Referring high-risk individuals for lung cancer screening: A systematic review of interventions with healthcare professionals

Lung cancer is the leading cause of cancer globally, yet screening to detect lung cancer early remains uncommon. Screening is especially important for high-risk patients. How can we identify high-risk patients and increase referrals for lung cancer screening in general practice? This systematic review explored the effect of interventions designed to increase lung cancer screening – specifically, those aimed towards primary healthcare professionals (HCPs, including GPs and nurses) in referring high-risk patients for screening. Nine studies were included in this systematic review. Most of the studies were based in the US and conducted in either hospital or primary care settings. The authors evaluated 9 different interventions in total. HCP engagement with processes around early detection and referral of high-risk patients was measured by number of referrals, consultations, screenings, and diagnoses for lung cancer. Consultations included noting patients’ smoking histories and initiating smoking cessation discussions. Overall, HCP engagement improved through several interventions: a smoking history procedure, chart prompting, oncology nurse navigation. Shared decision-making also boosted HCP engagement with lung cancer screening – and thus increased screening rates – through increased documentation of the decision process via electronic prompts. Educational interventions may also increase HCP engagement. Knowledge and awareness of lung cancer screening for HCPs was improved in a group-learning setting compared to lecture formats. Findings showed an enhanced detection of lung cancer and improved screening levels as a result of these interventions, particularly nurse navigation, electronic prompts, and shared decision making. Future research should potentially focus on wider implementation of the effective interventions highlighted in this systematic review to increase appropriate referral for lung cancer screening by HCPs for high-risk patients in primary care. Read the original article here.
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