Determinants of lung cancer screening intention among eligible individuals

Lung cancer screening (LCS) with low-dose computed tomography (LDCT) reduces mortality, yet uptake among eligible adults remains low. This study examined individual-level determinants of LCS intention among guideline-eligible adults who had never been screened.

We analyzed cross-sectional survey data collected through the Qualtrics Research Panel from December 2023 to February 2024. Participants were adults aged 50-80 years with no history of lung cancer who currently smoked or had formerly smoked and quit within the past 15 years. Of 1,074 respondents to the survey a total of 521 LCS-eligible individuals who reported no prior LCS use were included in this study. The primary outcome was intention to undergo LCS within 3 months if recommended by a healthcare provider, categorized as definitely/probably not, maybe/probably yes, and definitely yes. Descriptive analyses and multinomial multivariable regression were performed.

Participants were predominantly aged 50-64 years (70.1%), female (63.3%), White (83.6%), and current individuals with active tobacco users (83.6%) with a mean smoking history of 38.1 pack-years. About 56.2% had not heard of LCS, and only (6.5%), had discussed LCS with a provider in the past year. Intention to undergo LCS was reported as definitely/probably not by (13.6%), maybe/probably yes by (52.9%), and definitely yes by 33.4%. Older age and agreement that little can be done to lower cancer risk were associated with a reduced likelihood of definite intention forLCS.

Among never-screened LCS-eligible adults, intention to undergo LCS was limited and was associated with sociodemographic characteristics, healthcare access, and cancer-related beliefs. Interventions enhancing awareness, reducing fatalistic beliefs, and strengthening provider-patient communication may increase LCS intention and guideline-concordant screening.