Antigua-Made Alexander, Nguyen Sabrina, Rashidi Ali, Chen Wen-Pin, Ziogas Argyrios, Sadigh Gelareh
Anne Burnett School of Medicine, Texas Christian University, Fort Worth, TX, USA.
Department of Radiological Sciences, University of California Irvine, 101 The City Dr S, Orange, Irvine, CA, 92868, USA.
Cancer Causes Control. 2025 Mar 18. doi: 10.1007/s10552-025-01987-4.
Utilization of lung cancer screening (LCS) among eligible patients remains low at 16% in 2022. In this systematic review and meta-analysis we assessed the (a) LCS completion rate, and (b) intention to complete LCS, among patients who receive patient decision aids (PDAs).
PubMed, Cochrane, Scopus, CINAHL, and Web of Science were searched for articles published in English between 1 January 2011, and 28 February 2023. Two independent reviewers selected randomized controlled trials and prospective cohort studies that reported PDA interventions targeting either LCS completion rate or intention to complete LCS. Quality appraisal and data extraction were performed independently by 2 reviewers using the National Heart, Lung, and Blood Institute quality assessment tool. A random-effects model meta-analysis was performed. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines.
Thirteen studies with 2,277 total participants (51.5% male) were included. The pooled LCS completion rate across all follow-up periods (range, 1-6 months) was 40% (95% confidence interval [CI], 15-65%) with an I of 97% for heterogeneity. Pooled intention to complete LCS among patients who received PDA across all follow-up periods (same day to 3 months) was 57% (95% CI, 34% to 80%) with significant heterogeneity (I) of 96% (p < 0.0001). No publication bias was identified.
LCS completion and intention to complete LCS among patients who use PDAs is high. Our findings support the need to implement PDAs in clinical practice which could further facilitate shared decision-making and improve LCS uptake among eligible patients.
2022年符合条件的患者中肺癌筛查（LCS）的利用率仍然很低，仅为16%。在这项系统评价和荟萃分析中，我们评估了接受患者决策辅助工具（PDA）的患者的（a）LCS完成率，以及（b）完成LCS的意愿。
检索了PubMed、Cochrane、Scopus、CINAHL和Web of Science，查找2011年1月1日至2023年2月28日期间以英文发表的文章。两名独立审稿人选择了随机对照试验和前瞻性队列研究，这些研究报告了针对LCS完成率或完成LCS意愿的PDA干预措施。两名审稿人使用美国国立心肺血液研究所质量评估工具独立进行质量评估和数据提取。进行了随机效应模型荟萃分析。报告遵循系统评价和荟萃分析的首选报告项目指南。
纳入了13项研究，共有2277名参与者（51.5%为男性）。在所有随访期（范围为1至6个月）内，汇总的LCS完成率为40%（95%置信区间[CI]，15%至65%），异质性I²为97%。在所有随访期（同一天至3个月）内接受PDA的患者中，汇总的完成LCS的意愿为57%（95%CI，34%至80%），异质性（I²）显著为96%（p<0.0001）。未发现发表偏倚。
使用PDA的患者中LCS的完成率和完成LCS的意愿很高。我们的研究结果支持在临床实践中实施PDA的必要性，这可以进一步促进共同决策，并提高符合条件患者的LCS接受率。
