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

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.

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).

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}

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

The minimum sample size required is: N = 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 = 1.96 2 × 0.52 × 1 − 0.52 0.05 2

N = 383.54

N = 400. Ref. 11.

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.

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.

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.

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

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.

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

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.