P2.11-28 A Focus Group and Interview Study to Explore the Information-Needs of Lung Cancer Screening Participants

Lung cancer screening (LCS) by low-dose CT has been shown to improve mortality, but individuals must consider the potential benefits and harms before making an informed decision about taking part. In the US a shared decision-making process is mandated to qualify for LCS reimbursement. However, screening eligible individuals’ (SEI) specific views of these harms, and their preferences for accessing this information, are not well described. 16 semi-structured interviews were carried out with general practitioners, public health consultants, respiratory physicians and lung cancer nurse specialists. 35 SEI participated in seven focus groups, which were divided into current vs. former smokers and lower vs. higher educational backgrounds. Interviews and focus groups were audio-recorded and transcribed. Data were coded inductively and analysed using the framework method. Lung cancer was generally perceived as an incurable condition, and smokers appeared to be particularly fatalistic. Despite this, a ‘belief in screening’ emerged from the interviews and focus groups. Participants’ appetite for information varied; with many expressing a ‘right’ to be given all the information, while others cautioned against too much information, and HCPs also acknowledged this dichotomy. Of the harms of screening, false positives and false negatives generated the most concern, though for most participants, even these were unlikely to deter them from screening. Participants were aware of the harms of smoking though many current smokers perceived other factors as more detrimental to their health than smoking. Regarding smoking cessation advice at screening, most focus group and interview participants preferred an emphasis on the benefits of quitting, and for advice to be delivered in a positive and empowering manner. These findings can be used to directly inform the way in which information is presented to SEI in order to aid the shared decision-making process, motivate smoking cessation and minimise barriers to uptake of LCS.