Abstract for: Policy lenses for the implementation of lung cancer screening in Australia – A systems mapping approach

The aims of this study were to (i) identify the likely determinants of lung cancer screening uptake, and (ii) identify the relationships and dynamic behaviours between these determinants that may influence the uptake of screening in Australia. A participatory workshop and follow-up meeting with key stakeholders were held which included clinicians in lung cancer care (respiratory physicians, medical oncologists, pulmonologists, specialist lung cancer nurses), a general practitioner (GP), a health economist, and consumer advocates. Data from stakeholder discussions and evidence from existing literature were used to create a causal loop diagram (CLD). The CLD comprised three main perspectives of a lung cancer screening program: the health system perspective, primary care perspective and the patient perspective. Further eight main drivers (feedback loops) were identified as responsible for the dynamics impacting the implementation and uptake of lung cancer screening: patient fear; patient stigma; patient health literacy; patient waiting time for a scan; GP capacity; GP clarity about referral steps; specialist capacity with lung cancer expertise; benefit-cost ratio of a lung cancer screening program. Findings from this study can be used to identify any interventions in the system and inform the development of a quantitative system dynamics model to simulate different intervention scenarios.