Lung Cancer: A New Tool to Measure Literacy and Enhance Primary Prevention in Brazil

Lung cancer remains one of the leading causes of death worldwide, accounting for approximately 1.8 million deaths annually. In this context, low health literacy is frequent and represents a barrier to effective education on screening and early detection. The aim of this study was to translate, culturally adapt, and validate the Lung CAM questionnaire for use in Brazil, enabling the assessment of population literacy regarding lung cancer.

The instrument was translated and culturally adapted by three independent translators. An abridged version was reviewed by 12 healthcare professionals to enhance clarity. Subsequently, the questionnaire was tested with 30 individuals, who rated their understanding of each item on a scale from 0 to 5. Content validity was assessed by five oncology experts. Finally, the survey was administered to 100 patients, and internal consistency was measured using Cronbach's Alpha.

Healthcare professionals suggested 42 modifications across 20 items to improve clarity. In the pilot study, participants reported a mean comprehension score of 4.90 out of 5, leading to further refinements. Content validity analysis yielded final scores of 0.91 for clarity and 0.89 for relevance. Application of the instrument in the test phase demonstrated satisfactory results regarding knowledge of lung cancer symptoms and risk factors, with Cronbach's Alpha indicating strong internal consistency (0.87).

The study successfully produced a validated instrument for assessing and monitoring lung cancer literacy in the Brazilian population. The questionnaire was named QuIC-Pulmão.