Belief that biopsies spread cancer was significantly associated with screening interest and medical mistrust among adults in urban Pakistan, with 50.6% expressing interest in screening programs.
Cross-Sectional (n=358)
How do specific misconceptions and knowledge levels predict screening readiness and medical mistrust for lung cancer in an urban Pakistani population?
Misconceptions about diagnostic procedures drive both curiosity and mistrust toward lung cancer screening, highlighting the need for culturally adapted myth correction.
Abstract Rationale Lung cancer screening uptake in low- and middle-income countries (LMIC) remains poor despite rising disease burden. Beyond limited awareness, mistrust and procedural misconceptions may strongly influence screening behaviour. This study aimed to identify how specific misconceptions and knowledge levels predict both screening readiness and mistrust of medical professionals in an urban Pakistani population. Methods A cross-sectional survey of 358 adults in Islamabad assessed awareness, misconceptions, and trust related to lung cancer and screening. The primary outcome was screening readiness, defined as interest in attending screening or awareness programmes. The secondary outcome was medical mistrust, defined as lack of trust in professionals recommending screening. Independent variables included knowledge score, biopsy misconception, CT scan concerns, fear of late diagnosis, and demographic covariates (age, gender, employment, smoking). For the mistrust model, education and cultural barriers were also included. Independent variables were selected a priori from behavioural theory and prior evidence linking health beliefs, procedural misconceptions, and trust to screening behaviour. “Not sure” responses were treated as neutral or missing. Multivariable logistic regression was performed with complete-case analysis, reporting adjusted odds ratios (AOR) and 95% confidence intervals (CI). Model diagnostics indicated acceptable fit (Hosmer-Leme show p 0.30). Results Half of respondents (50.6%) expressed interest in screening or awareness programmes. In multivariable analysis, belief that biopsies spread cancer was significantly associated with screening interest, while concern about CT scans showed a positive trend. In the mistrust model, biopsy misconception again emerged as the strongest predictor, and CT scan concerns approached significance. Knowledge, education, cultural barriers, and demographics were not significant. Conclusions Misconceptions about diagnostic procedures are key behavioural determinants of both screening interest and mistrust. Knowledge alone does not counter mistrust. Misinformation may simultaneously increase curiosity about screening yet undermine confidence in healthcare systems. Screening implementation in LMICs must therefore focus on culturally sensitive myth correction and trust-building to ensure effective delivery. Funding none. AI Assistance Disclosure Language refinement and table formatting support were provided using ChatGPT under author supervision. All analyses, interpretation, and content were verified by the study investigators. 25-word summary Misconceptions drive both curiosity and mistrust toward lung cancer screening. Culturally adapted trust-building and myth correction are essential to strengthen screening uptake in low-resource settings. This abstract is funded by: none
Akram et al. (2026) conducted a cross-sectional in Lung cancer screening readiness and medical mistrust (n=358). Misconceptions and knowledge levels (e.g., biopsy misconception, CT scan concerns) was evaluated on Screening readiness, defined as interest in attending screening or awareness programmes. Belief that biopsies spread cancer was significantly associated with screening interest and medical mistrust among adults in urban Pakistan, with 50.6% expressing interest in screening programs.