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Updated: Jul 21, 2026

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Shared decision-making for lung cancer screening in a pre-implementation context: A mixed-methods study.

Lauren Michiels1, Caro Verlies1, Jana Duchateau1

  • 1Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.

Patient Education and Counseling
|July 15, 2026
PubMed
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Shared decision-making (SDM) in lung cancer screening needs flexible approaches. Tailoring support to individual patient needs and values is key for effective implementation and informed participation.

Area of Science:

  • Oncology
  • Public Health
  • Health Services Research

Background:

  • Low-dose computed tomography (LDCT) for lung cancer screening aims to reduce mortality.
  • Shared decision-making (SDM) is crucial for informed participation in screening programs.
  • Implementing SDM effectively in lung cancer screening remains a challenge.

Purpose of the Study:

  • To explore the description and application of SDM in lung cancer screening.
  • To understand healthcare professionals' (HCPs) and potential screening participants' (PSPs) perceptions and expectations of SDM.
  • To identify barriers and facilitators for SDM implementation in lung cancer screening.

Main Methods:

  • Mixed-methods study: scoping review of 7 databases and qualitative interviews with 22 HCPs and 13 PSPs in Flanders, Belgium.
Keywords:
Cancer screeningDecision supportDecision-makingLung cancerPrimary careQualitative researchScoping review

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  • Scoping review examined SDM in lung cancer screening literature.
  • Semi-structured interviews explored decision-making preferences and SDM expectations in a pre-implementation context.

    • Main Results:

    • Scoping review included 35 studies; SDM linked to better knowledge, lower conflict, and higher satisfaction, but often limited to information provision.
    • Interviews revealed varied PSP preferences for decisional roles, from independent to collaborative.
    • Key elements for decision-making included reassurance, feeling heard, and personalized support; HCPs cited time, workload, training, and health literacy as barriers.

    Conclusions:

    • Effective SDM integration requires flexible, adaptive strategies, avoiding rigid, tick-box approaches.
    • Embedding SDM in existing care pathways and utilizing complementary professional roles can improve feasibility.
    • Screening programs should offer adaptable decision support, distributing SDM across encounters to tailor guidance to individual values.