KEY TAKEAWAYS
- The study aimed to investigate risk factors for psychosocial burden during LC screening to improve participant support.
- Researchers noted that more robust research is needed to improve psychosocial outcomes in LCS by understanding participant factors.
The psychosocial impacts of lung cancer screening (LCS) can both harm individuals and act as barriers to screening participation and adherence. While preliminary data suggest that these impacts are influenced by factors such as sociodemographic characteristics and beliefs, a comprehensive synthesis of evidence is still needed.
This systematic review aimed to identify individual-level risk factors contributing to psychosocial burden during LCS, to develop strategies to better support participants and enhance LCS engagement.
Kathleen McFadden and the team aimed to assess the individual-level risk factors for psychosocial burden during LCS to inform strategies for improving participant support and engagement.
They performed an inclusive analysis by searching 4 databases for full-text articles published in English that reported associations between participant factors and psychosocial outcomes experienced during LCS. The quality of the studies was evaluated by 2 independent investigators, and the findings were synthesized narratively. The review was pre-registered with PROSPERO and adhered to PRISMA guidelines.
About 35 articles were included in the review; most studies (33/35) were assessed at high or moderate risk of bias. Study designs included pre-post (n = 13), cross-sectional (n = 13), qualitative (n = 8), and mixed-methods (n = 1), with the majority conducted in the United States (n = 17).
Psychological burden during LCS varied and was often associated with younger age, female gender, current smoking status or increased smoking history, lower education, lower socio-economic status, not being married or cohabiting, and experience with cancer.
However, results were mixed, and non-significant associations were reported across all factors. Beliefs such as fatalism, stigma, and expectations of LDCT results, as well as comorbid psychological burden, were also linked to psychosocial outcomes, although evidence was sparse.
Associations between risk perception, other participant factors, and psychosocial outcomes were inconclusive, likely reflecting individual biases in risk conceptualization.
The study concluded that several participant factors are consistently associated with the psychosocial impacts of LCS, though study heterogeneity and high risk of bias highlight the need for a more robust evaluation. Further research is necessary to explore how perceptions, beliefs, and expectations can be leveraged to improve psychosocial outcomes during LCS.
KM is supported by The Daffodil Centre Postgraduate Research Scholarship. NH is supported by the National Breast Cancer Foundation (NBCF) Chair in Breast Cancer Prevention grant (EC-21-001) and a NHMRC Investigator (Leader) grant (1194410). BN is supported by a NHMRC Investigator Emerging Leader Research Fellowship (1194108). TL is supported by a Cancer Institute NSW Early Career Fellowship (#2022/ECF1420). CJJ is supported by The Daffodil Centre Postgraduate Research Scholarship. SLQ is supported by a Barts Charity programme grant (G-001522, MGU0461).
Source: https://pubmed.ncbi.nlm.nih.gov/39096118/
McFadden K, Nickel B, Rankin NM, et al. (2024). “Participant factors associated with psychosocial impacts of lung cancer screening: A systematic review.” Cancer Med. 2024 Aug;13(15):e70054. doi: 10.1002/cam4.70054. PMID: 39096118; PMCID: PMC11297455.
