation, 27(1), 110–117. doi:10.1002/humu.20277

may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express

written permission. However, users may print, download, or email articles for individual use.