"Someone seeking lung cancer screening presumably has at least some concern about their risk of developing lung cancer," said Jamie S. Ostroff, Ph.D., first author of the study and the Director of MSKCC's Smoking Cessation Program. "This study demonstrates that lung cancer screening represents an important opportunity for delivering smoking cessation information."
The retrospective, self-reported study looked at 134 active smokers, all of whom were enrolled in the Early Lung Cancer Action Program (ELCAP). ELCAP screens high-risk active and former smokers with low-dose CT scanning, a procedure which preliminary evidence has shown to have increased sensitivity in the detection of early stage lung tumors-when lung cancer is most treatable. Individuals who enrolled in the study, which did not provide any formal smoking cessation advice or counseling, completed a brief telephone interview following their screening. Eighty-seven percent of enrollees stated that the screening process had been a major influence in increasing their motivation to quit smoking.
Twenty-three percent of the study participants reported that they had quit smoking following screening (markedly higher than the expected annual quit rate of about seven percent estimated for the general population of smokers). Twenty-six percent reported decreased smoking and 48 percent reported no change in smoking status or rate, while just under three percent reported increased smoking after ELCAP enrollment. The median time between screening and quitting was six months. Among those who reported quitting or cutting down after screening, only 10 percent used nicotine replacement therapy or other pharmacological approaches.
Some of the respondents' most frequently endorsed motivating factors for changes in their smoking behavior include heightened awareness of the hazards of smoking, fear of lung cancer detection during follow-up scan, discussion with their physician about the findings, and the desire to have an improved lung CT scan at the follow-up.
"Piggybacking smoking cessation advice with screening may be a promising way to reach smokers," Dr. Ostroff noted. "In our research, we look for 'teachable moments' for enhancing health-promoting behavior change, and lung cancer screening represents one of these moments. Our responsibility as healthcare providers is to seize these opportunities and deliver proven methods to accelerate and sustain health behavior change."
Today, lung cancer is the leading cause of cancer death in the United States, with an estimated 156,000 annual deaths. Lung cancer is also the most preventable form of cancer, with approximately 90 percent of all lung cancer cases attributable to tobacco exposure. As a result, smoking cessation and early detection remain critical goals for lung cancer prevention and control. "Continued smoking greatly increases the risk for lung cancer and other tobacco-related diseases, and there are now several quitting methods proven to be effective," Dr. Ostroff said.
The study was supported in part by the National Institutes of Health and the Division of Health Policy and Technology Assessment, Department of Radiology, Weill Medical College of Cornell University.
Memorial Sloan-Kettering is currently participating in a statewide study of low-dose spiral CT scanning for the early detection of lung cancer in long-term, current, and former smokers. For those interested in the screening, call the MSK Cancer Prevention and Wellness Program at 1-888-MSK-WELL (1-888-675-9355).
Memorial Sloan-Kettering Cancer Center is the world's oldest and largest institution devoted to prevention, patient care, research and education in cancer. Our scientists and clinicians generate innovative approaches to better understand, diagnose, and treat cancer. Our specialists are leaders in biomedical research and in translating the latest research to advance the standard of cancer care worldwide.
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Preventive Medicine