Lung cancer screening in diverse populations: a scoping review protocol

Problem

Lung cancer is the leading cause of cancer-related mortality worldwide with most cancers being detected at a late stage. Early detection through targeted screening is paramount for curative treatment and improving survival. Despite this, engagement with lung cancer screening is often poor (less than 50%), with the lowest participation observed among those patients who are most at risk. Existing studies have consistently highlighted the negative impact of current smoking and socio-economic deprivation on participation. However, there is still much to be learnt about factors influencing participation in diverse populations.

Approach

This review aims to map and identify gaps in the existing literature regarding lung cancer screening uptake in diverse populations. Keywords and medical subject headings for lung cancer screening and diverse patient characteristics will be searched in a minimum of four bibliographic databases. Populations of interest include but are not limited to different ethnic groups (including travelling and migrant communities), gender identities, cultures, religions, languages spoken, military background and disabilities. Outcomes of interest include lung cancer screening uptake rates, clinical outcomes and factors affecting engagement and implementation. Studies will be grouped and interpreted in the context of their geographical location and healthcare system in which they are situated.

Findings

Evidence on lung cancer screening is rapidly emerging. Existing studies have identified several practical and psychological factors which influence engagement with lung cancer screening internationally, however, preliminary scoping suggests that few studies focus specifically on diverse populations. Furthermore, there is a wide variation in the reporting of patient characteristics, such as ethnicity. Where reported, these characteristics are usually considered broadly rather than specifically. The confounding effect of intersectionality on lung cancer screening remains poorly understood.

Consequences

Further research is required to explore the diverse factors influencing lung cancer screening uptake. There is a need for reliable statistical information to quantify the disparity in lung cancer screening for specific diverse patient groups and the impact of intersectionality. Studies which explore motivators and demotivators in diverse groups will enable the development of evidence-based implementation strategies and culturally sensitive shared decision-making tools.