RT Journal Article
SR Electronic
T1 Invitation strategies and participation in a community-based lung cancer screening programme located in areas of high socioeconomic deprivation
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 58
OP 67
DO 10.1136/thorax-2023-220001
VO 79
IS 1
A1 Goodley, Patrick
A1 Balata, Haval
A1 Alonso, Alberto
A1 Brockelsby, Christopher
A1 Conroy, Matthew
A1 Cooper-Moss, Nicola
A1 Craig, Christopher
A1 Evison, Matthew
A1 Hewitt, Kath
A1 Higgins, Coral
A1 Johnson, William
A1 Lyons, Judith
A1 Merchant, Zoe
A1 Rowlands, Ailsa
A1 Sharman, Anna
A1 Sinnott, Nicola
A1 Sperrin, Matthew
A1 Booton, Richard
A1 Crosbie, Philip A J
YR 2024
UL http://thorax.bmj.com/content/79/1/58.abstract
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.