Knowledge and attitudes about lung cancer screening amongst American Indian adults who use commercial tobacco.

Lung cancer is the leading cause of cancer related death in the US and the world. In some parts of the US, American Indian adults experience extreme disparities in lung cancer incidence and mortality that mirror commercial tobacco use disparities. Lung cancer screening (LCS) with low-dose chest computed tomography has been underutilized in all groups, including in American Indian communities, although they have the greatest proportion of people who smoke older than 50 years of age eligible for LCS. This is a secondary analysis of LCS knowledge, attitudes and behavior collected during a pilot study testing a culturally aligned digital tool for smoking cessation. Data were collected in 2023 via web surveys from American Indian adults residing in the Midwestern US. We found striking similarities to national studies showing most participants are unaware of, but open to, LCS and are looking to their doctors and clinics to provide recommendations for screening. American Indian adults who use commercial tobacco have knowledge, attitudes and intentions similar to other Americans eligible for LCS. Healthcare organizations must find systematic ways to offer LCS to eligible persons.