Knowledge translation strategies to enhance lung cancer screening programme implementation: a systematic review and...

Low-dose computed tomography (LDCT) lung cancer screening (LCS) improves outcomes including mortality in clinical trials, but it is unclear whether this evidence is implemented effectively in real-world practice settings. This systematic review explored how knowledge translation (KT) strategies have been used to improve knowledge, decisional confidence and participation in LDCT LCS programmes.

Literature searches were performed for comparative studies incorporating KT strategies in relation to LDCT LCS. Articles included a KT intervention intended to facilitate knowledge, participation in screening, improve decisional confidence or increase screening uptake.

40 studies were selected for data extraction. Studies emanated from the USA (36), Canada (one), the UK (two) and Japan (one), published between 2014 and 2024. KT interventions reported included 41 implementation strategies targeting staff training, patient and provider education, shared decision-making tools, nurse clinics, navigators, forms, electronic reminders and triggers, data presentation modalities, materials targeting specific populations, and quality improvement tools. Meta-analysis identified significant increase in knowledge of risk (OR 2.87, 95% CI 1.29-6.38), LCS candidacy (OR 2.50, 95% CI 1.51-4.14), risk-benefit knowledge (OR 2.82, 95% CI 1.21-6.58), awareness of screening test (OR 11.91, 9.00-15.76) and increased LCS screening participation (OR 2.24, 95% CI 1.44-3.47) in response to KT strategies.

This systematic review identified multiple studies addressing the utilisation and effectiveness of implementation science strategies in KT interventions in the context of LCS. These included a broad range of implementation strategies and KT methodologies that were associated with increased LCS knowledge and participation. There is an urgent need to identify effective implementation strategies leading to enhanced knowledge and screening participation amongst at risk individuals in LDCT LCS programmes.