期刊
BMC CANCER
卷 16, 期 -, 页码 -出版社
BMC
DOI: 10.1186/s12885-016-2316-z
关键词
Lung cancer; Cancer screening; Smoking; Health inequalities
类别
资金
- National Awareness and Early Diagnosis Initiative (NAEDI) project - Cancer Research UK
- Department of Health (England)
- Economic and Social Research Council
- Health and Social Care R&D Division, Public Health Agency, Northern Ireland
- National Institute for Social Care and Health Research, Wales
- Scottish Government
- Cancer Research UK
- Rosetrees Trust
- Welton Trust
- Garfield Weston Trust
- UCLH Charitable Foundation
- Department of Healths NIHR Biomedical Research Centres funding scheme
- Roy Castle Lung Cancer Foundation
- Medical Research Council
- Cancer Research UK [17976] Funding Source: researchfish
- Medical Research Council [1337958] Funding Source: researchfish
Background: Participation in low-dose CT (LDCT) lung cancer screening offered in the trial context has been poor, especially among smokers from socioeconomically deprived backgrounds; a group for whom the risk-benefit ratio is improved due to their high risk of lung cancer. Attracting high risk participants is essential to the success and equity of any future screening programme. This study will investigate whether the observed low and biased uptake of screening can be improved using a targeted invitation strategy. Methods/design: A randomised controlled trial design will be used to test whether targeted invitation materials are effective at improving engagement with an offer of lung cancer screening for high risk candidates. Two thousand patients aged 60-75 and recorded as a smoker within the last five years by their GP, will be identified from primary care records and individually randomised to receive either intervention invitation materials (which take a targeted, stepped and low burden approach to information provision prior to the appointment) or control invitation materials. The primary outcome is uptake of a nurse-led 'lung health check' hospital appointment, during which patients will be offered a spirometry test, an exhaled carbon monoxide (CO) reading, and an LDCT if eligible. Initial data on demographics (i.e. age, sex, ethnicity, deprivation score) and smoking status will be collected in primary care and analysed to explore differences between attenders and non-attenders with respect to invitation group. Those who attend the lung health check will have further data on smoking collected during their appointment (including pack-year history, nicotine dependence and confidence to quit). Secondary outcomes will include willingness to be screened, uptake of LDCT and measures of informed decision-making to ensure the latter is not compromised by either invitation strategy. Discussion: If effective at improving informed uptake of screening and reducing bias in participation, this invitation strategy could be adopted by local screening pilots or a national programme.
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