Rethinking how mobile units can catalyze progress on lung cancer screening: a scoping review of what we have learned

Background: Despite United States Preventive Services Task Force (USPSTF) recommendations, low uptake of lung cancer screening (LCS) highlights the need for measures to promote adoption. This scoping review aims to outline the global landscape of mobile low-dose computed tomography (LDCT) platforms, summarizing research and evaluating efficacy in screening at-risk populations.

Methods: We comprehensively searched Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Embase, Scopus, and Web of Science for articles published between 2017 and 2023. Selected studies focused on mobile LCS programs using LDCT, providing details on program location, design, sample size, age, targeted population, lung cancer detection rate, and outcomes. Only studies meeting these criteria were considered.

Results: The search found 12 studies meeting inclusion criteria, documenting ten mobile LDCT platforms across several countries. These studies primarily evaluated platform effectiveness in screening populations at risk, particularly targeting individuals who have ever smoked, high-risk individuals, and underserved populations. Two studies compared outcomes between mobile and hospital-based screening, while 10 other studies reported outcomes from mobile LDCT platforms. In US studies, most participants in mobile LCS programs came from rural areas, were uninsured or under-insured, and included a notable number of racial/ethnic minorities. The frequency of lung cancer diagnoses ranged from 0.33% to 3%, with the majority (80%) of detected at stages I and II.

Conclusions: The mobile LDCT platforms emerge as a powerful solution to enhance access to LCS, especially for marginalized populations. By improving screening rates and enabling early detection, these platforms hold promise in narrowing healthcare disparities. Mobile LDCT presents a crucial opportunity to save lives and promote equity in healthcare access.