PLUS: Promoting Lung Cancer Screening Among Screening-Eligible Individuals in Environmentally Burdened Communities Through Enhanced Risk Communication

In the city of Philadelphia, lung cancer incidence and mortality rates exceed state and national rates. Both smoking and air pollutants are known risk factors for lung cancer. In lower socioeconomic neighborhoods in Philadelphia, smoking prevalence is 30% or higher. While education around smoking and individual risk is a mainstay of lung cancer screening approaches, education regarding exposure to air pollution has been less common. This may be due to a lack of information, but recent efforts led by Penn investigators have aggregated air pollution data to demonstrate areas of higher risk in Philadelphia, identifying 10 zip codes of Abramson Cancer Center’s 421 zip code catchment area with the highest levels of air pollution. Neighborhoods bearing a disproportionate and unjust burden of air pollutants and cancer disparities are called environmentally burdened communities.

Project PLUS seeks to develop effective strategies for promoting lung cancer screening in these environmentally burdened communities. The project utilizes an enhanced risk communication approach to assess how adding environmental-level factors (zip code-level information on air pollution) to risk communication about individual risk (e.g., smoking history, age) may or may not impact screening intentions. The project will first gather insights from screening-eligible adults living in environmentally burdened communities to develop a brief and novel video including education on involuntary exposure to air pollution with persuasive framing for obtaining lung cancer screening. Project PLUS will then conduct preliminary testing to assess the impact of viewing the video on intent to pursue lung cancer screening in contrast to standard risk communication strategies.

Project PLUS evaluates the feasibility and preliminary efficacy of utilizing an enhanced risk communication approach to improve lung cancer screening among interested and eligible adults with a long-term goal to reduce lung cancer burden and disparities among environmentally burdened communities within and outside of Philadelphia.

Abramson Cancer Center Pilot Award

Annenberg School for Communication; Perelman School of Medicine; Chester Environmental Partnership; Clean Water Action