Public perceptions of lung cancer screening: a population-based assessment of acceptability and feasibility

BACKGROUND: Despite strong evidence supporting screening in reducing lung cancer mortality, uptake remains low globally. This study aimed to assess the public perceptions of the acceptability and feasibility of lung cancer screening among potentially high-risk adults in Hong Kong, and to identify associated factors. METHODS: A cross-sectional survey was conducted among adults in Hong Kong identified as potentially high-risk for lung cancer. Perceptions of screening acceptability, and feasibility were measured alongside sociodemographic characteristics, health status, and psychosocial beliefs based on Health Belief Model (HBM) constructs. Multivariable logistic regressions were used to examine associations between participant characteristics and implementation outcomes. RESULTS: Among the 1,100 participants, 90.1% found lung cancer screening acceptable and 88.4% found it feasible. Financial factors, including health insurance coverage and household income ≥ HKD 50,000, were positively associated with perceived screening acceptability. Responsibility for household cooking was also associated with both acceptability and feasibility. Regarding HBM constructs, higher perceived benefits and self-efficacy were the strongest predictors of both acceptability and feasibility. Perceived higher threat of lung cancer were significantly more likely to perceive lung cancer screening as feasible compared to their counterparts. Perceived barriers were negatively associated with both outcomes (p < 0.05). CONCLUSION: Acceptability and feasibility toward lung cancer screening in Hong Kong are influenced by psychosocial readiness and financial capacity. Enhancing public education, addressing affordability, and embedding screening in primary care with public-private partnerships may support future program success. Findings offer actionable insights for policymakers designing equitable and sustainable lung cancer screening strategies in Hong Kong and similar contexts.