Acceptability of adding a non-contrast abdominal CT scan to screen for kidney cancer and other abdominal pathology within a community-based CT screening programme for lung cancer: A qualitative study

PLoS One. 2024 Jul 1;19(7):e0300313. doi: 10.1371/journal.pone.0300313. eCollection 2024.

Abstract

Objectives: The Yorkshire Kidney Screening Trial (YKST) is a feasibility study of adding non-contrast abdominal CT scanning to screen for kidney cancer and other abdominal malignancies to community-based CT screening for lung cancer within the Yorkshire Lung Screening Trial (YLST). This study explored the acceptability of the combined screening approach to participants and healthcare professionals (HCPs) involved in the trial.

Methods: We conducted semi-structured interviews with eight HCPs and 25 participants returning for the second round of scanning within YLST, 20 who had taken up the offer of the additional abdominal CT scan and five who had declined. Transcripts were analysed using thematic analysis, guided by the Theoretical Framework of Acceptability.

Results: Overall, combining the offer of a non-contrast abdominal CT scan alongside the low-dose thoracic CT was considered acceptable to participants, including those who had declined the abdominal scan. The offer of the additional scan made sense and fitted well within the process, and participants could see benefits in terms of efficiency, cost and convenience both for themselves as individuals and also more widely for the NHS. Almost all participants made an instant decision at the point of initial invitation based more on trust and emotions than the information provided. Despite this, there was a clear desire for more time to decide whether to accept the scan or not. HCPs also raised concerns about the burden on the study team and wider healthcare system arising from additional workload both within the screening process and downstream following findings on the abdominal CT scan.

Conclusions: Adding a non-contrast abdominal CT scan to community-based CT screening for lung cancer is acceptable to both participants and healthcare professionals. Giving potential participants prior notice and having clear pathways for downstream management of findings will be important if it is to be offered more widely.

MeSH terms

  • Aged
  • Early Detection of Cancer* / methods
  • Female
  • Humans
  • Kidney Neoplasms* / diagnosis
  • Kidney Neoplasms* / diagnostic imaging
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / diagnostic imaging
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Patient Acceptance of Health Care
  • Qualitative Research
  • Tomography, X-Ray Computed* / methods

Grants and funding

YKST is funded by Yorkshire Cancer Research grant number L403C. This qualitative sub-study is funded by a grant from Kidney Cancer UK. GDS is supported by The Mark Foundation for Cancer Research, the Cancer Research UK Cambridge Centre [C9685/A25177 and CTRQQR-2021\100012] and NIHR Cambridge Biomedical Research Centre (NIHR203312). JUS is supported by an NIHR Advanced Fellowship (NIHR300861). PAJC is supported by the Manchester National Institute for Health Research Manchester Biomedical Research Centre (IS-BRC-1215-20007). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.