Lung Screen Uptake Trial (LSUT): Randomized Controlled Clinical Trial Testing Targeted Invitation Materials

Area of Science:

• Public Health
• Preventive Medicine
• Health Services Research

Background:

• Low-dose computed tomography (LDCT) lung cancer screening uptake is suboptimal, particularly among current smokers from lower socioeconomic backgrounds, impacting program effectiveness and equity.
• Targeted strategies are needed to improve participation in lung cancer screening programs.
• Hospital-based Lung Health Checks offer LDCT screening but require effective outreach to maximize attendance.

Purpose of the Study:

• To evaluate the impact of a targeted, low-burden, stepped invitation strategy on the uptake of hospital-based Lung Health Check appointments offering LDCT screening.
• To compare the effectiveness of an intervention leaflet addressing psychological barriers against a control group.
• To identify factors influencing screening appointment attendance.

Main Methods:

• A two-arm, blinded, randomized controlled trial involving 2,012 participants aged 60-75 who were current or recent smokers without LDCT contraindications.
• Participants received stepped invitations (preinvitation, invitation, reminder) from primary care practices.
• The intervention group received an additional leaflet designed to address psychological barriers and provide low-burden information, mimicking a vehicle test concept.

Main Results:

• Overall uptake was 52.6%, with no statistically significant difference between the intervention (52.3%) and control (52.9%) groups.
• Current smokers were less likely to attend appointments than former smokers (adjusted OR, 0.70).
• Socioeconomic deprivation was associated with lower uptake in the control group only (P < 0.01).

Conclusions:

• The tested intervention strategy did not significantly improve LDCT lung cancer screening uptake.
• The Lung Health Check approach, common to both arms, resulted in higher uptake than previously reported, especially among lower socioeconomic position smokers.
• The findings suggest that the Lung Health Check model itself may represent a successful baseline strategy for lung cancer screening outreach.