4948. Effectiveness of Decisions Aids to Improve Lung Cancer Screening: A Systematic Review and Meta-Analysis
Authors* Denotes Presenting Author
Alexander Antigua Made *;
Anne Burnett School of Medicine at Texas Christian University
Sabrina Nguyen;
University of California Irvine
Desiree Anderson;
University of California Irvine
Harman Araich;
Case Western Reserve University School of Medicine
Wen-Pin Chen;
University of California Irvine
Argyrios Ziogas;
University of California Irvine
Gelareh Sadigh;
University of California Irvine
Objective:
Lung cancer is a significant public health concern and a leading cause of cancer-related deaths in the United States. The US Preventive Services Task Force (USPSTF) recommends annual screening for lung cancer using low-dose CT (LDCT) among individuals aged 50 to 80 years who have a minimum smoking history of 20 pack-years and are either current smokers or have quit within the past 15 years. However, utilization rate of LDCT ranges between 1.8% to 20% among those eligible depending on patient, provider, or practice-level factors. This systematic review and meta-analysis aims to assess the effectiveness of decision aids interventions on completion of lung cancer screening among eligible patients.
Materials and Methods:
Five electronic databases (PubMed, Cochrane, Scopus, CINAHL, and Web of Science) were searched for articles published in English between January 1, 2011, and February 28, 2023. Four independent reviewers selected randomized controlled trials and prospective cohort studies that reported decision-aid interventions targeting the completion of lung cancer screening from a pool of 97 potential studies. Quality appraisal and data extraction were performed independently by two reviewers using the National Heart, Lung, and Blood Institute quality assessment tool. The primary endpoint was LDCT scan completion following the intervention. A random-effects model meta-analysis was conducted. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guideline.
Results:
Ten studies with a total of 544 individuals were included in this systematic review and meta-analysis. Tested interventions included decision aids in video, paper, and computer format. The pooled LCS adherence rate across all follow-up periods (range, 1 - 4 months) was 45% (95% CI, 20% - 70%) with I<sup>2</sup> of 97% for heterogeneity. No publication bias was identified.
Conclusion:
Patient decision aids resulted in a 45% completion rate of lung cancer screening, a rate much higher than the 1.8 - 20% reported in the general population without any intervention. Providers should utilize decision aids alongside a shared decision making (SDM) approach to increase adherence to lung cancer screening.
