IARC 60th Anniversary - 19-21 May 2026
Session : 20/05/26 - Posters
Translating Lung Cancer Screening Evidence into Equitable Primary Care Practice
DWORKIN S. 11, JEJI T. 1, REDDIT V. 5,21, RAMASAMY V. 1, WRIGHT V. 21, RICHE D. 22, NAIR V. 23, ESPIN S. 24, SAYANI A. 1,2, MEDVEDYUK S. 1, LADAK Z. 1,3,4, NIWE S. 1, LOFTERS A. 1,5,6, PRATT A. 1, AMENU B. 1, EDWARDS A. 7, FINLEY C. 8,9,10, NICHOLSON E. 9, BLOCH G. 5,12,13, FREEDMAN H. 1, TIMM L. 14, PARSONS J. 5, HOCHMAN J. 15, ROGERS J. 16, CAMUS J. 1, MOFFAT J. 17, NYHOF-YOUNG J. 11,18, SELBY P. 5,19,20
1 Women's College Hospital, Toronto, Canada; 2 Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; 3 Office of Spread & Scale, Women’s College Hospital Institute for Health System Solutions & Virtual Care, Toronto, Canada; 4 Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Canada; 5 Department of Family and Community Medicine, University of Toronto, Toronto, Canada; 6 Peter Gilgan Centre for Women’s Cancers, Women’s College Hospital, Toronto, Canada; 7 Cancer Strategy and Innovation, Canadian Cancer Society, Toronto, Canada; 8 Thoracic Surgery, St. Joseph’s Healthcare, Hamilton, Canada; 9 Canadian Partnership Against Cancer, Toronto, Canada; 10 Lung Cancer Screening, Ontario Health, Toronto, Canada; 11 Canadian Partnership Against Cancer, Toronto, Canada; 12 Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, Canada; 13 Inner City Health Associates, Toronto, Canada; 14 Canadian Cancer Survivor Network, Toronto, Canada; 15 Nova Scotia Association of Black Social Workers, Halifax, Canada; 16 Association of Family Health Teams of Ontario, Toronto, Canada; 17 Programs & Health System Partnerships, Lung Health Foundation, Toronto, Canada; 18 Learning Institute & Family Practice Unit, Women’s College Hospital, Toronto, Canada; 19 INTREPID Lab, Centre for Addictions & Mental Health, Toronto, Canada; 20 Institute for Mental Health Policy Research, Centre for Addictions & Mental Health, Toronto, Canada; 21 Crossroads Clinic, Women’s College Hospital, Toronto, Canada; 22 Saskatchewan Cancer Agency, Saskatoon, Canada; 23 Cancer Care Program, Nova Scotia Health, Halifax, Canada; 24 Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Canada
Background: Despite strong evidence that low-dose CT screening reduces lung cancer mortality, uptake remains persistently low among populations experiencing structural disadvantage. These inequities reflect not only eligibility and access barriers, but also how screening is offered, discussed, and delivered within primary care. Primary care providers (PCPs) play a pivotal role in translating evidence-based screening guidelines into routine preventive practice, yet often lack practical preparation to address stigma, trauma, and social contexts shaping cancer risk and screening decisions. Interventions that strengthen provider capacity at this implementation interface are essential for translating research into equitable public health action.
Objectives: To assess whether a patient-partner co-designed, CME-accredited e-learning intervention can strengthen primary care capacity to implement equity-oriented, trauma- and violence-informed lung cancer screening, and to examine conditions supporting sustained integration into routine preventive cancer care.
Methods: We evaluated Creating Safe Connection, an asynchronous e-learning module co-designed with patient partners with lived experience of lung cancer screening inequities. The evaluation was guided by Moore’s Expanded Outcomes Framework and the RE-AIM implementation framework. Quantitative pre- and post-module assessments measured participation, satisfaction, perceived relevance, and changes in declarative and procedural knowledge related to equity-oriented cancer screening practices. To examine real-world translation beyond knowledge acquisition, semi-structured interviews conducted 3–6 months post-completion explored Reach, Effectiveness, Adoption, Implementation, and Maintenance, with attention to practice-level and organizational factors influencing sustainability.
Results: Among participating PCPs across nine primary care settings (n = 54), baseline capacity to deliver equity-oriented lung cancer screening was low, indicating a substantial implementation gap between evidence and practice. Mean scores increased markedly following module completion for knowledge (4.83 to 7.81/10), understanding of trauma- and violence-informed approaches in screening (3.11 to 7.92/10), and confidence applying learning in practice (3.49 to 7.94/10). Most participants reported high readiness to act (90%), relevance to practice (87%), and satisfaction (85%). Follow-up interviews (n = 15) identified concrete practice changes directly addressing known barriers to equitable screening, including use of non-stigmatizing language, reflective approaches to bias, collaborative decision-making, and intentional creation of emotionally and physically safe clinical environments. Participants emphasized that sustained translation into practice depends on team-based reinforcement, organizational support, and continued learning opportunities.
Conclusions: This study demonstrates that equity-oriented, patient-partner co-designed CME can function as a scalable implementation strategy to translate lung cancer screening evidence into everyday primary care practice. By reshaping how screening conversations and encounters occur, such interventions address upstream determinants of participation and improve the conditions for equitable early detection. Strengthening provider capacity at this critical interface represents a pragmatic pathway for advancing population-level cancer prevention and reducing lung cancer inequities through routine health system action.