NEED FOR COGNITIVE CLOSURE DOES NOT EXPLAIN VARIATION IN LUNG CANCER SCREENING PARTICIPATION IN A VETERAN POPULATION

   Purpose: The need for cognitive closure (NFCC) describes the extent to which a person, faced with a decision or judgment, prefers any answer in lieu of continued uncertainty or ambiguity. This characteristic may help describe individual differences in motivation to seek low-dose computed tomography (LDCT)-based lung cancer screening, which offers a way to reduce uncertainty despite its potentially harmful consequences. The current research examined how individual differences can influence LDCT-based lung cancer screening participation among Veterans, focusing on NFCC.

   Method: Observational survey study of the Minneapolis VA LCS Clinical Demonstration Project in which LDCT-eligible Veterans (N=1,388) were randomly allocated to either Direct Invitation (mailed with decision aid; n=926) or Usual Care (provider referral; n=462). We surveyed participants 3 months post-randomization, including a shortened Need for Closure Scale (NFCS), lung cancer risk perception measured on a 5-point Likert Scale, and sociodemographics; LDCT completion was assessed via medical record. We used logistic regressions to model the predictive role of NFCC in LDCT completion and the moderating effect of NFCC in the relationship between lung cancer risk perception and LDCT completion. We hypothesized that Veterans higher in NFCC would be more likely to have LDCT-based lung cancer screening, in order to reduce uncertainty (whatever the result). We also hypothesized that the association between lung cancer risk perception and LDCT completion would be moderated by NFCC, such that risk perception would predict screening for low-NFCC, but not high-NFCC, respondents.

   Result: 588 surveys were returned (response rate=44%), of which 550 (94%) completed the NFCS (α=.85, M=4.09, SD=0.90). An increase in the NFCS was not associated with the likelihood of completing LDCT-based lung cancer screening (OR=1.03, CI .83, 1.31, p=0.74). Additionally, our moderating hypothesis was not supported; with each increase on the risk perception measure low-NFCC respondents were equally as likely to complete LDCT-based lung cancer screening as high-NFCC respondents (OR=0.92, CI .58, 1.46, p=0.72).

   Conclusion: The present study is the first to examine NFCC in lung cancer screening. Contrary to our hypotheses, individual differences in NFCC may not have direct or moderating consequences in LDCT-based lung cancer screening.