Acceptance of Lung Cancer Screening and Associated Factors in Hong Kong: A Population-Based Study

Low-dose computed tomography (LDCT) enables early detection of lung cancer and reduces mortality, yet public willingness to undergo screening remains suboptimal. This study aimed to assess willingness and its associated factors among high-risk individuals in Hong Kong.

A territory-wide cross-sectional survey was conducted among adults aged 54 years or above, and those aged 45-54 years with at least one lung cancer risk factor (e.g., smoking, secondhand smoke exposure, or family history) in Hong Kong. Data were collected via self-administered questionnaires, which included socio-demographic information, risk exposure, awareness and experience of LDCT, and constructs from the Health Belief Model (HBM). Logistic regression was performed to identify factors associated with willingness to undergo LDCT screening.

A total of 1100 participants were included in the analysis. Among them, 57.3% expressed willingness to undergo LDCT within the next year. Multivariable logistic regression showed that higher self-efficacy was the strongest factor of willingness, followed by greater perceived benefits and stronger cues to. Additional significant factors included being a current or former smoker, secondhand smoke exposure, age > 65 years, and being responsible for cooking at home. In contrast, unmarried individuals were significantly less likely to be willing to undergo LDCT (aOR = 0.678; 95% CI: 0.486-0.946; p = 0.022).

Willingness to undergo LDCT screening was suboptimal among high-risk individuals in Hong Kong. Key facilitators included higher self-efficacy, perceived benefits, and cues to action-central domains of the Health Belief Model. Targeted strategies that strengthen these domains may improve screening uptake.