Public opinion on implementing the national lung cancer screening program in Korea

Abstract

Background: Lung cancer screening for high-risk population using low-dose computed tomography is a valid strategy to reduce lung cancer mortality. This study investigated public opinions toward the initiation and participation in the National Lung Cancer Screening Program (NLCSP) launched in Korea. Methods: In this cross-sectional analysis of the 2018 Korean National Cancer Screening Survey, we analyzed the responses related to lung cancer screening. Eligible participants for NLCSP are aged 55-74 years with at least 30 pack-years of smoking history. We compared public opinions on implementing lung cancer screening according to smoking status and eligibility for NLCSP. Results: Among 3,495 respondents, 205 (5.9%) were eligible for screening. Most of the respondents (71.2%) agreed with implementing NLCSP. Agreement rates were relatively lower in never smokers (66.2%) and higher in former (80.8%) and current smokers (82.3%). Factors associated with agreement included the presence of private health insurance [odds ratio (OR) 1.36, 95% confidence interval (CI), 1.04-1.78], regular health checkup (OR 2.10, 95% CI, 1.72-2.57), and smoking history (former, OR 1.66, 95% CI, 1.09-2.55; current, OR 1.97, 95% CI, 1.45-2.67). Preference of the screening facilities showed that quality was considered more important than accessibility (46.9% vs. 31.9%). Furthermore, people were more affirmative (75.5%) towards receiving mandatory smoking cessation counseling included in NLCSP. Conclusions: Public agreement and active participation of the eligible population are key factors in the successful implementation of NLCSP. Our data would be a valuable resource in building appropriate strategies to maximize the benefits of nationwide lung cancer screening.