Public opinion on implementing the National Lung Cancer Screening Program in Korea

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.