# Barriers to Timely Lung Cancer Screening Among High-Risk Populations in Saudi Arabia: A Cross-Sectional Survey

## TL;DR

This study identifies barriers like low awareness, cost, and fear preventing high-risk individuals in Saudi Arabia from getting timely lung cancer screening.

## Contribution

The study provides new insights into barriers to lung cancer screening in Saudi Arabia, focusing on awareness, cost, and access issues among high-risk populations.

## Key findings

- Only 36% of participants were fully aware of lung cancer screening programs.
- Lack of awareness, high cost, and fear of results were the top barriers reported.
- 74.5% of participants would be willing to undergo screening if it were free.

## Abstract

Background

Lung cancer is a leading cause of cancer-related mortality worldwide, primarily driven by smoking. Although low-dose computed tomography screening effectively reduces lung cancer mortality through early detection, participation in screening programs remains low, particularly among high-risk populations. In Saudi Arabia, data on barriers to screening uptake are limited. This study aimed to identify and evaluate the barriers to timely lung cancer screening among high-risk individuals in Saudi Arabia, including awareness levels, access issues, personal attitudes, and perceived obstacles.

Methodology

A cross-sectional survey was administered between January and March 2025 to high-risk individuals in Saudi Arabia, defined by either a smoking history or a family history of lung cancer. Participants were recruited from multiple healthcare centers using convenience sampling. The survey assessed demographic information, knowledge and awareness of screening, perceived barriers, access to services, and attitudes toward screening.

Results

Of the 200 participants, 112 (56.0%) were male and 88 (44.0%) were female. Full awareness of lung cancer screening programs was reported by 72 (36.0%) participants, while 63 (31.5%) were unaware. Key reported barriers included lack of awareness (28.0%, n = 56), high screening cost (20.5%, n = 41), and fear of results (18.0%, n = 36). A total of 149 (74.5%) participants indicated willingness to undergo screening if it were free. Difficulty accessing screening services was reported by 49 (24.5%) participants, and 20 (10.0%) stated screening was not available in their area. Regarding stigma, 44 (22.0%) participants believed it negatively influenced screening uptake. Most respondents (54.5%, n = 109) viewed regular screening for high-risk individuals as very important. Suggested supports to improve screening included more awareness campaigns (43.0%, n = 86) and financial subsidies (31.5%, n = 63).

Conclusions

This study highlights significant barriers to lung cancer screening among high-risk populations in Saudi Arabia, including limited awareness, fear of diagnosis, cost, and access challenges. Interventions such as national awareness campaigns, cost reduction strategies, mobile screening units, and stigma mitigation are essential to improve screening uptake and reduce lung cancer mortality in the region.