Overview of Domain 4

It is essential to define the eligibility criteria and recruitment process for a screening programme ahead of implementation. Domain 4 draws attention to targeted approaches that can help secure attendance from those who may be at highest risk of lung cancer. The recruitment process must also take into consideration health inequalities that can both increase the risk of lung cancer and make it difficult for people to undergo screening. As such, this domain also encourages users of the framework to think about the cultural sensitivity of the screening programme.

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Assessment framework key questions

In this domain, metrics are designed to assess:

Defining the eligible population

How to define the population eligible for lung cancer screening, including:

  • assessing the epidemiology of lung cancer in the population and the risk factors
  • the proposed eligibility criteria for the screening programme
  • methods to identify the target population

Engaging the target population

  • the informational needs of the target population to make an informed decision on participating in screening
  • whether the programme is culturally sensitive for all groups at high risk of lung cancer
  • the process for recruitment, including the different ways to access screening

Engaging healthcare professionals in recruitment

  • the engagement of healthcare professionals involved in referring the target population
  • what resources may be required to support healthcare professionals in assessing eligibility for screening

Corresponding policy brief

When planning for a screening programme, it is important to determine who will be eligible and how healthcare professionals will be supported to deliver the programme, and to ensure the programme design helps address inequities in lung cancer. To help those planning to implement screening programmes, we have published a policy brief focusing on the importance of eligibility and recruitment.


‘It’s really important that lung cancer screening is equitable. When it is designed and delivered with this in mind, it can help us to realise more equitable outcomes for lung cancer.’

Professor Sue Crengle, University of Otago

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