Lung Screen Uptake Trial
Condition: Lung Cancer
MeSH terms: Lung Neoplasms
Study type: Interventional

Summary: 
      This study tests the impact of a novel invitation strategy on attendance rates to a pre-lung
      cancer screening lung health check appointment. Patients will be individually randomised
      (1:1) to receive either control invitation materials or intervention invitation materials.
      Those who attend will undergo a "lung health check" and be invited to a baseline screening
      scan if eligibility criteria are fulfilled.
    

Detailed description: 
      Lung cancer screening using low dose computed tomography (LDCT) scans has been shown to
      reduce lung cancer-specific and all-cause mortality in a large United States (US) trial, and
      screening is now being carried out in the US. Studies have shown that participation rates are
      invariably low, particularly by current smokers and those from socioeconomically deprived
      backgrounds; groups within which high risk candidates are overrepresented.

      In this study the investigators aim to improve informed participation in screening and reduce
      socioeconomic and smoking-related biases in participation. The investigators will identify
      individuals at high risk of lung cancer; specifically adults aged 60-75 who are current or
      recent former smokers. Eligible individuals will be invited by their General Practitioner to
      a "lung health check appointment" via one of two randomly allocated invitation strategies.
      The control materials will be similar to those used by UK screening programmes for other
      cancer types. The intervention materials have been designed to reduce barriers to
      participation among smokers from low socioeconomic status backgrounds.

      Those that attend will have a lung cancer risk assessment, and if confirmed to be eligible,
      will undergo a baseline LDCT scan. Data will be collected with respect to demographics, risk
      and various clinical and radiological outcomes.
    

Intervention name(s): Control invitation materials; Intervention invitation materials
Intervention type(s): Behavioral; Behavioral
Intervention description(s): In the absence of usual care screening invitation materials, the control invitation materials and strategy are based upon the best available materials and methods of existing cancer screening programmes. These are comprised of the following:
a pre-invitation letter notifying patients of the lung health check service and an information booklet mimicking those of existing screening programmes
an invitation letter with a pre-scheduled appointment plus the same information booklet
a reminder re-invitation letter for those who miss their appointment without cancelling; The intervention invitation strategy is comprised of the same stages of invitation materials as the control group. The two differences are i) Instead of the information booklet they will received a targeted leaflet, and ii) the invitation and reminder letters will use indirect phrasing to explain that smokers and ex-smokers are being invited. Together, these manipulations aim to deliver a targeted, stepped and low burden approach to information provision prior to the appointment.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Screening
Keywords: Screening; Early detection; Health inequality; Uptake