Factors influencing screening adherence in the Yorkshire Lung Screening Trial.

<bold>Introduction:</bold> Lung cancer screening saves lives by detecting cancers at early curable stage. Continued adherence to screening is required for participants to realise the maximum clinical benefit. Here we describe the factors associated with screening adherence in the Yorkshire Lung Screening Trial. <bold>Methods:</bold> All individuals who remained eligible for screening following baseline (prevalence) screening were invited for an incidence screen two years later. Participants were contacted by phone (up to two attempts) to arrange an appointment or were sent a pre-arranged appointment letter if uncontactable. Characteristics of attenders versus non-attenders were compared using univariate and multivariable models. <bold>Results:</bold> Of the 6,650 individuals who attended a baseline screening scan, 5,975 were eligible for the second round of screening. Of these, 5,184 (87%) attended their second screen and 791 (13%) did not. Factors associated with lower attendance following multivariable analysis were socio-economic deprivation (OR 0.78, 95% CI 0.60-1.02 for most versus least deprived quintile according to index of multiple deprivation) and being a current smoker (OR 0.57, 95% CI 0.46-0.66). Gender, age, and ethnicity were not found to be associated with attendance. Attendance was more likely in people who had had an indeterminate (OR 2.10, 95% CI 1.61-2.73) or positive (OR 3.16, 95% CI 0.98-10.19) result from their baseline scan. <bold>Conclusion:</bold> Adherence was good overall but lower adherence amongst current smokers and those from deprived populations is a concern as these people are at greater risk of lung cancer death. Further research is needed into interventions that increase adherence in these high-risk populations.