Abstract
In Aotearoa New Zealand, lung cancer (LC) is the leading cause of death for indigenous Māori women and second (after cardiovascular disease) for Māori men. Māori develop LC ∼8 years earlier than non-Māori and it is the greatest contributor to inequity in mortality for Māori compared to NZ European/Other. Internationally, low dose CT screening in asymptomatic people at high risk of LC demonstrates significant reductions in mortality. No population-based testing of screening for LC has been conducted in Aotearoa, and internationally there have been no studies focussing on equity or indigenous populations. Our Māori-led research programme focusses on accelerating Māori health gain through early detection and treatment and aims to generate specific evidence to ensure that any national programme works for Māori. This trial addresses the primary research question of whether an invitation to screening from primary care results in higher levels of participation by Māori than a central hub-based invitation with established expertise in conducting screening programmes and skills in active follow-up of Māori. This study also investigates other key parameters and will evaluate contextual implementation factors to optimise a future NZ screening programme. As the first study of its kind in New Zealand, this will inform future implementation of early detection of LC in Māori, and what aspects of the invitation, risk assessment and other processes work for this population.