Recruitment preferences for lung cancer screening among 4-IN-THE-LUNG-RUN participants

Implementing a tailored approach that addresses both socioeconomic status (SES)-specific and sex-specific needs may enhance the effectiveness of information delivery, thereby potentially increasing lung cancer screening uptake. However, to date, there is a gap in knowledge regarding how recruitment strategies can be best adapted to these factors. This study investigates recruitment preferences among participants of the 4-IN-THE-LUNG-RUN study, the European implementation trial for lung cancer screening.

An online questionnaire regarding reasons for participating (or not) in lung cancer screening and recruitment preferences was sent to 848 Dutch individuals, aged 60-79 years. All participants were randomized previously within the 4-IN-THE-LUNG-RUN study. Hereafter, two focus groups were conducted with a subsample of these participants (n = 14) to gain deeper insights into their responses. Data were analyzed using SPSS software.

Of 479 respondents (56.5%) with fully completed questionnaires, 377 (78.7%) preferred to be informed about lung cancer screening via email. This preference is significantly higher among the high and middle SES compared to those with lower SES (84.3% and 83.2%, versus 68.2%, p < .001). Only 9.8% (n = 47) expressed a desire to be contacted exclusively through a paper-based communication. The latter preference was primarily observed among individuals with a low SES, in comparison to those with middle or high SES (53.2% versus 23.4% and 23.4%). A total of 43.4% indicated that they would appreciate the integration of lifestyle advice within screening. Men were more open to this option than women (p = 0.018). In terms of sex-related differences, recruitment preferences were comparable between men and women. The focus groups revealed that participants preferred to receive the results by email rather than by post, to reduce waiting time and thereby alleviate anxiety. No added value was seen in recruitment being conducted through their general practitioner. Both of these statements were supported by the vast majority of participants.

Recruitment for (lung) cancer screening should focus primarily on providing clear and concise information - independent of sex. A majority of participants prefer digital information delivery. Nevertheless, maintaining the option of paper-based information for lower SES groups may be essential to ensure inclusive and equitable access.

Clinical trial registration NTR-new: NL9710. Registered on 31 August 2021.