In partnership with the Michigan Department of Health & Human Services and the Michigan Public Health Institute, MiCHWA compiled resources that illustrate the vital role CHWs play in cancer control and prevention. This page is specific to Lung Cancer. For other health conditions that are covered by MiCHWA, refer to the sidebar to the right.
Health Disparities in Lung Cancer
More men and women die of lung cancer in the United States than any other form of cancer.1 It is estimated that 158,040 lung cancer deaths will occur in 2015, accounting for about 27% of all cancer deaths.1 Tobacco use is the primary cause of lung cancer in the United States.2 While incidence has decreased for most subpopulations since 1999,3 there still exist important lung cancer disparities.
|In 2011, black men had the highest incidence of lung cancer, followed by white, American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic men3||Lung cancer incidence is higher for black men (106.6 deaths per 100,000) and women (68) than White men (83.8) and women (62.5)4|
|Among men in 2011, black men were more likely to die of lung cancer than any other racial group (about 79 deaths per 100,000) 3||Lung cancer mortality is higher for black men (88.8 deaths per 100,000) than White men (66.3)4|
|Rural young adults are 27 percent more likely to smoke than urban young adults, and they have higher rates of smokeless tobacco use5||Lung cancer incidence and death rates are higher in rural areas of Michigan.6 Smoking rates are higher in rural areas (26.2%) than metropolitan areas (22.5%).7|
|Socioeconomically deprived and rural groups face excess risk of lung cancer and lung cancer mortality for white and black men8||Adult Medicaid enrollees have a higher incidence of lung cancer. Enrollees younger than 65 are more likely to be diagnosed at advanced stages.9|
Community Health Worker (CHW) Interventions
Education and Smoking Cessation
CHWs are commonly employed in smoking cessation interventions targeting vulnerable communities such as minority groups and pregnant women.10 A systematic review found that bilingual lay health advisors can lead to more effective interventions.10 At the University of Arizona, Spanish-speaking CHWs were trained as tobacco cessation counselors to identify tobacco users and offer counseling. CHWs indicated high confidence in delivering brief cessation interventions.11 In another intervention, CHWs led group sessions to provide smoking self-efficacy and social support to African American women living in public housing, leading to higher likelihood of smoking cessation.12 Other research has shown that web-based and in-person interventions led by “lay health influencers” also increase self-efficacy and knowledge.13
In New York City, a tobacco cessation curriculum was delivered in English and Mandarin by lay health advocates and other partners to Chinese American 7th grade students. incorporating the cultural views held by Chinese immigrant students on the individual and society was important to successful curriculum implementation.14
Health System Navigation
CHW navigators are employed in both lung cancer treatment and prevention efforts. Lung cancer patients and their families benefit from community health workers as navigators.15 A volunteer lay navigation program for patients with newly diagnosed lung cancer found that patients benefit from emotional support, information, and referrals to other services provided by lay navigators.15 A study of physicians found that a majority of primary care providers are interested in integrating patient navigation models (using lay navigators) into their practice.16
Article abstracts available by clicking the hyperlinked article titles above; full citations are located in the References category.
Fact Sheet: CHWs & Lung Cancer
Click To View All External Links & References
1. Centers for Disease Control and Prevention. Lung Cancer Statistics. http://www.cdc.gov/cancer/lung/statistics/. Accessed August 20, 2015.
2. American Lung Association. Smoking. http://www.lung.org/stop-smoking/about-smoking/health-effects/smoking.html?referrer=https://www.google.com/. Accessed August 19, 2015.
3. Centers for Disease Control. Lung Cancer Rates by Race and Ethnicity. http://www.cdc.gov/cancer/lung/statistics/race.htm. Accessed August 18, 2015.
4. Michigan Public Health Institute. The Cancer Burden In Michigan: Selected Statistics 1993-2011. https://www.michigan.gov/documents/mdch/Ca_burden_MI_select_stats_1993-2011_371092_7.pdf. Accessed July 13, 2015.
5. Cutting Tobacco’s Rural Roots – Tobacco Use In Rural Communities. http://www.lung.org/assets/documents/publications/lung-disease-data/cutting-tobaccos-ruralroots.pdf. Accessed August 18, 2015.
6. Michigan Department of Community Health. Michigan Rural Health Profile. 2008. https://www.michigan.gov/documents/mdch/MichiganRuralHealthProfile-2008-0801_243955_7.pdf. Accessed August 18, 2015.
7. Michigan Rural Health Profile http://www.michigan.gov/documents/mdch/MichiganRuralHealthProfile-2008-0801_243955_7.pdf. Accessed August 18, 2015.
8. Singh GK, Williams SD, Siahpush M, Mulhollen A. Socioeconomic, Rural-Urban, and Racial Inequalities in US Cancer Mortality: Part I-All Cancers and Lung Cancer and Part II Colorectal, Prostate, Breast, and Cervical Cancers. J Cancer Epidemiol. 2011;2011:107497. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3307012&tool=pmcentrez&rendertype=abstract. Accessed August 18, 2015.
9. Susan G. Komen for the Cure. The Societal and Economic Impact of Cancer Health Disparities.; 2010. http://cchangetogether.org/Websites/cchange/images/Disparities/Societal_EconomicImpactofCancerHealthDisparitiesCaseStatement.pdf. Accessed August 18, 2015.
10. Fitzgerald EM. Evidence-based tobacco cessation strategies with pregnant Latina women. Nurs Clin North Am. 2012;47(1):45-54. http://www.ncbi.nlm.nih.gov/pubmed/22289397. Accessed July 9, 2015.
11. Martinez-Bristow Z, Sias JJ, Urquidi UJ, Feng C. Tobacco cessation services through community health workers for Spanish-speaking populations. Am J Public Health. 2006;96(2):211-213. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1470484&tool=pmcentrez&rendertype=abstract. Accessed July 9, 2015.
12. Andrews JO, Felton G, Ellen Wewers M, Waller J, Tingen M. The effect of a multi-component smoking cessation intervention in African American women residing in public housing. Res Nurs Health. 2007;30(1):45-60. doi:10.1002/nur.20174.
13. Muramoto ML, Hall JR, Nichter M, et al. Activating lay health influencers to promote tobacco cessation. Am J Health Behav. 2014;38(3):392-403. http://www.ncbi.nlm.nih.gov/pubmed/24636035. Accessed July 9, 2015.
14. Ferketich AK, Kwong K, Shek A, Lee M. Design and evaluation of a tobacco-prevention program targeting Chinese American youth in New York City. Nicotine Tob Res. 2007;9(2):249-256. http://www.ncbi.nlm.nih.gov/pubmed/17365756. Accessed July 9, 2015.
15. Lorhan S, Dennis D, van der Westhuizen M, Hodgson S, Berrang T, Daudt H. The experience of people with lung cancer with a volunteer-based lay navigation intervention at an outpatient cancer center. Patient Educ Couns. 2014;96(2):237-248. http://www.sciencedirect.com/science/article/pii/S0738399114001815. Accessed August 19, 2015.
16. Ostroff JS, Shuk E, Krebs P, et al. Qualitative evaluation of a new tobacco cessation training curriculum for patient navigators. J Cancer Educ. 2011;26(3):427-435. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3449085&tool=pmcentrez&rendertype=abstract. Accessed July 9, 2015.