Abstract Rational Lung cancer is a leading cause of cancer deaths worldwide. Low-dose computed tomography (LDCT) screening reduces mortality through early detection. However, low participation rates hinder its effectiveness, highlighting the need for better interventions to encourage screening participation. This study aims to evaluate the effectiveness of interventions for increasing lung cancer screening (LCS) uptake and identify implementation factors influencing their success. Methods We conducted a systematic review and meta-analysis according to the PRISMA guidelines. We searched MEDLINE, CINAHL, EMBASE, Cochrane Library, and Web of Science from January 2010 to November 2024. Included studies were randomized controlled trials involving high-risk adults eligible for LDCT screening, evaluating interventions to improve screening uptake. The primary outcome measured was the uptake of LDCT screening, and we synthesized the barriers and facilitators influencing its implementation. Results Ten RCTs were included, primarily from the United States (N = 8). Interventions were categorized as patient navigation (N = 2), decision aids (N = 3), digital/web-based outreach (N = 2), and educational materials (N = 3). Overall, interventions showed no significant effect on LCS uptake (RR = 1.19, 95% CI: 0.86-1.64, P=0.29). Subgroup analyses for patient navigation (RR = 2.18), decision aids (RR = 1.40), digital/web-based outreach (RR = 0.70), and educational materials (RR = 1.03) also showed no significant effects. Innovation and inner setting factors were identified as key determinants of implementation success. Conclusion Current interventions did not significantly increase LCS uptake, with patient navigation showing potential but requiring further study. Future research should prioritize multicomponent interventions that support the entire screening continuum, equity-focused designs, and high-quality trials in diverse international settings. This abstract is funded by: the National Natural Science Foundation of China (Grant No.72504194) and the Humanities and Social Sciences Research Project of the Ministry of Education (Grant No.24YJCZH275)
Tao et al. (Fri,) studied this question.