Preferences for Decision Control among a High-Risk Cohort Offered Lung Cancer Screening: A Brief Report of Secondary Analyses from the Lung Screen Uptake Trial (LSUT)

Abstract

Background. Personal autonomy in lung cancer screening is advocated internationally, but health systems diverge in their approach, mandating either shared decision making (with a health care professional) or individual decision making. Studies of other cancer screening programs have found that individual preferences for the level of involvement in screening decisions vary across different sociodemographic groups and that aligning approaches with individual preferences has the potential to improve uptake. Method. For the first time, we examined preferences for decision control among a cohort of UK-based high-risk lung cancer screening candidates ( N = 727). We used descriptive statistics to report the distribution of preferences and chi-square tests to examine associations between decision preferences and sociodemographic variables. Results. Most (69.7%) preferred to be involved in the decision with varying degrees of input from a health care professional. Few (10.2%) wanted to make the decision alone. Preferences were also associated with educational attainment. Conclusion. These findings suggest one-size-fits-all approaches may be inadequate in meeting diverse preferences, particularly those placing sole onus on the individual. Highlights Preferences for involvement in decision making about lung cancer screening are heterogeneous among high-risk individuals in the United Kingdom and vary by educational attainment. Further work is needed to understand how policy makers might implement hybrid approaches to accommodate individual preferences and optimize lung cancer screening program outcomes.

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review

“…Additionally, considered approaches for implementation of any participant‐led preparation in culturally and linguistically diverse or deprived communities are needed, as study samples to date mostly do not represent these groups. Participants also vary in how much they want to be involved in decisions about their care, which has recently been confirmed in the LCS context 52 . Tailoring levels of SDM may therefore be both cost‐effective in reducing time burden, as well as better align with individual preferences.…”

“…Participants also vary in how much they want to be involved in decisions about their care, which has recently been confirmed in the LCS context. 52 Tailoring levels of SDM may therefore be both cost-effective in reducing time burden, as well as better align with individual preferences.…”