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. 2022 Dec 23;23(1):374.
doi: 10.1186/s12931-022-02255-8.

Understanding patient barriers and facilitators to uptake of lung screening using low dose computed tomography: a mixed methods scoping review of the current literature

Debbie Cavers  1 , Mia Nelson  2 , Jasmin Rostron  3 , Kathryn A Robb  4 , Lynsey R Brown  5 , Christine Campbell  2 , Ahsan R Akram  6 , Graeme Dickie  2 , Melanie Mackean  7 , Edwin J R van Beek  8 , Frank Sullivan  5 , Robert J Steele  9 , Aileen R Neilson  2 , David Weller  2
Affiliations

Understanding patient barriers and facilitators to uptake of lung screening using low dose computed tomography: a mixed methods scoping review of the current literature

Debbie Cavers et al. Respir Res. .

Abstract

Background: Targeted lung cancer screening is effective in reducing mortality by upwards of twenty percent. However, screening is not universally available and uptake is variable and socially patterned. Understanding screening behaviour is integral to designing a service that serves its population and promotes equitable uptake. We sought to review the literature to identify barriers and facilitators to screening to inform the development of a pilot lung screening study in Scotland.

Methods: We used Arksey and O'Malley's scoping review methodology and PRISMA-ScR framework to identify relevant literature to meet the study aims. Qualitative, quantitative and mixed methods primary studies published between January 2000 and May 2021 were identified and reviewed by two reviewers for inclusion, using a list of search terms developed by the study team and adapted for chosen databases.

Results: Twenty-one articles met the final inclusion criteria. Articles were published between 2003 and 2021 and came from high income countries. Following data extraction and synthesis, findings were organised into four categories: Awareness of lung screening, Enthusiasm for lung screening, Barriers to lung screening, and Facilitators or ways of promoting uptake of lung screening. Awareness of lung screening was low while enthusiasm was high. Barriers to screening included fear of a cancer diagnosis, low perceived risk of lung cancer as well as practical barriers of cost, travel and time off work. Being health conscious, provider endorsement and seeking reassurance were all identified as facilitators of screening participation.

Conclusions: Understanding patient reported barriers and facilitators to lung screening can help inform the implementation of future lung screening pilots and national lung screening programmes.

Keywords: Cancer screening; Early detection; Lung cancer screening; Mixed methods; Respiratory health; Scoping review.

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Conflict of interest statement

Frank Sullivan declares that the Universities of Dundee and St. Andrew’s received funding from Oncimmune for the Early Detection of Cancer of the Lung Scotland (ECLS) trial from 2013 to 2021.

Figures

Fig. 1
Fig. 1
PRISMA diagram showing screening process and study selection. Adapted From: Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. https://doi.org/10.1136/bmj.n71
See this image and copyright information in PMC

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