Effectiveness of interventions for increasing lung cancer screening uptake: A systematic review and meta-analysis of randomized clinical trials.

Abstract

This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions for increasing lung cancer screening (LCS) uptake and to identify factors influencing their implementation. We searched MEDLINE, CINAHL, EMBASE, Cochrane Library, and Web of Science from January 2010 to November 2025. Included studies were randomized controlled trials involving high-risk adults eligible for LCS with low-dose computed tomography, evaluating interventions to improve screening uptake as a primary or secondary outcome. Eleven trials were included, primarily from the United States (N = 9). Interventions were categorized as patient navigation, decision aids, educational video/film, targeted invitation/outreach, and multi-component intervention. Overall, interventions showed a modest but significant effect on LCS uptake (RR = 1.34; 95 % CI: 1.02, 1.76). The multi-component intervention (RR = 2.11; 95 % CI: 1.21, 3.68) demonstrated significant effects, while patient navigation showed potential (RR = 2.18; 95 % CI: 0.53, 9.08). Innovation and inner setting were identified as potentially important factors influencing intervention implementation. Interventions modestly increased LCS uptake, with multi-component intervention and patient navigation showing the most promising effects. Future research should prioritize multicomponent strategies that address the entire screening continuum, equity-focused designs for priority populations, and trials in diverse international settings.