Assessing the awareness regarding lung cancer and attitude toward screening practice: Protocol for a cross-sectional study from Wardha District

Vaishnavi V. Ajankar; Gaurav Mude

doi:10.12688/f1000research.135232.1

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Study Protocol

Assessing the awareness regarding lung cancer and attitude toward screening practice: Protocol for a cross-sectional study from Wardha District

[version 1; peer review: awaiting peer review]

Vaishnavi V. Ajankar ¹, Gaurav Mude²

PUBLISHED 19 Sep 2023

Author details Author details

¹ Clinical Research, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
² Department of Pharmacology, Datta Meghe College of Pharmacy, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India

Vaishnavi V. Ajankar
Roles: Conceptualization, Formal Analysis, Writing – Original Draft Preparation

Gaurav Mude
Roles: Validation, Visualization, Writing – Review & Editing

OPEN PEER REVIEW

REVIEWER STATUS AWAITING PEER REVIEW

This article is included in the Datta Meghe Institute of Higher Education and Research collection.

Abstract

Background: Due to a lack of knowledge about risk factors and symptoms lung cancer is often found at later stages. A total of 19.3 million new cancer cases were recorded last year and resulted in nearly 10 million fatalities. The aim of this study is to evaluate the level of awareness among the general population about lung cancer, its risk factor, symptoms, and available screening methods, as well as to assess the attitude toward screening practice for early detection among a common population in the Wardha district.
Protocol: This study focuses on assessing the level of awareness of lung cancer in Wardha district. It is an observational cross-sectional study design that will be conducted using a standardized questionnaire. The study aims to recruit 400 subjects, both male and female, aged between 18 and 65 years old, from various communities. The participant should be capable of providing informed consent and responding to the survey question. Age, sex, educational level, occupation this are the variable. Participants will be randomly selected from different communities in Wardha district. A structured questionnaire will be administered to collect data on awareness, attitudes, knowledge, and other relevant variables. Chi-squared test will be used to explore associations between awareness, attitudes, and demographic variables (e.g., age, sex, education).
Conclusions: It is hoped that this study will encourage people to participate in screening programs in order to detect cancer at early stages and lead to better treatment outcomes.

Keywords

Lung Cancer, Burden, Mortality, Tobacco, Smoking, Risk Factors, Symptoms, Public Awareness

Corresponding author: Vaishnavi V. Ajankar

Competing interests: No competing interests were disclosed.

Grant information: The author(s) declared that no grants were involved in supporting this work.

Copyright: © 2023 Ajankar VV and Mude G. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to cite: Ajankar VV and Mude G. Assessing the awareness regarding lung cancer and attitude toward screening practice: Protocol for a cross-sectional study from Wardha District [version 1; peer review: awaiting peer review]. F1000Research 2023, 12:1172 (https://doi.org/10.12688/f1000research.135232.1) First published: 19 Sep 2023, 12:1172 (https://doi.org/10.12688/f1000research.135232.1) Latest published: 19 Sep 2023, 12:1172 (https://doi.org/10.12688/f1000research.135232.1)

Introduction

All around the world, the population is dealing with an abundance of new and challenging environmental troubles every day. It takes millions of years to recover from air, water, and soil pollution. The word “Cancer” originated from the Greek word “KARKINOS”. The World Health Organization (WHO) describes a broad range of disorders collectively as cancer as ‘abnormal cell development that extends beyond normal cell borders and has the potential to infiltrate or spread to other organs’.¹ The aging and growth of the world’s population, as well as the rising predominance of cancer-causing behaviors, particularly smoking, in economically growing nations, are the main causes of the rising global burden of cancer. In addition to the disproportionately high burden of malignancies related to infections, female breast cancer, lung cancer, and colorectal cancers are becoming more common.²

The 10 most important drivers of increasing cases (i.e., the causes that had the largest absolute increases in the number of disability-adjusted life year (DALYs) between 1990 and 2019) include six causes that largely affect older adults (ischemic heart disease, diabetes, stroke, chronic kidney disease, lung cancer, and age-related hearing loss).³ Cancer, a condition caused by pathophysiological changes in the natural development of cell division, has become a significant disorder that leads to the death of a high number of people every year worldwide. According to the data, more than 19.3 million (19,300,000) new cancer cases were investigated and recorded last year, resulting in nearly 10 million fatalities by 2020. The ever-increasing occurrences of cancer globally, which cause millions of deaths every year, has created a need and demand for the development of effective medications for treating various tumors.²

Lung cancer is one of the most common types of cancer at present, accounting for approximately one out of every 10 (11.4%) cancers investigated and one out of every five (18.0%) deaths in 2020, will make it the second most frequently investigated carcinoma. The overall leading cause of death in 2020 was cancer. In both men and women, lung cancer is the leading cause of cancer-related morbidity and death. Men experience higher rates of prevalence and mortality than women.⁴ Across all nations, cigarette smoking is the primary cause of lung cancer occurrence as well as mortality. The incidence of lung cancer is closely correlated with the prevalence rate of smoking. As the male smoking population grows, there are increased numbers of male patients with lung cancer.⁵

The type of the lung cancer in India has changed over time. In the past, squamous and small cell lung cancer were common, but now adenocarcinoma is the most common type. The majority of this change in historical profile has occurred in the previous 10 years, and this element lags behind the change seen in developed nations.⁶ The development of novel treatments and therapies for treating various malignancies, as well as the modification of diagnostic techniques and techniques for initial cancer diagnosis, have a direct influence on the statistics related to cancer. For the purpose of detecting carcinoma, researchers are continuously making an effort to expand cutting-edge methods and improve existing ones.⁷

Aim

This cross-sectional study will aim to assess the level of awareness regarding lung cancer and attitude towards screening practices among the general population.

Objectives

An observational cross-sectional study design will be performed using a standardized questionnaire to assess the awareness of lung cancer and attitudes towards screening practices for lung cancer among the rural and semi-urban population in the Wardha district.

Protocol

Ethical considerations

This study has been approved by the Institutional Ethics Committee of Datta Meghe Institute of Higher Education and Research dated on 06/02/2023 (Ref. No. DMIHER (DU)/IEC/2023/592).

Methodology

This will be an observational cross-sectional study investigating lung cancer that lasts five months. The recruitment of the general population will be done independently from the Wardha district.

Awareness regarding lung cancer as well as perceptions of lung cancer screening will be assessed using a questionnaire created by our team using three previously published questionnaires.⁸^–¹⁰

The questionnaire will be given to the participants by the investigator and filled out by the participant. Participants who do not understand the question will have it explained by the investigator. If anyone cannot read and write, the investigator will read and explain to the subject. The response received from the participant will be filled in or entered on the questionnaire by the investigator.

An example of the questionnaire and model consent form that will be used can be found as Extended data.²⁹^,³⁰

Study design

The observational cross-sectional of awareness and attitude towards screening will be done using the standardized questionnaire tool mentioned above.

Sample size

The minimum sample size required is:

N = \frac{Z_{1 - α / 2}^{2} * p * (1 - p)}{E^{2}}

Where:

$Z_{1 - α / 2}^{2}$ is the level of significance at 5% i.e., 95%

confidence interval = 1.96

p = Proportion of respondents aware about lung cancer = 52% = 0.52

E = Error of Margin = 5% = 0.05

N = \frac{{1.96}^{2} \times 0.52 \times (1 - 0.52)}{{0.05}^{2}}

N = 383.54

N = 400. Ref. 11.

Participants

Inclusion criteria

Subjects of both sexes i.e., male and female will be included randomly. The age range will include subjects aged between 18 and 65 years old.

Exclusion criteria

Participants who are not willing to participate after they are provided with information on the study protocol.

Sources of patient selection

The study will be conducted on the general population in Wardha district. Subjects will be randomly selected from different locations e.g., hospitals, various neighborhoods, semi-urban and rural areas, local institutions, visiting homes, and conducting awareness campaigns in public spaces. Those who are willing to participate after the protocol is explained to them will be included.

Variables

To assess the risk factor, symptoms, and available screening methods, exposure to carcinogen such as occupational or environmental exposure to carcinogenic substances, as well as to assess the attitude among the general population toward screening practice for early detection of lung cancer.

Data sources/measurement

We will be using the pretested questionnaire on assessing the awareness regarding lung cancer and screening attitude as described above. The recruitment of the general population will be done independently from the Wardha district.

Method of data collection

Simple random sampling will be used and the researcher has prepared a structured questionnaire consisting of multiple-choice questions (MCQs).

Steps of data collection

Before data collection, approval was obtained from the ethics committee as aforementioned. Then, there will be an introduction between the participants and the researcher. Thirdly, the participants will be assigned to the 18-65 age group by using a random sampling method. Following which, an informed consent form (ICF) will be taken from the participants who are willing to participate, after explaining the study’s purpose. Lastly, standardized questionnaires will be completed by face-to-face interactions with the participants.

Bias

The requirement of the subject will be performed through simple randomization technique to avoid bias. Only consenting participants will be recruited in the study.

Statistical methods

All the entries from Excel file will be saved into database based on sections and variables defined. This will ensure the quality of data and confidentiality. All entities for values will be completely ensured of not having any missing data for full analysis of the dataset. Results will be calculated using R-software version 4.3. Variables for the demographic descriptions including sex, residence, occupation, will be tabulated and described for categorial representation of frequency and percentage. Proforma with multiple options will be described for frequency and percentage. All other questions in the proforma will record for the responses of the participants will be described over frequency, percentage & median. Questions with Likert scale responses will be assessed individually over the frequency and percentage. Results for the association over demographic variables against awareness will be calculated using Chi- squared analysis at significant value at P = 0.05. This method will be used by a qualified statistician.

Dissemination

Results will be published in an indexed journal.

Study status

The study has started but the study has not been completed and no data analysis has been performed.

The first subject was recruited to the study on 24th April 2023. The duration of this study will be five months i.e., April to August so complete data will be collected until 30th August 2023.

Discussion

In 2020, over 1.8 million and 2.2 million lung cancer cases were assessed.¹² Lung cancer has two vital histological subtypes, small cell lung cancer and non-small cell lung cancer, which account for 76 and 13% of all cases of lung cancer in the United States, respectively.¹³ Lung cancer is one of the main causes of death around the world that can be prevented as long-term cigarette smoking is the main cause of 85% of lung cancer cases, so not smoking can lower your chances of getting lung cancer. Notably, more than 50% of patients with lung cancer receive their diagnosis after it is already advanced, which reduces their possibility of surviving. One of the contributing causes to the late diagnosis could be a lack of information on the symptoms of lung cancer.¹⁴

Lung cancer is a type of lethal cancer that is characterized by unchecked cell growth in the lung tissue.¹²^,¹³ Over time, if this growth is not stopped, it can spread through the blood to nearby tissue or other, more distant parts of the body, or it could metastasize (spread outside the lung).¹⁵ The stage of the disease affects the possibility of survival, with worse prognoses in advanced disease stages.¹⁶ The second most typical location of metastatic focus is the lung. A notable fact about subungual melanoma is that despite a long history of distant metastasis, there is an absence of local or distant metastasis, a rare phenomenon. It is estimated that 20 to 54% of malignant tumors developing elsewhere in our bodies would have pulmonary metastasis.¹⁷

Long-term cigarette smoking is the primary factor in 85% of instances of lung carcinoma.¹⁵ Active smoking was accredited to be the source of lung cancer in around nine out of 10 men and at least six out of 10 women. Passive smoking increases the risk as well.¹⁸ Lung cancer risk rises with even occasional or light smoking or even a few cigarettes per day. People who have never smoked make up about 10% to 15% of all cases.¹⁹ These instances are typically brought on by a confluence of genetic factors, radon gas, asbestos, passive smoking, or other types of air pollution.²⁰ High consumption of meat, specifically fried meat, may increase the chances of lung cancer.²¹

Tobacco smoke in the environment should be regarded as a human carcinogen, but there is still a debate about how likely it is that smoking will cause lung cancer in the future.²² Even though radon was first through to be a problem for minors, there is now concern that radon can leak into homes from the uranium that naturally builds up in basements.²³ Asbestos, which is utilized in industry and production, has been related to an increased rate of mesothelioma and lung carcinoma.²⁴

Beryllium and beryllium oxide, which are present in X-ray and radiation advances, as well as arsenic and its derivatives, which are present in open-air wood additions, antifungals, bug sprays, and herbicides. Inhalation of some gases and chemicals may also trigger an allergic response that leads to inflammation and infection in the lungs.²⁵ Lung cancer mortality from all sources has increased by 8% as an effect of air pollution.²⁶ Lung carcinoma risk factors also include a person’s personal or family history of the disease.²⁷ Lung carcinoma can be detected by computed tomography (CT) scans and chest radiography. A biopsy, which is frequently carried out with bronchoscopy or CT guidance, confirms the diagnosis.²⁸

Data availability

Underlying data

No data are associated with this article.

Extended data

Zenodo: Vaishnavi Ajankar (Questionnaire), https://doi.org/10.5281/zenodo.8201519.²⁹

Zenodo: Vaishnavi Ajankar (english ICF), https://doi.org/10.5281/zenodo.8201493.³⁰

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

References

1. Hiwale KM, Alagh A, Vagha S: Role of Frozen Section in Neck Dissection of Oral Cancer Patients. Indian J. Forensic Med. Toxicol. 2020 Oct 1; 14(4).
2. Mafra A, Laversanne M, Gospodarowicz M, et al.: Global patterns of non-Hodgkin lymphoma in 2020. Int. J. Cancer. 2022 Nov 1; 151(9): 1474–1481. Publisher Full Text
3. Murray CJ, Aravkin AY, Zheng P, et al.: Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17; 396(10258): 1223–1249. PubMed Abstract | Publisher Full Text | Free Full Text
4. Sandoval RC, Bacelar Gomes A, Roche M, et al.: Advances in tobacco control in the Region of the Americas, 2020. Rev. Panam. Salud Publica. 2023 May 19; 46: 1. Publisher Full Text
5. Barta JA, Powell CA, Wisnivesky JP: Global epidemiology of lung cancer. Ann. Glob. Health. 2019; 85(1). PubMed Abstract | Publisher Full Text | Free Full Text
6. Singh N, Agrawal S, Jiwnani S, et al.: Lung cancer in India. J. Thorac. Oncol. 2021 Aug 1; 16(8): 1250–1266. Publisher Full Text
7. Bargahi N, Ghasemali S, Jahandar-Lashaki S, et al.: Recent advances for cancer detection and treatment by microfluidic technology, review and update. Biol. Proced. Online. 2022 Dec; 24(1): 1–20.
8. lung_tablet_questionnaire.pdf.[cited 2023 Aug 24]. Reference Source
9. Hanson HM, Raag M, Adrat M, et al.: Awareness of lung cancer symptoms and risk factors in general population. Open Journal of Respiratory Diseases. 2016 Dec 16; 07(1): 1–1, 11. Publisher Full Text
10. Dlamini SB, Sartorius B, Ginindza TG: Pre-and post-intervention survey on lung cancer awareness among adults in selected communities in KwaZulu-Natal, South Africa: A quasi-experimental study. J. Public Health Afr. 2023 Jan 1; 14(1). PubMed Abstract | Publisher Full Text | Free Full Text
11. Sharma A, Kasza K, Hyland A, et al.: Awareness and interest in lung cancer screening among current and former smokers: findings from the ITC United States Survey. Cancer Causes Control. 2019 Jul; 30(7): 733–745. PubMed Abstract | Publisher Full Text
12. Bray F, Laversanne M, Weiderpass E, et al.: The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer. 2021 Aug 15; 127(16): 3029–3030. PubMed Abstract | Publisher Full Text
13. Williams LB, Looney SW, Joshua T, et al.: Promoting community awareness of lung cancer screening among disparate populations: results of the cancer-community awareness access research and education project. Cancer Nurs. 2021 Mar 1; 44(2): 89–97. PubMed Abstract | Publisher Full Text
14. Elshami M, Abukmail H, Aqel W, et al.: Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study. BMC Pulm. Med. 2022 Dec; 22(1): 1–4. Publisher Full Text
15. NCI: Non-Small Cell Lung Cancer Treatment (PDQ®)–Patient Version. National Cancer Institute; 2022 [cited 2023 Jan 9]. Reference Source
16. Zahir R, Khan ZA, Aleem B, et al.: Association of High Immunohistochemical Expression of Minichromosome Maintenance 3 with Human Oral Squamous Cell Carcinoma—A Preliminary Study. Diagnostics. 2022 Dec 26; 13(1): 61. PubMed Abstract | Publisher Full Text | Free Full Text
17. Bhattacharjee A, Kalagani B, Ponnugoti R, et al.: A rare presentation of a subungual melanoma with distant metastasis. J. Datta Meghe Inst. Med. Sci. Univ. 2020 Jul 1; 15(3): 506–509. Publisher Full Text
18. Sinha AK, Namdev N: Mathematical modelling of lung cancer using rough sets. International Journal of Advanced Research in Engineering and Technology (IJARET). 2020 Mar 31; 11(3): 1–9.
19. Aaby P, Aavitsland P, Abate E, et al.: Krebs in Deutschland 2015/2016. Publication Server of Robert Koch Institute; 2019. Publisher Full Text
20. Shrivastava JP, Shrivastava A: Lung cancer: the global killer. J. Lung Pulm. Respir. Res. 2018; 5(2): 49.
21. Wikipedia: Lung cancer. Wikimedia Foundation; Last modified August 1, 2023. Reference Source
22. Sinha R, Kulldorff M, Swanson CA, et al.: Dietary heterocyclic amines and the risk of lung cancer among Missouri women. Cancer Res. 2000 Jul 15; 60(14): 3753–3756. PubMed Abstract
23. Biesalski HK, De Mesquita BB, Chesson A, et al.: European consensus statement on lung cancer: risk factors and prevention. lung cancer panel. CA Cancer J. Clin. 1998 May; 48(3): 167–176. PubMed Abstract | Publisher Full Text
24. Krewski D, Lubin JH, Zielinski JM, et al.: Residential radon and risk of lung cancer: a combined analysis of 7 North American case-control studies. Epidemiology. 2005 Mar; 16(2): 137–145. Publisher Full Text
25. Stayner L, Kuempel E, Gilbert S, et al.: An epidemiological study of the role of chrysotile asbestos fibre dimensions in determining respiratory disease risk in exposed workers. Occup. Environ. Med. 2008 Sep 1; 65(9): 613–619. PubMed Abstract | Publisher Full Text
26. Spyratos D, Zarogoulidis P, Porpodis K, et al.: Occupational exposure and lung cancer. J. Thorac. Dis. 2013 Sep; 5 Suppl 4(Suppl 4): S440–S445. PubMed Abstract | Publisher Full Text
27. Pope CA, Burnett RT, Thun MJ, et al.: Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA. 2002 Mar 6; 287(9): 1132–1141. PubMed Abstract | Publisher Full Text | Free Full Text
28. Sellers TA, Yang P: Familial and genetic influences on risk of lung cancer. OXFORD MONOGRAPHS ON MEDICAL GENETICS. 2002; 44(1): 700–712.
29. Ajankar V, Mude G: Vaishnavi Ajankar (Questionnaire) (Version V1). [Dataset]. Zenodo. 2023. Publisher Full Text
30. Ajankar V, Mude G: Vaishnavi Ajankar (english ICF) (Version V1). [Dataset]. Zenodo. 2023. Publisher Full Text

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Version 1

VERSION 1 PUBLISHED 19 Sep 2023

Author details Author details

¹ Clinical Research, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
² Department of Pharmacology, Datta Meghe College of Pharmacy, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India

Vaishnavi V. Ajankar
Roles: Conceptualization, Formal Analysis, Writing – Original Draft Preparation

Gaurav Mude
Roles: Validation, Visualization, Writing – Review & Editing

Competing interests

No competing interests were disclosed.

Grant information

The author(s) declared that no grants were involved in supporting this work.

Article Versions (1)

version 1

Published: 19 Sep 2023, 12:1172

https://doi.org/10.12688/f1000research.135232.1

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© 2023 Ajankar VV and Mude G. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Ajankar VV and Mude G. Assessing the awareness regarding lung cancer and attitude toward screening practice: Protocol for a cross-sectional study from Wardha District [version 1; peer review: awaiting peer review]. F1000Research 2023, 12:1172 (https://doi.org/10.12688/f1000research.135232.1)

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[1] 1. Hiwale KM, Alagh A, Vagha S: Role of Frozen Section in Neck Dissection of Oral Cancer Patients. Indian J. Forensic Med. Toxicol. 2020 Oct 1; 14(4).

[2] 2. Mafra A, Laversanne M, Gospodarowicz M, et al.: Global patterns of non-Hodgkin lymphoma in 2020. Int. J. Cancer. 2022 Nov 1; 151(9): 1474–1481. Publisher Full Text

[3] 3. Murray CJ, Aravkin AY, Zheng P, et al.: Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17; 396(10258): 1223–1249. PubMed Abstract | Publisher Full Text | Free Full Text

[4] 4. Sandoval RC, Bacelar Gomes A, Roche M, et al.: Advances in tobacco control in the Region of the Americas, 2020. Rev. Panam. Salud Publica. 2023 May 19; 46: 1. Publisher Full Text

[5] 5. Barta JA, Powell CA, Wisnivesky JP: Global epidemiology of lung cancer. Ann. Glob. Health. 2019; 85(1). PubMed Abstract | Publisher Full Text | Free Full Text

[6] 6. Singh N, Agrawal S, Jiwnani S, et al.: Lung cancer in India. J. Thorac. Oncol. 2021 Aug 1; 16(8): 1250–1266. Publisher Full Text

[7] 7. Bargahi N, Ghasemali S, Jahandar-Lashaki S, et al.: Recent advances for cancer detection and treatment by microfluidic technology, review and update. Biol. Proced. Online. 2022 Dec; 24(1): 1–20.

[8] 8. lung_tablet_questionnaire.pdf.[cited 2023 Aug 24]. Reference Source

[9] 9. Hanson HM, Raag M, Adrat M, et al.: Awareness of lung cancer symptoms and risk factors in general population. Open Journal of Respiratory Diseases. 2016 Dec 16; 07(1): 1–1, 11. Publisher Full Text

[10] 10. Dlamini SB, Sartorius B, Ginindza TG: Pre-and post-intervention survey on lung cancer awareness among adults in selected communities in KwaZulu-Natal, South Africa: A quasi-experimental study. J. Public Health Afr. 2023 Jan 1; 14(1). PubMed Abstract | Publisher Full Text | Free Full Text

[11] 11. Sharma A, Kasza K, Hyland A, et al.: Awareness and interest in lung cancer screening among current and former smokers: findings from the ITC United States Survey. Cancer Causes Control. 2019 Jul; 30(7): 733–745. PubMed Abstract | Publisher Full Text

[12] 12. Bray F, Laversanne M, Weiderpass E, et al.: The ever-increasing importance of cancer as a leading cause of premature death worldwide. Cancer. 2021 Aug 15; 127(16): 3029–3030. PubMed Abstract | Publisher Full Text

[13] 13. Williams LB, Looney SW, Joshua T, et al.: Promoting community awareness of lung cancer screening among disparate populations: results of the cancer-community awareness access research and education project. Cancer Nurs. 2021 Mar 1; 44(2): 89–97. PubMed Abstract | Publisher Full Text

[14] 14. Elshami M, Abukmail H, Aqel W, et al.: Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study. BMC Pulm. Med. 2022 Dec; 22(1): 1–4. Publisher Full Text

[15] 15. NCI: Non-Small Cell Lung Cancer Treatment (PDQ®)–Patient Version. National Cancer Institute; 2022 [cited 2023 Jan 9]. Reference Source

[16] 16. Zahir R, Khan ZA, Aleem B, et al.: Association of High Immunohistochemical Expression of Minichromosome Maintenance 3 with Human Oral Squamous Cell Carcinoma—A Preliminary Study. Diagnostics. 2022 Dec 26; 13(1): 61. PubMed Abstract | Publisher Full Text | Free Full Text

[17] 17. Bhattacharjee A, Kalagani B, Ponnugoti R, et al.: A rare presentation of a subungual melanoma with distant metastasis. J. Datta Meghe Inst. Med. Sci. Univ. 2020 Jul 1; 15(3): 506–509. Publisher Full Text

[18] 18. Sinha AK, Namdev N: Mathematical modelling of lung cancer using rough sets. International Journal of Advanced Research in Engineering and Technology (IJARET). 2020 Mar 31; 11(3): 1–9.

[19] 19. Aaby P, Aavitsland P, Abate E, et al.: Krebs in Deutschland 2015/2016. Publication Server of Robert Koch Institute; 2019. Publisher Full Text

[20] 20. Shrivastava JP, Shrivastava A: Lung cancer: the global killer. J. Lung Pulm. Respir. Res. 2018; 5(2): 49.

[21] 21. Wikipedia: Lung cancer. Wikimedia Foundation; Last modified August 1, 2023. Reference Source

[22] 22. Sinha R, Kulldorff M, Swanson CA, et al.: Dietary heterocyclic amines and the risk of lung cancer among Missouri women. Cancer Res. 2000 Jul 15; 60(14): 3753–3756. PubMed Abstract

[23] 23. Biesalski HK, De Mesquita BB, Chesson A, et al.: European consensus statement on lung cancer: risk factors and prevention. lung cancer panel. CA Cancer J. Clin. 1998 May; 48(3): 167–176. PubMed Abstract | Publisher Full Text

[24] 24. Krewski D, Lubin JH, Zielinski JM, et al.: Residential radon and risk of lung cancer: a combined analysis of 7 North American case-control studies. Epidemiology. 2005 Mar; 16(2): 137–145. Publisher Full Text

[25] 25. Stayner L, Kuempel E, Gilbert S, et al.: An epidemiological study of the role of chrysotile asbestos fibre dimensions in determining respiratory disease risk in exposed workers. Occup. Environ. Med. 2008 Sep 1; 65(9): 613–619. PubMed Abstract | Publisher Full Text

[26] 26. Spyratos D, Zarogoulidis P, Porpodis K, et al.: Occupational exposure and lung cancer. J. Thorac. Dis. 2013 Sep; 5 Suppl 4(Suppl 4): S440–S445. PubMed Abstract | Publisher Full Text

[27] 27. Pope CA, Burnett RT, Thun MJ, et al.: Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA. 2002 Mar 6; 287(9): 1132–1141. PubMed Abstract | Publisher Full Text | Free Full Text

[28] 28. Sellers TA, Yang P: Familial and genetic influences on risk of lung cancer. OXFORD MONOGRAPHS ON MEDICAL GENETICS. 2002; 44(1): 700–712.

[29] 29. Ajankar V, Mude G: Vaishnavi Ajankar (Questionnaire) (Version V1). [Dataset]. Zenodo. 2023. Publisher Full Text

[30] 30. Ajankar V, Mude G: Vaishnavi Ajankar (english ICF) (Version V1). [Dataset]. Zenodo. 2023. Publisher Full Text

Assessing the awareness regarding lung cancer and attitude toward screening practice: Protocol for a cross-sectional study from Wardha District

Abstract

Keywords

Introduction

Aim

Objectives

Protocol

Ethical considerations

Methodology

Study design

Sample size

Participants

Variables

Data sources/measurement

Method of data collection

Steps of data collection

Bias

Statistical methods

Discussion

Data availability

Underlying data

Extended data

References

Comments on this article Comments (0)

Open Peer Review

Comments on this article Comments (0)

Open Peer Review

Reviewer Status

Comments on this article

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