Impact of lung cancer screening results on smoking cessation.

BACKGROUND Lung cancer screening programs may provide opportunities to reduce smoking rates among participants. This study evaluates the impact of lung cancer screening results on smoking cessation. METHODS Data from Lung Screening Study participants in the National Lung Screening Trial (NLST; 2002-2009) were used to prepare multivariable longitudinal regression models predicting annual smoking cessation in those who were current smokers at study entry (n = 15489, excluding those developing lung cancer in follow-up). The associations of lung cancer screening results on smoking cessation over the trial period were analyzed. All hypothesis testing used two sided P values. RESULTS In adjusted analyses, smoking cessation was strongly associated with the amount of abnormality observed in the previous year's screening (P < .0001). Compared with those with a normal screen, individuals were less likely to be smokers if their previous year's screen had a major abnormality that was not suspicious for lung cancer (odds ratio [OR] = 0.811; 95% confidence interval [CI] = 0.722 to 0.912; P < .001), was suspicious for lung cancer but stable from previous screens (OR = 0.785; 95% CI = 0.706 to 0.872; P < .001), or was suspicious for lung cancer and was new or changed from the previous screen (OR = 0.663; 95% CI = 0.607 to 0.724; P < .001). Differences in smoking prevalence were present up to 5 years after the last screen. CONCLUSIONS Smoking cessation is statistically significantly associated with screen-detected abnormality. Integration of effective smoking cessation programs within screening programs should lead to further reduction in smoking-related morbidity and mortality.

[1]  H. D. de Koning,et al.  The impact of a lung cancer computed tomography screening result on smoking abstinence , 2010, European Respiratory Journal.

[2]  Office on Smoking.  How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General , 2010 .

[3]  C. Henschke,et al.  Smoking cessation following CT screening for early detection of lung cancer. , 2001, Preventive medicine.

[4]  S. Swensen,et al.  Relation between smoking cessation and receiving results from three annual spiral chest computed tomography scans for lung carcinoma screening , 2005, Cancer.

[5]  D. Lynch,et al.  The National Lung Screening Trial: overview and study design. , 2011, Radiology.

[6]  D. Berry,et al.  Benefits and harms of CT screening for lung cancer: a systematic review. , 2012, JAMA.

[7]  Sunil J Rao,et al.  Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis , 2003 .

[8]  V. Moyer.  Screening for Lung Cancer: U.S. Preventive Services Task Force Recommendation Statement , 2014, Annals of Internal Medicine.

[9]  C. Henschke,et al.  Smoking Cessation and Relapse during a Lung Cancer Screening Program , 2009, Cancer Epidemiology, Biomarkers & Prevention.

[10]  K. Emmons,et al.  Understanding the potential of teachable moments: the case of smoking cessation. , 2003, Health education research.

[11]  G. Colditz,et al.  Online Continuing Education Activity Article Title: American Cancer Society Lung Cancer Screening Guidelines Continuing Medical Education Accreditation and Designation Statement: Continuing Nursing Education Accreditation and Designation Statement: Educational Objectives: Activity Disclosures Acs Co , 2022 .

[12]  A. Dirksen,et al.  Effect of CT screening on smoking habits at 1-year follow-up in the Danish Lung Cancer Screening Trial (DLCST) , 2008, Thorax.

[13]  James L Mulshine,et al.  Lung cancer screening. , 2005, The oncologist.

[14]  S. Lam,et al.  Probability of cancer in pulmonary nodules detected on first screening CT. , 2013, The New England journal of medicine.

[15]  C. Gatsonis,et al.  Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening , 2012 .

[16]  M. Romkes,et al.  Smoking Behavior 1 Year after Computed Tomography Screening for Lung Cancer: Effect of Physician Referral for Abnormal CT Findings , 2009, Cancer Epidemiology, Biomarkers & Prevention.

[17]  Heber MacMahon,et al.  The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. , 2012, The Journal of thoracic and cardiovascular surgery.

[18]  J. Austin,et al.  Development of The American Association for Thoracic Surgery guidelines for low-dose computed tomography scans to screen for lung cancer in North America: recommendations of The American Association for Thoracic Surgery Task Force for Lung Cancer Screening and Surveillance. , 2012, The Journal of thoracic and cardiovascular surgery.

[19]  Christopher N. Barnes,et al.  Validity of Self-reported Smoking Status among Participants in a Lung Cancer Screening Trial , 2006, Cancer Epidemiology Biomarkers & Prevention.

[20]  Office on Smoking.  The Health Consequences of Smoking: A Report of the Surgeon General , 2004 .

[21]  Caroline S. Dorfman,et al.  Predictors of adverse smoking outcomes in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. , 2012, Journal of the National Cancer Institute.

[22]  Lu Shi,et al.  "Risk homeostasis"or "teachable moment"? the interaction between smoking behavior and lung cancer screening in the Mayo Lung Project , 2011, Tobacco induced diseases.

[23]  G. Bepler,et al.  Screening for lung cancer. , 2000, The New England journal of medicine.

[24]  Denise R. Aberle,et al.  Baseline Characteristics of Participants in the Randomized National Lung Screening Trial , 2010, Journal of the National Cancer Institute.

[25]  S. Swensen,et al.  Change in smoking status after spiral chest computed tomography scan screening , 2003, Cancer.

[26]  Ella A. Kazerooni,et al.  Lung cancer screening: Clinical practice guidelines in oncology , 2012 .

[27]  L. Cox,et al.  Lung cancer screening as a teachable moment for smoking cessation. , 2007, Lung cancer.