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Updated: Sep 10, 2025

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Effectiveness of Technology-Based Interventions in Promoting Lung Cancer Screening Uptake and Decision-Making Among

Safa Elkefi1,2, Nelson Gaillard2,3, Rongyi Wu2,4

  • 1School of Systems Science and Industrial Engineering, Watson College, Binghamton University, Vestal, NY 13902, USA.

International Journal of Environmental Research and Public Health
|August 28, 2025
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Summary
This summary is machine-generated.

Digital tools show promise for promoting lung cancer screening (LCS) and improving patient decision-making. However, challenges like digital literacy and access must be addressed for wider adoption and reduced disparities.

Keywords:
decision-makingdigital healthlung cancerlung healthscreening

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Area of Science:

  • Oncology and preventive medicine focusing on early detection strategies.
  • Digital health informatics and the implementation of lung cancer screening interventions.
  • Health services research evaluating patient engagement and shared decision-making frameworks.

Background:

Early detection of pulmonary malignancies through Low-Dose Computed Tomography (LDCT) significantly improves survival rates by identifying tumors at treatable stages and therapeutic interventions. Prior research has shown that patient adherence to Lung Cancer Screening (LCS) protocols remains suboptimal despite established clinical guidelines and the availability of diagnostic imaging. Traditional outreach methods often fail to address complex barriers such as geographic isolation, limited health literacy, and the psychological burden of a potential diagnosis. Healthcare systems require scalable, cost-effective solutions to educate high-risk populations about the nuanced benefits and potential risks associated with diagnostic imaging procedures. The integration of electronic health records has provided a foundation for automated patient identification, yet the optimal method for engaging these individuals remains unclear. Historically, the transition from paper-based education to interactive digital platforms has been slow due to concerns regarding data privacy and technological infrastructure. This absence of evidence motivated a comprehensive evaluation of how modern communication platforms and digital health technologies influence screening behaviors and patient outcomes.

Purpose Of The Study:

This systematic review evaluates the design and implementation of technology-based platforms intended to boost Lung Cancer Screening (LCS) participation among high-risk individuals and patient-centered outreach. Researchers sought to determine how digital tools support Shared Decision-Making (SDM) between patients and clinicians by providing accessible, evidence-based information. The investigation focuses on the specific features of interventions that enhance patient engagement, knowledge acquisition, and concurrent smoking cessation efforts. Analysis centered on identifying the most effective delivery modes, such as mobile applications, telehealth platforms, or automated patient portal messaging systems. The study aims to categorize the technical components, including personalized risk calculators and multimedia content, that drive informed choices in clinical settings. By examining these diverse digital strategies, the review provides a roadmap for optimizing patient-centered communication in oncology. Evaluating the impact of these interventions on knowledge acquisition and decision-making confidence was a primary objective to guide future digital health development.

Main Methods:

Investigators conducted a systematic search across six comprehensive electronic databases and scholarly repositories in February 2025 to identify relevant peer-reviewed literature. The selection criteria identified 28 eligible studies published between 2014 and 2025 that focused on digital health strategies for cancer prevention. Data extraction focused on home-based, self-guided interventions including telehealth platforms, interactive websites, and mobile applications designed for patient use. The review analyzed specific functional elements such as personalized risk calculators, simplified navigation pathways, and multimedia educational modules within the software. Researchers assessed how these tools integrated with Electronic Medical Records (EMR) to facilitate clinical workflow and improve communication between providers and patients. Specifically, the methodological framework categorized interventions by their primary delivery mechanism, target user demographic, and the specific behavioral outcomes measured in each study. The review identifies both the potential and limitations of current interventions while offering guidance for enhancing impact through user-informed approaches.

Main Results:

Approximately 82% of the analyzed studies demonstrated significant improvements in patient knowledge and decision-making confidence regarding Lung Cancer Screening (LCS) protocols and clinical outcomes. Digital interventions consistently enhanced informed decision-making by clarifying the trade-offs between early detection benefits and the risks of radiation or false positives. Only a subset of the reviewed studies reported a statistically significant increase in actual screening uptake rates relative to baseline levels despite improvements in patient attitudes. Commonly utilized features like personalized risk calculators and multimedia content were associated with higher levels of patient engagement and satisfaction. Barriers such as limited internet access and low digital literacy significantly hindered the effectiveness of several home-based, self-guided tools. Persistent challenges such as provider time constraints and patient anxiety regarding radiation exposure or potential costs remained prevalent across the diverse study cohorts. These tools also aimed to support smoking cessation alongside screening promotion to address comprehensive patient health needs.

Conclusions:

Digital health solutions offer a promising avenue for advancing Lung Cancer Screening (LCS) promotion and public health through targeted outreach and enhanced patient education. Successful implementation requires the thoughtful design of user interfaces that accommodate varying levels of technological proficiency and health literacy. Future research must prioritize the integration of these tools into existing clinical workflows to minimize provider burden and maximize patient reach. Addressing structural challenges like equitable internet access and digital literacy is essential to reduce disparities in screening participation among underserved populations. The study suggests that user-informed approaches will be necessary to scale these interventions effectively across diverse healthcare systems and geographic regions. Institutional support and policy changes may be required to ensure that digital health tools are implemented sustainably within large-scale healthcare systems. Enhancing the impact of digital tools depends on overcoming contextual barriers such as cost concerns, radiation fears, and provider time constraints.

According to the study's authors, these tools utilize risk calculators and multimedia content to clarify the trade-offs of screening. This mechanistic approach improved decision-making confidence in 82% of the reviewed studies by providing personalized data regarding the benefits and risks of low-dose computed tomography.

The systematic review found that 82% of the 28 eligible studies reported positive effects on patient knowledge and decision-making confidence. However, the researchers noted that this increased understanding did not always translate into a statistically significant rise in actual screening uptake rates relative to baseline levels.

The researchers analyzed EMR integration because it facilitates clinical workflows by connecting patient portal messages and risk data directly to provider systems. This specific methodological focus revealed that seamless integration is necessary to overcome provider time constraints and improve screening participation compared to non-integrated systems.

The findings are constrained by structural barriers such as limited internet access and low digital literacy among certain patient populations compared to more technologically advantaged groups. The authors also identified that patient anxiety regarding radiation exposure and concerns about out-of-pocket costs can prevent the successful adoption of these digital tools.

The authors state that future work must address structural challenges and contextual barriers to reduce disparities in screening participation. They propose that scaling these solutions requires user-informed designs that are deeply integrated into clinical workflows to ensure equitable access for all patients.