Understanding public awareness and knowledge of lung cancer screening practices: a cross-sectional study from the Asir region, Saudi Arabia

Our plain-English summary of Understanding public awareness and knowledge of lung cancer screening practices: a cross-sectional study from the Asir region, Saudi Arabia, by G. Kandasamy, K. Orayj, A.M. Alshahrani, et al (Frontiers in Public Health, 2025).

The study

• Authors: G. Kandasamy, K. Orayj, A.M. Alshahrani, T.S. Alanazi, A. Hmlan, S. Alharthi, H. Alyami, A. Khaled
• Journal: Frontiers in Public Health
• Published: 2025;13:1678080
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Lung Cancer (LC) remains one of the leading causes of cancer-related deaths globally, primarily due to late-stage diagnosis and inadequate public awareness of early symptoms and available screening methods. In Saudi Arabia, rising smoking rates and environmental risks increase the burden, particularly in regions like Asir. This study assesses public knowledge and awareness of LC symptoms, risk factors, and screening practices in the Asir region.

Methods: A cross-sectional online survey was conducted from April to June 2025 among adults (≥18 years) in the Asir region, Saudi Arabia. Using convenience sampling, 437 participants completed a validated Arabic questionnaire assessing demographics, knowledge of LC symptoms and risk factors, and awareness of screening practices. Multivariable logistic regression identified factors significantly associated with knowledge levels (p < 0.05).

Results: Out of 437 participants, only 192 (43.9%) demonstrated good knowledge of LC, while the majority 245 (56.1%) had poor knowledge. Symptom awareness varied, with shortness of breath 277 (63.5%) most commonly identified, while frequent chest infections 198 (45.3%) and shoulder pain 129 (29.5%) were less recognized. Only 212 (48.5%) knew of screening methods, though 267 (61.1%) acknowledged the importance of early detection. Logistic regression showed significantly lower odds of good knowledge among high school graduates (OR = 0.242, 95% CI: 0.133-0.440, p < 0.001), diploma holders (OR = 0.120, 95% CI: 0.061-0.230, p < 0.001), and uneducated individuals (OR = 0.435, 95% CI: 0.215-0.870, p = 0.020) compared to degree holders. Employed participants (175; 40.0%) were more likely to have good knowledge than students (OR = 5.384, 95% CI: 2.650-10.939, p < 0.001). Those with smoker exposure among family/friends 228 (52.2%) had lower knowledge (OR = 0.382, 95% CI: 0.237-0.613, p < 0.001).

Conclusion: This study highlights insufficient public knowledge of LC in the Asir region, with only 43.9% demonstrating good awareness. While smoking was widely recognized as a major risk factor, awareness of asbestos exposure, chronic obstructive pulmonary disease (COPD), and environmental pollutants was limited, and recognition of less common symptoms was often poor. Knowledge levels were significantly influenced by education, employment, and exposure to smokers. The findings highlight a critical need for targeted educational campaigns and awareness initiatives, particularly among less educated and high-risk populations, to promote early detection and reduce LC burden in the region.

Copyright © 2025 Kandasamy, Orayj, Alshahrani, Alanazi, Hmlan, Alharthi, Alyami and Khaled.

In plain English

This online cross-sectional survey, run from April to June 2025, asked adults in the Asir region of Saudi Arabia about lung cancer. It did not recruit or measure people by asbestos exposure; asbestos appeared only in one question about knowledge of risk factors. A convenience sample of 437 adults answered 21 knowledge questions, and 11 or more correct counted as good knowledge. Of the 437, 192 (43.9%) had good knowledge and 245 (56.1%) had poor knowledge. Asked whether asbestos exposure increases lung cancer risk, 226 (51.72%) said yes, 138 (31.58%) said no and 73 (16.70%) did not know. Only 212 (48.51%) knew that screening methods exist. Compared with bachelor's or master's degree holders, people with high school, diploma or no education had lower odds of good knowledge. Employed people had higher odds than college students. The article contradicts itself on whether having smokers among family or friends was linked to knowledge. The authors concluded that public knowledge was insufficient, with limited awareness of asbestos exposure. They noted that their self-selected online sample may limit generalizability.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional online questionnaire survey (observational), April to June 2025
• Who was studied: 437 adults aged 18 or older living in the Asir region of Saudi Arabia, recruited by convenience sampling through health facilities, pharmacies and social media; 259 (59.27%) were female
• Exposure: The study did not measure asbestos exposure or any other exposure as a cause of disease. It measured knowledge with 21 questions on general knowledge, risk factors (one of them about asbestos) and symptoms. Scores ran from 0 to 21, and a score of 11 or more counted as good knowledge.
• Main results:
  • Of all 437 respondents, 192 (43.9%) had good knowledge of lung cancer and 245 (56.1%) had poor knowledge
  • Asked whether exposure to asbestos increases the risk of lung cancer, 226 (51.72%) answered yes, 138 (31.58%) answered no and 73 (16.70%) did not know
  • 212 (48.51%) of respondents were aware that screening methods for early detection of lung cancer exist
  • Compared with bachelor's or master's degree holders, high school graduates had lower odds of good knowledge (OR 0.242; 95% CI 0.133 to 0.440; p less than 0.001)
  • Compared with bachelor's or master's degree holders, diploma holders had lower odds of good knowledge (OR 0.120; 95% CI 0.061 to 0.230; p less than 0.001)
  • Compared with bachelor's or master's degree holders, uneducated participants had lower odds of good knowledge (OR 0.435; 95% CI 0.215 to 0.870; p = 0.020)
  • Employed participants had higher odds of good knowledge than college students (OR 5.384; 95% CI 2.650 to 10.939; p less than 0.001)
  • The Results text says that having smokers among family or friends was not significantly associated with knowledge. Table 6 marks it as significant (OR 0.382; 95% CI 0.237 to 0.613), and the abstract and conclusion describe it as associated with lower knowledge.
  • Age, gender, marital status, monthly income and personal smoking status were not significantly associated with lung cancer knowledge
• The authors' conclusion: The authors concluded that there is a gap in public knowledge of lung cancer in the Asir region. They wrote that smoking was widely recognized as a risk factor, but awareness of other contributors such as asbestos exposure, COPD and environmental pollutants was limited. They called for targeted, community-based education.
• Limitations the authors state:
  • The cross-sectional design captures one point in time and does not allow conclusions about cause between knowledge levels and associated factors
  • Data were self-reported, especially smoking behavior, and may be affected by recall and social desirability bias
  • The study covered a single region, which may limit how far the findings apply to other parts of Saudi Arabia
  • The online method may have excluded people without internet access or digital literacy, possibly biasing the sample toward more educated respondents
  • 59.04% of participants did not report monthly income, limiting the assessment of socioeconomic influences
  • Participants were self-selected through convenience sampling and may be more health-conscious or technologically literate, introducing possible selection bias
  • The questionnaire did not assess actual participation in screening programs

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Low-Dose CT Screening, Lung Cancer, Asbestos Exposure, COPD.

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