Targeted lung cancer screening has the potential to detect lung cancer earlier and improve outcomes for people at higher risk. Cancer Research UK commissioned research to understand public awareness and perceptions of lung cancer, attitudes towards lung cancer screening, likely uptake of screening invitations, and potential unintended consequences of a targeted approach. The study examined views among people who currently smoke, formerly smoked, and have never smoked, to identify groups that may need additional support or engagement. The findings are based on a nationally representative survey of more than 4,000 UK adults conducted in 2022 conducted by YouGov.
There was strong public support for lung cancer screening. Around 77% of adults said they would attend a lung cancer risk assessment if invited, and 86% said they would attend screening if they were identified as being at higher risk.
Most people understood the benefits of screening. The majority recognised that lung screening can detect cancer early and save lives, and most felt they would benefit from screening if it were offered to them.
Awareness of lung cancer risk factors was generally high, with smoking the most widely recognised risk factor. However, people who currently smoke were less likely than former or never smokers to recognise some lung cancer risk factors, including smoking itself.
Lung cancer is viewed as a particularly serious disease. It was one of the cancers people were most concerned about receiving a diagnosis of, and many people who smoke reported worrying about getting lung cancer.
Acceptance of risk-based eligibility for screening was generally high. Most people agreed (64%) that it is appropriate for screening eligibility to be determined by a person's level of risk rather than offering screening to everyone.
Nevertheless, around a quarter of former (28%) and never smokers (25%)said they would mind not being included in a screening programme, suggesting that risk-based eligibility may require careful communication.
People who currently smoke, who are the group most likely to be eligible for targeted screening, were less likely than former or never smokers to say they would attend screening. And 20% of smokers agree that they would be too worried about lung cancer to take part in a screening. Some expressed concerns that they would be too worried about the possibility of lung cancer to take part, indicating potential barriers related to fear, denial or fatalistic beliefs.
These findings suggest there is broad public support for targeted lung cancer screening and strong recognition of its potential benefits. This provides encouraging evidence for the introduction and expansion of lung screening programmes aimed at people at higher risk of developing lung cancer.
However, the results also highlight important challenges for successful implementation. The people most likely to benefit from screening, particularly some people who currently smoke, appear less willing to take part than other groups. Fear of receiving a diagnosis, perceptions that it may be too late to benefit, and other fatalistic beliefs could act as barriers to participation.
The findings also suggest that clear communication about who is eligible for screening and why eligibility is based on risk will be important. While most people accepted a targeted approach, some former and never smokers felt concerned about not being included, raising the possibility of unintended consequences if eligibility criteria are not well understood.
Future research should continue to explore how best to encourage screening participation among higher-risk groups, particularly people who smoke, and how to communicate the rationale for risk-based screening in ways that maximise understanding, trust and engagement across the population.
Read the report in fullMaya Kamar, Jodie Moffat, Mathew Stoker, Briony Gunstone.
Supported by Scottish Power.
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