The American Cancer Society estimates that 222,500 new cases of lung cancer will be diagnosed in 2017, with 155,870 resulting in death. Lung cancer is the leading cause of death among men and women. Each year, more people die of lung cancer than of breast, colon, and prostate cancers combined; however, lung cancer is a preventable form of cancer with approximately 90% attributed to tobacco exposure.1 As a result, smoking cessation and early detection of lung cancer remain important goals of prevention and control.
A study recently published in the journal Thorax suggests that integrating CT screening for lung cancer with evidence-based smoking cessation interventions could encourage quitting in the motivated high-risk smoker. Smoking cessation was examined among a subset of current smokers who were high-risk participants in the UK Lung Cancer Screening pilot trial (UKLS) of low-dose CT screening.2
High-risk individuals aged 50 to 75 years who completed baseline questionnaires were randomized to CT screening (intervention) or usual care (no screening control). The smoking habit was determined at baseline using participant self-report. Of 4,055 participants, 1,546 were baseline smokers (787 control, 759 intervention).
This study is the first to report on the behavioral impact of CT screening in the UK high-risk population and confirms the findings of previous studies that lung cancer screening does not falsely reassure smokers or reduce their motivation to stop smoking.
Smoking cessation rates were 5% for the control versus 10% for the CT scan/intervention at 2 weeks, and 10% control versus 15% intervention up to 2 years. Findings indicate that smoking cessation was higher in the intervention arm and that CT lung cancer screening increased the likelihood of stopping smoking in the long term.
This UK Lung Cancer Screening pilot trial is the first to assess the feasibility, cost effectiveness, and psychosocial impact of lung cancer screening using a low-dose CT screen versus no screening in a UK high-risk population. Current evidence suggests that an integrated package of CT lung screening and smoking cessation support has the potential to prompt quitting in smokers who are motivated and receptive. Further behavioral research is needed to identify ways of engaging difficult to reach smokers, as well asto test the timing and type of smoking cessation programs to offer.
1. American Cancer Society. Key Statistics for Lung Cancer. Last accessed August 31, 2017. https://www.cancer.org/cancer/non-small-cell-lung-cancer/about/key-statistics.html
2. Brain K, Carter B, Lifford KJ, et al. Impact of low-dose CT screening on smoking cessation among high-risk participants in the UK Lung Cancer Screening Trial. Thorax. 2017; Jul 14. pii: thoraxjnl-2016-209690. [Epub ahead of print]