Recruitment methods employed in the National Lung Screening Trial.

Posted: Jan 17, 2013
J Med Screen. 19. 2. 94-102.
KEYWORDS: Staff Experience Level, Verbal Communications, Radio, TV, Print Media, Brochure or Flyer, Letter, Cancer, Screening


Direct mail was the most expensive, yet the most effective, recruitment strategy in a large screening trial.

Why this item may be useful

Site coordinators reported helpful 'lessons learned' for recruiting participants to a large cancer screening trial. Recruitment must be tracked from the beginning of a study and records should include personnel time required for each recruitment strategy. Respondants should be asked how they heard about the study, be allowed to indicate more than one source, and be queried regarding their motivations for participation. Data should be analyzed frequently during recruitment, especially during the early months of the study. This will allow failing methods to be identified and remedied if possible and excessive costs to be recognized and addressed. Tracking effectiveness and costs associated with multiple recruitment strategies is an essential part of trial management, and the resulting data can help trialists improve their strategies in future trials.


  • Thirty-three US medical centers recruited 53,454 participants to the National Lung Screening Trial (NLST) in 20 months; recruitment was completed 4 months ahead of schedule.
  • Data were obtained from 22 of the 33 study sites that were able to report both (1) numbers recruited by each recruitment strategy and (2) costs per participant.
  • Most participants (approximately 19,000) were recruited through direct mail, at a median cost of $1.01 per participant. 
  • ​Mass media resulted in about 4,200 enrollments at a median cost of $79.00 per person, and community outreach resulted in about 1,000 enrollments at a median cost of $4.00 per person.