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Determining factors influencing patient participation in and adherence to cancer screening recommendations is key to successful cancer screening programs. However, the collection of variables necessary to anticipate patient behavior in cancer screening has not been systematically examined. Using lung cancer screening as a representative example, we conducted an exploratory analysis to characterize the current representations of 18 demographic, health-related, and psychosocial variables collected as part of a conceptual model to understand factors for lung cancer screening participation and adherence. Our analysis revealed a lack of standardization in controlled terminologies and common data elements for these variables. For example, only eight (44%) demographic and health-related variables were recorded consistently in the electronic health record. Multiple survey instruments could collect the remaining variables but were highly inconsistent in how variables were represented. This analysis suggests opportunities to establish standardized data formats for psychological, cognitive, social, and environmental variables to improve data collection., (©2022 AMIA - All rights reserved.)

Lung cancer screening (LCS) is effective in reducing mortality, particularly when patients adhere to follow-up recommendations standardized by the Lung CT Screening Reporting & Data System (Lung-RADS). Nevertheless, patient adherence to recommended intervals varies, potentially diminishing benefit from screening. We conducted a systematic review and meta-analysis of patient adherence to Lung-RADS-recommended screening intervals. We systematically searched MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and major radiology and oncology conference archives between April 28, 2014, and December 17, 2020. Eligible studies mentioned patient adherence to the recommendations of Lung-RADS. The review protocol was registered with PROSPERO (CRD42020189326). We identified 24 eligible studies for qualitative summary, of which 21 were suitable for meta-analysis. The pooled adherence rate was 57% (95% confidence interval: 46%-69%) for defined adherence (e.g., an annual incidence screen was performed within 15 mo) among 6689 patients and 65% (95% confidence interval: 55%-75%) for anytime adherence among 5085 patients. Large heterogeneity in adherence rates between studies was observed (I 2  = 99% for defined adherence, I 2  = 98% for anytime adherence). Heterogeneous adherence rates were associated with Lung-RADS scores, with significantly higher adherence rates among Lung-RADS 3 to 4 than Lung-RADS 1 to 2 (p < 0.05). Patient adherence to Lung-RADS-recommended screening intervals is suboptimal across clinical LCS programs in the United States, especially among patients with results of Lung-RADS categories 1 to 2. To improve adherence rates, future research may focus on implementing tailored interventions after identifying barriers to LCS. We also propose a minimum standardized set of data elements for future pooled analyses of LCS adherence on the basis of our findings., (Copyright © 2021 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.)