On the road to early detection: A survey of barriers and facilitators to community participation in mobile lung cancer screening

Introduction: Mobile screening units (MSUs) are an innovative strategy to mitigate barriers to community access to cancer screening modalities. A pivotal step in implementing an MSU is identifying potential barriers that may impact community utilization. Therefore, the goal of this study was to conduct a community-wide cross-sectional survey to assess barriers and facilitators to mobile lung cancer screening using validated survey measures. Methods: Patient eligibility included have undergone any cancer screening at Moffitt Cancer Center (MCC) between Jan 1, 2023 and Dec 1, 2024, or patients who visited MCC during the same time and met current lung cancer screening guidelines. The web-based survey was administered from May 2025 to June 2025 and included items derived from validated measures, existing literature, and questions developed by the study team. The survey collected data on health behaviors, barriers, facilitators, screening preferences, and demographics. Participants were offered a $10 Amazon gift card upon survey completion. Descriptive statistics and exploratory stratified analyses were used to quantify survey responses. Results: Among the 218 participants who completed the survey, 33% reported a prior clinician discussion about lung cancer screening. Most participants (73.4%) reported no concerns about getting screened in a mobile screening unit, but 67.9% reported concerned about the cost or if insurance covered mobile lung cancer screening, and 84.4% reported they would be screened if a voucher or insurance would pay for it. Regarding preferences, 54.1% reported no preference for the time of year for a mobile screening event, 59.6% reported they will be willing to wait up to 30 minutes to get screened, 44% would travel more than 20 minutes to get screened, and 44% preferred only Monday-Friday 9 am to 5 pm to get screened in a mobile unit. There were only few statistically significant differences found in stratified analyses by smoking status (ever vs. never), race/ethnicity (non-Hispanic Whites vs. all other groups), age (<67 vs. ≥67), and veteran status (former/active vs. no). Conclusions: In this community-wide survey study, mobile lung cancer screening was broadly acceptable. Actionable preferences included: daytime weekday events, indoor waiting, short waits, proximity to home, clear cost coverage, and streamlined clinician recommendation. Implementation strategies that focus on provider prompts/referrals, financial transparency (vouchers/coverage), and hybrid workflows (vouchers/coverage) may enhance uptake.