Interventions targeted to improve lung cancer screening uptake among high-risk individuals: A systematic review and meta-analysis

旨在提高高危人群肺癌筛查率的干预措施:系统评价和荟萃分析

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Abstract

OBJECTIVE: To synthesise evidence on interventions aimed at increasing lung cancer screening uptake among high-risk individuals, and examine the effectiveness of each intervention category. METHODS: Eight databases, namely EMBASE, CINAHL, MEDLINE, Scopus, PubMed, Web of Science, Wan Fang Database, and China National Knowledge Infrastructure, were systematically searched from inception to June 2024. The reference lists of identified studies were manually searched. Two reviewers independently assessed eligibility, extracted data, and evaluated methodological quality using the Cochrane risk of bias 2.0 tool. Meta-analyses and descriptive analyses were conducted. Subgroup analyses were performed for intervention category. All analyses were conducted using RevMan 5.4. RESULTS: A total of 13 trials from 12 studies were included. Six categories of interventions were identified: online education, patient navigation, shared decision-making, outreach promotion, targeted invitation materials, and combined intervention. The meta-analysis findings revealed that lung cancer screening uptake was enhanced among high-risk individuals receiving various interventions (OR, 1.70; 95% CI, 1.10-2.62; P ​= ​0.02) compared with no intervention or usual care. Subgroup analysis indicated that combined intervention (OR, 3.38; 95% CI, 2.08-5.52; P ​< ​0.001) and patient navigation (OR, 3.31; 95% CI, 1.70-6.41; P ​< ​0.001) could be effective strategies to improve lung cancer screening uptake among high-risk individuals. CONCLUSIONS: Combined intervention and patient navigation are most effective in increasing lung cancer screening uptake among high-risk individuals. However, the optimal design, tailoring, and delivery methods remain unclear due to the limited number of studies included and require further research.

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