IMPALA: Increasing informed participation in lung cancer screening
Research type
Research Study
Full title
Increasing informed participation in lung cancer screening using pathway navigation (IMPALA): a multi-centre randomised controlled trial using a hybrid effectiveness/ implementation design
IRAS ID
349605
Contact name
Anna Bibby
Contact email
Sponsor organisation
Research Sponsor, North Bristol NHS Trust
Duration of Study in the UK
4 years, 0 months, 0 days
Research summary
Lung cancer is the third most commonly diagnosed cancer in the UK and the leading cause of cancer death. Survival is worse in those diagnosed at a later stage, where treatment options are limited. Many people do not have symptoms prior to diagnosis, particularly in earlier stages of the disease. Screening with low dose computed tomography (CT) scanning enables detection of asymptomatic lung cancer. Trials have shown that screening reduces lung cancer deaths.
In the UK, screening for lung cancer was recommended in June 2022, and a national screening programme, the ‘Targeted Lung Health Check’ (TLHC) was implemented. Individuals aged 55-74, who have ever smoked, are invited to a telephone risk assessment, followed by a CT scan appointment if found to be high risk.
Unfortunately, a significant proportion of people do not participate in lung cancer screening; the evidence suggests that higher risk people, specifically those from socioeconomically disadvantaged and under-served populations, are less likely to attend screening appointments. Addressing non-participation is fundamental to maximise screening effectiveness and reduce health inequalities.
Pathway navigation is a process involving motivational interviewing and decision coaching that aims to increase participant confidence to make an informed decision about screening participation. Preliminary studies have shown that pathway navigation improves uptake of initial lung cancer screening invitations, but this hasn’t been trialed within NHS TLHCs, nor has it been investigated for screening follow-up appointments.
IMPALA aims to assess the impact of pathway navigation within TLHC. The primary outcome is an individuals attendance at their subsequent TLHC appointment, either baseline and follow up. Impact on screen- and non-screen-detected lung cancer diagnosis and staging will also be evaluated. We will assess implementation of pathway navigation in busy NHS services, through qualitative interviews with participants and providers, and through assessment of delivery metrics and cost-effectiveness.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
25/YH/0033
Date of REC Opinion
24 Mar 2025
REC opinion
Further Information Favourable Opinion