Interventions to increase participation in lung cancer screening programmes: a systematic review and meta-analysis
In brief
Navigation paired with outreach or decision support boosts lung cancer screening
In a review of 14 studies, navigation combined with shared decision-making or outreach was linked to more completed low-dose CT scans; multicomponent approaches also outperformed single interventions. Education alone and shared decision-making alone did not increase uptake. Evidence certainty was low, and provider- and system-level strategies remain understudied.
- Journal
- European respiratory review : an official journal of the European Respiratory Society (Q1)
- Published
- 21 October 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Olivera Djuric, Andrea Guida, Francesca Bononi, Francesco Venturelli, Maria Chiara Bassi, Giuseppe Gorini, et al.
- PMID
- 42906938
- DOI
- 10.1183/16000617.0108-2026
Why clinicians should know about it
- Picked for Pulmonary and Respiratory Medicine (paper of the day, 23 October 2026): Meta-analysis assesses interventions to increase lung cancer screening uptake
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.