Lung cancer screening is clinically effective and, if implemented successfully, will directly impact on lung cancer-specific mortality. However, implementation and roll out is highly complex, and many factors need to be considered to achieve the best possible outcomes for participants. There are many lessons that can be learned when examining real-world implementation in other countries. In Australia, a paucity of data about feasibility of screening for lung cancer requires that pre-implementation evidence is generated using rigorous methods.
This presentation will report the results of two qualitative studies conducted with Australian stakeholders in 2020-21. The first study aimed to understand motivation for lung cancer screening with people who were eligible to participate in the International Lung cancer Screening Trial, including those who completed a low-dose CT scan and those declined. The second study involved conducting focus groups with health care providers and program managers to elicit their views about barriers and enablers to implementation of lung cancer screening in the Australian setting.
Across both studies, the data show that most participants found lung cancer screening to be feasible but identified numerous challenges for implementation and roll out. The most salient challenges will be considered regarding participation, such as encouraging recruitment in high-risk priority groups. Focus group participants strongly advocated for developing awareness and education campaigns to engage participants and health professionals. Health system factors were emphasised including workforce resources, physical infrastructure (e.g. access to CT scanners) and establishing a quality assurance program, as well as practical considerations to enhance accessibility (e.g. using mobile vans). Integrating smoking cessation interventions and addressing stigma were highlighted as key challenges that will impact on feasibility.
The presentation will conclude with an overview about the next stages of funded research to engage diverse communities in how lung cancer screening can be optimally implemented in Australia.