. 2024 Feb 29;13(2):240-255.

doi: 10.21037/tlcr-23-623. Epub 2024 Feb 21.

"We need to work towards it, whatever it takes."-participation factors in the acceptability and feasibility of lung cancer screening in Australia: the perspectives of key stakeholders

Rachael Helen Dodd^{1

2}, Ashleigh Rebecca Sharman², Mei Ling Yap^{2

3

4

5}, Emily Stone^{6

7}, Henry Marshall⁸, Joel Rhee^{9

10}, Sue McCullough¹¹, Nicole Marion Rankin¹²

Affiliations

¹ The Daffodil Centre, A Joint Venture between The University of Sydney and Cancer Council New South Wales, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
² Faculty of Medicine and Health, School of Public Health, The University of Sydney, New South Wales, Australia.
³ Collaboration for Cancer Outcomes, Research and Evaluation, Ingham Institute, University of New South Wales Sydney, Liverpool, New South Wales, Australia.
⁴ Liverpool and Macarthur Cancer Therapy Centres, Western Sydney University, Campbelltown, New South Wales, Australia.
⁵ The George Institute, University of New South Wales Sydney, New South Wales, Australia.
⁶ Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney, New South Wales, Australia.
⁷ School of Clinical Medicine University of New South Wales Sydney, New South Wales, Australia.
⁸ University of Queensland Thoracic Research Centre and Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.
⁹ School of Population Health, Faculty of Medicine and Health, University of New South Wales Sydney, New South Wales, Australia.
¹⁰ Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
¹¹ Thoracic Oncology Group Australasia Consumer Advisory Panel, Melbourne, Victoria, Australia.
¹² Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.

PMID: 38496699
PMCID: PMC10938089
DOI: 10.21037/tlcr-23-623

"We need to work towards it, whatever it takes."-participation factors in the acceptability and feasibility of lung cancer screening in Australia: the perspectives of key stakeholders

Rachael Helen Dodd et al. Transl Lung Cancer Res. 2024.

. 2024 Feb 29;13(2):240-255.

doi: 10.21037/tlcr-23-623. Epub 2024 Feb 21.

Authors

Rachael Helen Dodd^{1

2}, Ashleigh Rebecca Sharman², Mei Ling Yap^{2

3

4

5}, Emily Stone^{6

7}, Henry Marshall⁸, Joel Rhee^{9

10}, Sue McCullough¹¹, Nicole Marion Rankin¹²

Affiliations

¹ The Daffodil Centre, A Joint Venture between The University of Sydney and Cancer Council New South Wales, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
² Faculty of Medicine and Health, School of Public Health, The University of Sydney, New South Wales, Australia.
³ Collaboration for Cancer Outcomes, Research and Evaluation, Ingham Institute, University of New South Wales Sydney, Liverpool, New South Wales, Australia.
⁴ Liverpool and Macarthur Cancer Therapy Centres, Western Sydney University, Campbelltown, New South Wales, Australia.
⁵ The George Institute, University of New South Wales Sydney, New South Wales, Australia.
⁶ Department of Thoracic Medicine and Lung Transplantation, St Vincent's Hospital Sydney, New South Wales, Australia.
⁷ School of Clinical Medicine University of New South Wales Sydney, New South Wales, Australia.
⁸ University of Queensland Thoracic Research Centre and Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.
⁹ School of Population Health, Faculty of Medicine and Health, University of New South Wales Sydney, New South Wales, Australia.
¹⁰ Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia.
¹¹ Thoracic Oncology Group Australasia Consumer Advisory Panel, Melbourne, Victoria, Australia.
¹² Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.

PMID: 38496699
PMCID: PMC10938089
DOI: 10.21037/tlcr-23-623

Abstract

Background: Low dose computed tomography (LDCT) screening, targeted at those at high-risk, has been shown to significantly reduce lung cancer mortality and detect cancers at an early stage. Practical, attitudinal and demographic factors can inhibit screening participation in high-risk populations. This study aimed to explore stakeholders' views about barriers and enablers (determinants) to participation in lung cancer screening (LCS) in Australia.

Methods: Twenty-four focus groups (range 2-5 participants) were conducted in 2021 using the Zoom platform. Participants were 84 health professionals, researchers, policy makers and program managers of current screening programs. Focus groups consisted of a structured presentation with facilitated discussion lasting about 1 hour. The content was analysed thematically and mapped to the Consolidated Framework for Implementation Research (CFIR).

Results: Screening determinants were identified across each stage of the proposed screening and assessment pathway. Challenges included participant factors such as encouraging participation for individuals at high-risk, whilst ensuring that access and equity issues were carefully considered in program design. The development of awareness campaigns that engaged LCS participants and health professionals, as well as streamlined referral processes for initial entry and follow-up, were strongly advocated for. Considering practical factors included the use of mobile vans in convenient locations.

Conclusions: Participants reported that LCS in Australia was acceptable and feasible. Participants identified a complex set of determinants across the proposed screening and assessment pathway. Strategies that enable the best chance for program success must be identified prior to implementation of a national LCS program.

Keywords: Lung cancer screening (LCS); barriers and facilitators; implementation; qualitative research.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-23-623/coif). M.L.Y. reports the funding from an NHMRC Investigator Grant (APP 2018108). E.S. has received honoraria for lectures from AstraZeneca, Merck Sharp & Dohme, and The Limbic, support to attend meetings from AstraZeneca LOBES 2022 and has received ad hoc advisory board payment from Bristol Myers Squibb. She holds leadership roles as Deputy Board Chair for the Thoracic Oncology Group of Australasia and Editor in Chief of JTO Clinical and Research Reports. She is the past Co-Convenor of the Tobacco and Related Substances Special Interest Group, Thoracic Society of Australasia. H.M. is supported by a Metro North Hospital and Health Service (Queensland, Australia) Clinical Academic Fellowship and an NHMRC Investigator Grant, and has received honoraria for lectures from AstraZeneca, funding for travel from International Association for the Study of Lung Cancer (IASLC), and holds leadership roles for the Thoracic Society of Australia and New Zealand (Convenor of Tobacco and Related Substances Special Interest Group) and IASLC (committee member). NMR reports the funding from an Australian National Health and Medical Research Council (NHMRC) Ideas Grant (2019/GA65812). The other authors have no conflicts of interest to disclose.

Figures

**Figure 1**
Participant and health system factors identified (in blue ovals) during analysis including cross-cutting topics (in orange ovals), with the dotted line indicating those topics included within this manuscript.

See this image and copyright information in PMC

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"We need to work towards it, whatever it takes."-participation factors in the acceptability and feasibility of lung cancer screening in Australia: the perspectives of key stakeholders

Affiliations

"We need to work towards it, whatever it takes."-participation factors in the acceptability and feasibility of lung cancer screening in Australia: the perspectives of key stakeholders

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