{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:00:53Z","timestamp":1785477653795,"version":"3.56.0"},"reference-count":87,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A mobile low-dose computed tomography (LDCT) unit is an effective strategy for early lung cancer detection, particularly in high-risk populations affected by social and healthcare disparities. However, existing reviews are limited by only focusing on diagnostic outcomes. This study aimed to evaluate the characteristics, effectiveness, and key influencing factors of mobile LDCT-based unit interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted from the inception of each bibliographic database to March 1, 2025. Two independent reviewers performed the study selection, quality assessment, and data extraction. Methodological quality was assessed via the Cochrane Risk of Bias 2 tool for randomized studies and the ROBINS-I tool for non-randomized studies. A qualitative synthesis was used to analyze intervention characteristics and effectiveness. Influencing factors were synthesized via the Consolidated Framework for Implementation Research (CFIR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighteen studies were included. Suspected cases ranged 23\u2013847 (detection 1.06\u201316.37%), with confirmed cases 2\u2013107 (0.33\u20134.33%). Five studies demonstrated economic efficiency for the mobile LDCT-based unit, with early detection yielding favorable cost ratios (\u00a511,143\u201316,950 per case) and substantial savings over late-stage treatment. Financial analyses indicated positive returns (e.g., net present value\u202f=\u202f$1\u202fM; internal rate of return\u202f=\u202f34.6%). Screen-detected cases reduced treatment costs by 56% and reduced hospital stays by 70%. Influencing factors, categorized via the CFIR, included intervention characteristics (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f2), outer setting (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f4), inner setting (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f4), and characteristics of individuals (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f2) but excluded implementation process (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This review shows mobile LDCT-based units have the potential benefit for early lung cancer detection and economic efficiency, particularly for underserved populations by reducing access barriers. Future research should identify implementation factors and develop practical frameworks to optimize program delivery and impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420251026810<\/jats:ext-link>\n                      , Identifier CRD420251026810.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1884561","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:39:08Z","timestamp":1785476348000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and implementation challenges of mobile low-dose computed tomography units for early lung cancer detection: a systematic review"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiujing","family":"Lin","sequence":"first","affiliation":[{"name":"School of Nursing, Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonglin","family":"Li","sequence":"additional","affiliation":[{"name":"School of Nursing, Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangfang","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialing","family":"Guo","sequence":"additional","affiliation":[{"name":"School of Nursing, Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujia","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Nursing, Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Arbing","sequence":"additional","affiliation":[{"name":"Joe C. Wen School of Nursing, University of California Los Angeles","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-Ti","family":"Chen","sequence":"additional","affiliation":[{"name":"Joe C. Wen School of Nursing, University of California Los Angeles","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Nursing, Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1136\/thoraxjnl-2012-202297","article-title":"Lung cancer survival and stage at diagnosis in Australia, Canada, Denmark, Norway, Sweden and the UK: a population-based study, 2004-2007","volume":"68","author":"Walters","year":"2013","journal-title":"Thorax"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e231988","DOI":"10.1148\/radiol.231988","article-title":"A 20-year Follow-up of the International Early Lung Cancer Action Program (I-ELCAP)","volume":"309","author":"Henschke","year":"2023","journal-title":"Radiology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"50","DOI":"10.3322\/caac.21811","article-title":"Screening for lung cancer: 2023 guideline update from the American Cancer Society","volume":"74","author":"Wolf","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3779\/j.issn.1009-3419.2023.102.10","article-title":"China national lung cancer screening guideline with low-dose computed tomography (2023 version)","volume":"26","year":"2023","journal-title":"Zhongguo Fei Ai Za Zhi"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"100936","DOI":"10.1016\/j.lanepe.2024.100936","article-title":"Impact of single round of low dose CT lung cancer screening on cause of mortality in different socio-economic groups: a post-hoc analysis of long-term follow-up of the UKLS trial","volume":"42","author":"Davies","year":"2024","journal-title":"Lancet Reg Health Eur"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1001\/jamaoncol.2016.6416","article-title":"Lung Cancer Screening With Low-Dose Computed Tomography in the United States-2010 to 2015","volume":"3","author":"Jemal","year":"2017","journal-title":"JAMA Oncol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/j.chest.2019.08.2176","article-title":"Lung Cancer Screening Uptake in the United States","volume":"157","author":"Yong","year":"2020","journal-title":"Chest"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"101594","DOI":"10.1016\/j.eclinm.2022.101594","article-title":"Uptake of lung cancer screening with low-dose computed tomography in China: A multi-centre population-based study","volume":"52","author":"Cao","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/j.lungcan.2022.07.022","article-title":"Barriers and facilitators to uptake of lung cancer screening: A mixed methods systematic review","volume":"172","author":"Lin","year":"2022","journal-title":"Lung Cancer"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"6","DOI":"10.21037\/ccts-20-173","article-title":"A narrative review of lung cancer screening in underserved populations","volume":"5","author":"Toubat","year":"2023","journal-title":"Curr Chall Thorac Surg"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e95","DOI":"10.1164\/rccm.202008-3053ST","article-title":"Addressing Disparities in Lung Cancer Screening Eligibility and Healthcare Access. 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