Patient Reminders and Longitudinal Adherence to Lung Cancer Screening in an Academic Setting

Patient Adherence to Screening for Lung Cancer in the US

“…Given the overall low rates of cancer screening adherence within the US population [31][32][33][34] and among high-risk individuals, 35,36 it is not surprising that LCS adherence was lower than that seen within the controlled setting of clinical trials. 37 The higher screening uptake and adherence rates for colon and breast cancer compared with lung cancer are the results of these tests being available and recommended for many years, and a great deal of effort has gone into educating patients, 40 working with practitioners, 41 and Bhandari et al, 13 2018 Hirsh et al, 17 2018, 2020…”

“…Ten studies 12,[14][15][16][17]23,25,[27][28][29] (67%) were judged to have a low risk of confounder bias. Thirteen studies [12][13][14][15][16][17]19,20,22,23,[27][28][29] (87%) confirmed screening adherence through medical records or large database records. However, 12 studies 12,[14][15][16][17][18]20,22,23,25,27,28 (80%) did not have a follow-up time that was long enough to adequately assess periodic adherence beyond 1 year.…”

Lung Screen Uptake Trial (LSUT): Randomized Controlled Clinical Trial Testing Targeted Invitation Materials

“…Our invitation methods and evidence are published (13,27) and appended (Supplementary File 1). Briefly, evidence-based methods were used for both invitation groups, including GP endorsement (21,28), pre-notification (29), reminders (30,31) and pre-scheduled appointments (32,33). Th L H C All participants received the same postal invitation letters from their primary care practice: preinvitation letter, invitation letter with scheduled appointment, and reminder re-invitation letter with a second scheduled appointment (sent to non-responders >4 weeks after missed appointment…”

Determinants Associated With Longitudinal Adherence to Annual Lung Cancer Screening: A Retrospective Analysis of Claims Data

“…Early descriptions of LCS adherence determinants [31,32] came from clinical trials performed before clear proof that LCS reduced mortality and are difficult to contextualize in an environment in which LCS is a preventive service delivered in community settings and is now covered by most insurance plans. More recent studies in academic [23][24][25][26][27], community [22], or federal health [33] settings have emerged, but no prior studies have used insurance claims to assess LCS adherence [20,21]. Using longitudinal claims data, we found that ages 55 to 64 and 75 to 79, rural residence, and Medicare FFS and Medicaid insurance are associated with reduced adherence to annual LCS.…”

“…Determinants of cancer screening adherence are multifaceted and include both individual factors (demographics, income, beliefs) and health care system factors (insurance, accessibility, clinician recommendation) [10][11][12][13][14][15][16][17][18][19][20][21]. Early reports of real-world screening cohorts describe LCS annual adherence rates outside clinical trials between 37% and 66% [22][23][24][25][26][27]. Recent systemic reviews and metaanalyses found higher adherence in participants in their 60s and former (as opposed to current) smokers and lower adherence in racial minorities, individuals with less education, and individuals who lived further from the screening facility [20,21].…”