PT - JOURNAL ARTICLE AU - Goodley, Patrick AU - Balata, Haval AU - Alonso, Alberto AU - Brockelsby, Christopher AU - Conroy, Matthew AU - Cooper-Moss, Nicola AU - Craig, Christopher AU - Evison, Matthew AU - Hewitt, Kath AU - Higgins, Coral AU - Johnson, William AU - Lyons, Judith AU - Merchant, Zoe AU - Rowlands, Ailsa AU - Sharman, Anna AU - Sinnott, Nicola AU - Sperrin, Matthew AU - Booton, Richard AU - Crosbie, Philip A J TI - Invitation strategies and participation in a community-based lung cancer screening programme located in areas of high socioeconomic deprivation AID - 10.1136/thorax-2023-220001 DP - 2024 Jan 01 TA - Thorax PG - 58--67 VI - 79 IP - 1 4099 - http://thorax.bmj.com/content/79/1/58.short 4100 - http://thorax.bmj.com/content/79/1/58.full SO - Thorax2024 Jan 01; 79 AB - Introduction Although lung cancer screening is being implemented in the UK, there is uncertainty about the optimal invitation strategy. Here, we report participation in a community screening programme following a population-based invitation approach, examine factors associated with participation, and compare outcomes with hypothetical targeted invitations.Methods Letters were sent to all individuals (age 55–80) registered with a general practice (n=35 practices) in North and East Manchester, inviting ever-smokers to attend a Lung Health Check (LHC). Attendees at higher risk (PLCOm2012NoRace score≥1.5%) were offered two rounds of annual low-dose CT screening. Primary care recorded smoking codes (live and historical) were used to model hypothetical targeted invitation approaches for comparison.Results Letters were sent to 35 899 individuals, 71% from the most socioeconomically deprived quintile. Estimated response rate in ever-smokers was 49%; a lower response rate was associated with younger age, male sex, and primary care recorded current smoking status (adjOR 0.55 (95% CI 0.52 to 0.58), p<0.001). 83% of eligible respondents attended an LHC (n=8887/10 708). 51% were eligible for screening (n=4540/8887) of whom 98% had a baseline scan (n=4468/4540). Screening adherence was 83% (n=3488/4199) and lung cancer detection 3.2% (n=144) over 2 rounds. Modelled targeted approaches required 32%–48% fewer invitations, identified 94.6%–99.3% individuals eligible for screening, and included 97.1%–98.6% of screen-detected lung cancers.Discussion Using a population-based invitation strategy, in an area of high socioeconomic deprivation, is effective and may increase screening accessibility. Due to limitations in primary care records, targeted approaches should incorporate historical smoking codes and individuals with absent smoking records.Data are available upon reasonable request.