Navigation, not leaflets, raised lung cancer screening uptake

Design

Systematic review and meta-analysis of randomised and non-randomised studies

Population

14 completed studies of interventions to increase LDCT screening

Primary outcome

Completion of low-dose CT screening

Effect

SDM + navigation OR 4.34 (95% CI 2.50-7.54); education alone OR 1.03

A meta-analysis in the European Respiratory Review examined interventions to increase uptake of low-dose CT lung cancer screening, including 14 completed studies. Published on 21 October 2026.

Shared decision-making combined with patient navigation increased screening completion (OR 4.34), as did outreach plus navigation (OR 2.20). Education alone (OR 1.03) and shared decision-making alone (OR 1.15) did not. Multicomponent interventions worked; single-component ones did not.

Screening only helps those who attend. The lesson is that a conversation needs someone to follow it through, booking the scan and chasing non-attenders.

Certainty was low, most studies were American, and few tested changes at the level of clinicians or health systems.

• Pair the screening conversation with a named person who books and follows up the scan
• Do not rely on leaflets or education alone to increase uptake
• Contact eligible patients actively rather than waiting for them to ask
• Track who was invited and who attended

Why it matters

The benefit of a screening programme depends on how many eligible people actually have the scan.

Don't overread it

Low-certainty evidence, mainly from the US.

The statistics, in plain English

An odds ratio of 4.34 means the odds of being screened were more than four times higher, but the confidence interval (2.50 to 7.54) is wide because few studies tested this combination.

Read the rest in the app

You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.

Get Daily Doctor — free

Scan to keep reading on your phone. No account needed to start.