scholarly journals Unexpected effect of smoking/drinking cessation among computed tomography lung screening consumers

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C-C Chen ◽  
W-C Wu ◽  
D-C Chan
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Smoking Cessation ◽  
High Risk ◽  
Daily Smoking ◽  
High Risk Population ◽  
Abnormal Finding ◽  
Screening Programs ◽  
Generalised Linear Mixed Model ◽  
Lung Screening

Abstract Background Low-dose computed tomography (LDCT) screening is an innovated tool for lung cancer prevention. The findings of LDCT trials indicated that the screening could increase the motivation of smoking cessation for high-risk groups. However, none studies have investigated the associations between commercial LDCT lung screening and unhealthy behaviours among those customers. Methods We established a prospective observational study at a community hospital in Taiwan. In total, 1326 customers of the commercial LDCT lung screening without lung cancer history were recruited. At the day of screening, interviewers collected their baseline demographic information and smoking/drinking habits. Only 605 participants completed two follow-up surveys at the 3rd and 12th month. Screening findings were defined as ’normal’ if there were no nodules or only definitely benign nodules and as ’abnormal’ if any lung nodule or ground-glass opacity were found. We applied the generalised linear mixed model to estimate the effects of time and screening findings on daily smoking and weekly drinking. Results The rates of daily smoking (weekly drinking) decreased from 13.1% (15.5%), to 10.9% (12.9%) in the 3rd month, and 7.9% (12.4%) in the 12th month. The associations between abnormal screening findings and smoking (-0.25, 95% CI: -0.77,0.28) or drinking (0.13, 95% CI: -0.29, 0.56) cessation are not significant. The time effect on smoking cessation was persistent (-0.23 and -0.62 at the two periods, 95% CI: -0.39, -0.07 and -0.85. -.038), and the effect on stopping drinking was relatively small (-0.23 and -0.28 at the two periods, 95% CI: -0.43, -0.04 and -0.52, -0.04). Conclusions Commercial LDCT screening would decrease the rates of smoking more than drinking among these consumers, and the abnormal finding was not further associated with cessations. It implies that commercial screenings may be beneficial for decreasing unhealthy behaviours as a teachable occasion. Key messages Commercial LDCT lung screening program may have benefits for decreasing smoking and even drinking behaviours among the non-specific high-risk population. It might be a good moment for health providers and practitioners to conduct cancer-related health education during commercial screening programs.

scholarly journals Computed Tomography Screening for Lung Cancer: Has It Finally Arrived? Implications of the National Lung Screening Trial

2013 ◽  
Vol 31 (8) ◽  
pp. 1002-1008 ◽  
Author(s):  
Denise R. Aberle ◽  
Fereidoun Abtin ◽  
Kathleen Brown
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Early Stage ◽  
Helical Computed Tomography ◽  
Future Research ◽  
Early Stage Disease ◽  
Screening Programs ◽  
National Lung Screening Trial ◽  
Lung Screening ◽  
Screening Trial

The National Lung Screening Trial (NLST) has provided compelling evidence of the efficacy of lung cancer screening using low-dose helical computed tomography (LDCT) to reduce lung cancer mortality. The NLST randomized 53,454 older current or former heavy smokers to receive LDCT or chest radiography (CXR) for three annual screens. Participants were observed for a median of 6.5 years for outcomes. Vital status was available in more than 95% of participants. LDCT was positive in 24.2% of screens, compared with 6.9% of CXRs; more than 95% of all positive LDCT screens were not associated with lung cancer. LDCT detected more than twice the number of early-stage lung cancers and resulted in a stage shift from advanced to early-stage disease. Complications of LDCT screening were minimal. Lung cancer–specific mortality was reduced by 20% relative to CXR; all-cause mortality was reduced by 6.7%. The major harms of LDCT are radiation exposure, high false-positive rates, and the potential for overdiagnosis. This review discusses the risks and benefits of LDCT screening as well as an approach to LDCT implementation that incorporates systematic screening practice with smoking cessation programs and offers opportunities for better determination of appropriate risk cohorts for screening and for better diagnostic prediction of lung cancer in the setting of screen-detected nodules. The challenges of implementation are considered for screening programs, for primary care clinicians, and across socioeconomic strata. Considerations for future research to complement imaging-based screening to reduce the burden of lung cancer are discussed.

Cost-effectiveness analysis of lung cancer screening with low-dose computed tomography in an Iranian high-risk population

2021 ◽  
pp. 096914132110182
Author(s):  
Mansur Haji Esmaeili ◽  
Farshad Seyednejad ◽  
Alireza Mahboub-Ahari ◽  
Hossein Ameri ◽  
Hadi Abdollahzad ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Cost Effectiveness ◽  
High Risk ◽  
Low Dose ◽  
High Risk Population ◽  
Risk Population ◽  
System Perspective ◽  
The Cost ◽  
Low Dose Computed Tomography

Objective The results of recent studies have shown that using low-dose computed tomography (LDCT) for screening of lung cancer (LC) improves cancer outcomes. The objective of the current study was to evaluate the cost-effectiveness of LDCT in an Iranian high-risk population. Methods A Markov cohort simulation model with four health states was used to evaluate the cost-effectiveness of LDCT from a healthcare system perspective in the people aged 55–74 who smoked 25 or more cigarettes per day for 10–30 years. Cost data were collected, reviewing 324 medical records of patients with LC, and utilities and transition probabilities were extracted from the literature. The Monte Carlo simulation method was applied to run the model. Probabilistic sensitivity analysis and one-way analysis were also performed. Results LC screening in comparison to a no-screening strategy was costly and effective. The incremental cost-effectiveness ratio of screening versus no-screening was IRR (Iranian rials) 98,515,014.04 which falls below the Iranian threshold of three times GDP (gross domestic product) per capita. One-way and probabilistic sensitivity analyses demonstrated that the results of the economic analysis were robust to variations in the key inputs for both. Conclusions Using LDCT for screening of LC patients in a high-risk population is a cost-effective strategy.

scholarly journals Computed Tomography Screening for Lung Cancer in a High-Risk Population: Update on Current Status

2008 ◽  
Vol 100 (14) ◽  
pp. 1043-1044 ◽  
Author(s):  
P. Russo ◽  
L. Paleari ◽  
P. Granone ◽  
A. Cesario ◽  
U. Pastorino
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
High Risk ◽  
Current Status ◽  
High Risk Population ◽  
Risk Population

scholarly journals Estimate of Lung Cancer Mortality From Low-Dose Spiral Computed Tomography Screening Trials: Implications for Current Mass Screening Recommendations

2004 ◽  
Vol 22 (11) ◽  
pp. 2202-2206 ◽  
Author(s):  
Edward F. Patz ◽  
Stephen J. Swensen ◽  
James E. Herndon
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
High Risk ◽  
Mass Screening ◽  
Cancer Mortality ◽  
Low Dose ◽  
Lung Cancer Mortality ◽  
High Risk Population ◽  
Ct Screening ◽  
Screening Trials

Purpose Low-dose computed tomography (CT) has been suggested for lung cancer screening. Several observational trials have published their preliminary results, and some investigators suggest that this technique will save lives. There are no mortality statistics, however, and the current study used published data from these trials to estimate the disease-specific mortality in this high-risk population. Patients and Methods Two nonrandomized CT screening trials were selected from the literature for analysis. The number of trial participants, the number of lung cancers diagnosed per year, and stage distribution of the cancers was recorded. Previously published 5-year survival data were used to calculate the number of predicted lung cancer deaths and estimate the overall lung cancer mortality per 1,000 person-years among participants screened. These statistics were then compared to the previous Mayo Lung Project, which used chest radiographs and sputum cytology for screening high-risk individuals. Results This study estimates the lung cancer mortality is 4.1 deaths per 1,000 person-years in the Mayo Clinic CT screening trial, and is 5.5 deaths per 1,000 person-years in the Early Lung Cancer Action Program trial. These data are similar to the lung cancer mortality of 4.4 deaths per 1,000 person-years in the interventional arm, and 3.9 deaths per 1,000 person-years in the usual-care arm of the previous Mayo Lung Project. Conclusion These data suggest that CT screening could produce similar outcomes to prior chest radiographic trials in this high-risk group. Results from randomized trials are required, however, before the true utility of mass screening with CT for lung cancer can be determined.

scholarly journals Determining the perception of a lung cancer screening programme among high-risk patients in a tertiary referral centre, Kuala Lumpur

2019 ◽  
Vol 29 (1) ◽  
pp. 19-24
Author(s):  
Wei Hao Kok ◽  
Andrea Ban Yu-Lin ◽  
Shamsul Azhar Shah ◽  
Faisal Abdul Hamid
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Screening Programme ◽  
Lung Cancer Screening ◽  
High Risk Population ◽  
Willingness To Participate ◽  
Tertiary Referral Centre ◽  
Cross Sectional ◽  
Cancer Screening Programme

Background: Lung cancer is the second most common cause of cancer-related death and the third most common cancer in Malaysia. The rising prevalence of lung cancer suggests the need to consider disease screening for early detection, especially in the high-risk population, as it offers the best chance of cure. Objectives: The study aims to determine the willingness of high-risk respondents to participate in a lung cancer screening programme if made available to them, and to determine their attitude towards lung cancer screening and explore factors that might affect participation in a screening programme. Method: This is a cross-sectional, descriptive study over 6 months conducted in adult patients attending medical clinics in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) using face-to-face administered questionnaires. Results: In total 180 respondents were analysed. There were 177 (98.3%) males. Mean age was 59.8 ± 9.1 years. Of the respondents, 138 (76.7%) had poor knowledge about cancer screening. Former smokers comprised 119 (66.1%) of the participants, and 61 (33.9%) were current smokers. In total, 141 (78.3%) respondents indicated willingness to participate in a lung cancer screening programme. Out of this group, 68 (48.2%) respondents were unwilling to pay for the procedure. Only 18 (12.8%) were unwilling to undergo lung cancer treatment if detected early. Conclusions: Awareness about general cancer screening is low. Our study showed that when informed of their high-risk status, respondents were willing to participate in lung cancer screening. There should be more health programmes to promote and raise awareness about lung cancer.

scholarly journals Cost-Effectiveness of Smoking Cessation Interventions in the Lung Cancer Screening Setting: A Simulation Study

2021 ◽  
Author(s):  
Christopher J Cadham ◽  
Pianpian Cao ◽  
Jinani Jayasekera ◽  
Kathryn L Taylor ◽  
David T Levy ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Task Force ◽  
Lung Cancer Screening ◽  
Cancer Registries ◽  
Web Based ◽  
Screening Programs ◽  
Life Years

Abstract Background Guidelines recommend offering cessation interventions to smokers eligible for lung cancer screening, but there is little data comparing specific cessation approaches in this setting. We compared the benefits and costs of different smoking cessation interventions to help screening programs select specific cessation approaches. Methods We conducted a societal-perspective cost-effectiveness analysis using a Cancer Intervention and Surveillance Modeling Network model simulating individuals born in 1960 over their lifetimes. Model inputs were derived from Medicare, national cancer registries, published studies, and micro-costing of cessation interventions. We modeled annual lung cancer screening following 2014 US Preventive Services Task Force guidelines plus cessation interventions offered to current smokers at first screen, including pharmacotherapy only or pharmacotherapy with electronic and/or web-based, telephone, individual, or group counseling. Outcomes included lung cancer cases and deaths, life-years saved, quality-adjusted life-years (QALYs) saved, costs, and incremental cost-effectiveness ratios. Results Compared with screening alone, all cessation interventions decreased cases of and deaths from lung cancer. Compared incrementally, efficient cessation strategies included pharmacotherapy with either web-based cessation ($555 per QALY), telephone counseling ($7562 per QALY), or individual counseling ($35 531 per QALY). Cessation interventions continued to have costs per QALY well below accepted willingness to pay thresholds even with the lowest intervention effects and was more cost-effective in cohorts with higher smoking prevalence. Conclusion All smoking cessation interventions delivered with lung cancer screening are likely to provide benefits at reasonable costs. Because the differences between approaches were small, the choice of intervention should be guided by practical concerns such as staff training and availability.

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