Interventions to increase participation in lung cancer screening programmes: a systematic review and meta-analysis.
8 affiliations
- 1Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy [email protected].
- 2Centre for Biostatistics, Epidemiology, and Public Health (C-BEPH), Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
- 3Staff di Direzione Sanitaria, Azienda USL Toscana Centro, Florence, Italy.
- 4Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
- 5Scientific Library, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
- 6Division of Epidemiology and Clinical Governance, Institute for Study, Prevention and Network in Oncology (ISPRO), Florence, Italy.
- 7Italian League against Cancer (LILT), Florence, Italy.
- 8Division of Screening, Institute for Study, Prevention and Network in Oncology (ISPRO), Florence, Italy.
Abstract
Introduction
We aimed to systematically review and meta-analyse the effectiveness of interventions in increasing informed choice and participation in lung cancer screening based on low-dose computed tomography (LDCT).Methods
Five electronic databases, Medline (PubMed version), Embase, Cinahl (Ebsco version), Scopus and Cochrane CENTRAL, were searched for randomised controlled trials, nonrandomised controlled trials and before-after studies published from 2000 until 15 March 2023. A random-effects meta-analysis was conducted to assess the effectiveness of interventions to increase rates of LDCT completion.Results
Out of 3483 studies identified, 14 completed and 21 ongoing studies were included in the review. Shared-decision making (SDM)+navigation (OR 4.34, 95% CI 2.50-7.54) and outreach+navigation (OR 2.20, 95% CI 1.70-2.84) resulted in a higher proportion of LDCT performed compared to the control group. Educational/informational interventions (OR 1.03, 95% CI 0.89-1.19) as well as SDM alone (OR 1.15, 95% CI 0.57-2.32) did not improve LDCT uptake, despite the second improving decisional outcomes in both intervention and control groups. Multicomponent interventions showed significantly higher LDCT uptake (OR 2.64, 95% CI 1.79-3.90), compared to unicomponent interventions (OR 1.00, 95% CI 0.87-1.14). The vast majority of interventions, including those in ongoing trials, are patient-oriented, while community-based, provider-level and system-level interventions remain rare.Conclusions
Combining high-intensity patient-oriented interventions, such as patient navigation, active outreach and SDM, appears to be the most promising strategy to increase lung cancer screening uptake (low certainty of evidence). However, implementation studies are needed to evaluate interventions targeting both provider and healthcare systems level.
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BibTeX
@article{djuric2026interventions,
title = {{Interventions to increase participation in lung cancer screening programmes: a systematic review and meta-analysis.}},
author = {Olivera Djuric and Andrea Guida and Francesca Bononi and Francesco Venturelli and Maria Chiara Bassi and Giuseppe Gorini and Eugenio Paci and Paola Mantellini and Paolo Giorgi Rossi},
journal = {European respiratory review : an official journal of the European Respiratory Society},
year = {2026},
month = oct,
doi = {10.1183/16000617.0108-2026},
url = {https://europepmc.org/article/MED/42906938},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Interventions to increase participation in lung cancer screening programmes: a systematic review and meta-analysis.
AU - Olivera Djuric
AU - Andrea Guida
AU - Francesca Bononi
AU - Francesco Venturelli
AU - Maria Chiara Bassi
AU - Giuseppe Gorini
AU - Eugenio Paci
AU - Paola Mantellini
AU - Paolo Giorgi Rossi
PY - 2026
DA - 2026/10/21
JO - European respiratory review : an official journal of the European Respiratory Society
DO - 10.1183/16000617.0108-2026
UR - https://europepmc.org/article/MED/42906938
AB - Introduction We aimed to systematically review and meta-analyse the effectiveness of interventions in increasing informed choice and participation in lung cancer screening based on low-dose computed tomography (LDCT).Methods Five electronic databases, Medline (PubMed version), Embase, Cinahl (Ebsco version), Scopus and Cochrane CENTRAL, were searched for randomised controlled trials, nonrandomised controlled trials and before-after studies published from 2000 until 15 March 2023. A random-effects meta-analysis was conducted to assess the effectiveness of interventions to increase rates of LDCT completion.Results Out of 3483 studies identified, 14 completed and 21 ongoing studies were included in the review. Shared-decision making (SDM)+navigation (OR 4.34, 95% CI 2.50-7.54) and outreach+navigation (OR 2.20, 95% CI 1.70-2.84) resulted in a higher proportion of LDCT performed compared to the control group. Educational/informational interventions (OR 1.03, 95% CI 0.89-1.19) as well as SDM alone (OR 1.15, 95% CI 0.57-2.32) did not improve LDCT uptake, despite the second improving decisional outcomes in both intervention and control groups. Multicomponent interventions showed significantly higher LDCT uptake (OR 2.64, 95% CI 1.79-3.90), compared to unicomponent interventions (OR 1.00, 95% CI 0.87-1.14). The vast majority of interventions, including those in ongoing trials, are patient-oriented, while community-based, provider-level and system-level interventions remain rare.Conclusions Combining high-intensity patient-oriented interventions, such as patient navigation, active outreach and SDM, appears to be the most promising strategy to increase lung cancer screening uptake (low certainty of evidence). However, implementation studies are needed to evaluate interventions targeting both provider and healthcare systems level.
SN - 0905-9180
SN - 1600-0617
ER -