Lung Cancer Screening in family members and peers of lung cancer patients: Protocol for a prospective cohort study (Preprint)

BACKGROUND Lung cancer screening reduces mortality from lung cancer and screening programs have been recently implemented in the US, Canada, and the UK, yet recruitment remains its greatest challenge. Identifying high-risk participants eligible for screening has traditionally been based on physician-led recruitment and mass advertising campaigns directed to the general public. OBJECTIVE This study aims to identify whether lung cancer patients can act as effective advocates for lung cancer screening in their family members and close contacts, and whether this is a worthwhile strategy to increase uptake at the population-wide level. METHODS We designed a prospective cohort study where lung cancer patients are approached and educated on effective tools for communicating with family members and close contacts about the benefits of lung cancer screening. Referred individuals will be directed to our study’s website and invited to have their lung cancer risk assessed using a validated lung cancer risk calculator via a questionnaire and will be directed towards the provincial screening program should they meet criteria. Baseline data for all participants included: age, sex, education level, ethnicity, health literacy (as assessed with a 3 item Brief Health Literacy Screen) and smoking status. RESULTS Primary outcomes of our study include the number of referred participants per lung cancer survivor and the mean risk of lung cancer of the referred population based on PLCOm2012 scores14. Secondary outcomes for the referred cohort will include (1) eligibility for the provincial lung cancer screening program as defined as a binary variable (being PLCOm2012 score above or below 2%); (2) the proportion of participants eligible for screening who complete LDCT screening within 18 months of referral from a lung cancer survivor; (3) the proportion of participants who demonstrate interest in theoretically undergoing genetic testing to inform lung cancer risk; and (4) the proportion of individuals who demonstrate interest in a smoking cessation program. CONCLUSIONS Non-traditional referral methods for lung cancer screening may show promise in enrolling a high-risk population that may benefit from lung cancer screening enrollment. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT05645731