scholarly journals Smoking cessation after lung cancer diagnosis improves disease prognosis

2022 ◽  
Vol 11 (3) ◽  
pp. 15-22
Author(s):  
D.  G. Zaridze ◽  
A.  F. Mukeria ◽  
O.  V. Shangina ◽  
I.  S. Stilidi
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
Clinical Guidelines ◽  
Cost Effective ◽  
Clinical Value ◽  
Lung Cancer Diagnosis ◽  
Specific Cancer ◽  
American Society

Abstract: The presented clinical and epidemiological study is the world»s first large prospective study of the effect of smoking cessation after lung cancer (LC) diagnosis on the prognosis. Follow‑up of 517 patients with NSCLC for 7 years in average showed that continued smoking after diagnosis is a serious negative prognostic factor. At the same time smoking cessation improves OS and PFS by 22,6 months and specific cancer mortality by 22,8 months; reduces the risk of all‑cause mortality by 33 %, the risk of progression by 30 % and the risk of specific cancer mortality by 25 %. Almost 60 % of patients in our study continued smoking after diagnosis. Consequently, they had avoidable excess mortality which eventually reduced their life by 2 years.The positive effect of smoking cessation after diagnosis found in our study significantly exceeds the «meaningful benefit» (improvement in median overall survival by 2,5–6 months) for antineoplastic agents proposed by the American Society of Clinical Oncology (ASCO). Moreover, the study suggests that the benefits of smoking cessation after LC diagnosis are at least equal or superior to the significant results obtained in clinical studies of the effectiveness of innovative treatments.We hope that the results of our study will contribute to the inclusion of smoking cessation in clinical guidelines for the treatment of NSCLC and other cancers. The treatment program for cancer patients should include evidence‑based methods of smoking cessation presented in the form of «Clinical Guidelines for Smoking Cessation for Cancer Patients».Treating smoking in cancer patients is cost‑effective for the health care system, especially when compared to other treat‑ments. Conversely, continuing smoking after diagnosis significantly increases treatment costs.The introduction of recommendations on smoking cessation and treatment of nicotine addiction into the practice will improve the overall mortality rate by 30–35 % in more than 60,000 patients annually diagnosed with lung cancer in Russia. The clinical value of this method is obvious, since it has been proven to be highly efficient in improving the life expectancy of patients, and, ultimately, in reducing cancer mortality in Russia.

Smoking Cessation and Lung Cancer Mortality in a Cohort of Middle-aged Canadian Women

2005 ◽  
Vol 15 (4) ◽  
pp. 302-309 ◽  
Author(s):  
Bo Zhang ◽  
Roberta Ferrence ◽  
Joanna Cohen ◽  
Susan Bondy ◽  
Mary Jane Ashley ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Cancer Mortality ◽  
Lung Cancer Mortality ◽  
Middle Aged

Worldwide Overview of the Current Status of Lung Cancer Diagnosis and Treatment

2012 ◽  
Vol 136 (12) ◽  
pp. 1478-1481 ◽  
Author(s):  
Paul A. Bunn
Keyword(s):  
Lung Cancer ◽  
Cancer Mortality ◽  
Kinase Inhibitors ◽  
False Positive Rate ◽  
Lung Cancer Mortality ◽  
Current Status ◽  
Advanced Lung Cancer ◽  
Lung Cancer Diagnosis ◽  
Positive Rate ◽  
Inhaled Prostacyclin

Lung cancer is the leading worldwide cause of cancer deaths. Smoking is the dominant cause of lung cancer and smoking cessation is the established method to reduce lung cancer mortality. While lung cancer risk is reduced in former smokers, they have a lifelong increase in risk, compared to never-smokers. Novel chemoprevention strategies, such as oral or inhaled prostacyclin analogs, hold promise for these subjects. Low-dose spiral computed tomography screening reduced lung cancer mortality by 20% in high-risk heavy smokers older than 50 years. However, the high false-positive rate (96%) means that screened patients required controlled follow-up in experienced centers. An increasing percentage of patients with advanced lung cancer have molecular drivers in genes for which oral tyrosine kinase inhibitors have been developed.

scholarly journals Potential clinical value of PET/CT in predicting occult nodal metastasis in T1-T2N0M0 lung cancer patients staged by PET/CT

Oncotarget ◽  
2017 ◽  
Vol 8 (47) ◽  
pp. 82437-82445 ◽  
Author(s):  
Xiang Zhou ◽  
Ruohua Chen ◽  
Gang Huang ◽  
Jianjun Liu
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Nodal Metastasis ◽  
Clinical Value ◽  
Lung Cancer Patients ◽  
Pet Ct

scholarly journals The lived experiences of smokers with lung cancer

2018 ◽  
Vol 8 (11) ◽  
pp. 75
Author(s):  
Sakina Badiallah Abulqassemi Kashkoei ◽  
Jessie Johnson ◽  
Janet Rankin ◽  
Robert Johnson
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Lived Experiences ◽  
Descriptive Phenomenology ◽  
Lung Cancer Patients ◽  
Self Blame ◽  
Lung Cancer Diagnosis ◽  
Nurses And Physicians ◽  
Insight Into ◽  
Smoke Tobacco

Objective: The aims of this research were to learn about the lived experiences of patients with lung cancer who smoke tobacco and to provide nurses with more insights into complexities of people’s relationship with their smoking.Methods: Descriptive phenomenology was used to explore the lived experiences of smokers with lung cancer. An in-depth unstructured conversational style interview was used as a method for data collection. The study was conducted in the inpatient, outpatient, and day care units at the National Center for Cancer Care and Research (NCCCR) in Qatar. Purposive sampling was used to recruit five lung cancer patients who smoke. Colaizzi’s (1978) method was used to analyze data.Results: Participants described three related themes: (a) fate, (b) a socially acceptable addiction, and (c) self-blame and guilt.Conclusions: The findings of this study are of interest to nurses and physicians who work with lung cancer patients. The findings provide insight into experiences of patients who continue to smoke after their lung cancer diagnosis. Nurses within the smoking cessation clinic will also benefit from patients’ descriptions of what they consider useful and supportive in regards to an empathetic, coaching response to their relationships with tobacco. Future study is needed to elucidate nurses' perception on lung cancer patients who continue to smoke.

scholarly journals Low-dose computed tomography for lung cancer screening in high-risk populations: a systematic review and economic evaluation

2018 ◽  
Vol 22 (69) ◽  
pp. 1-276 ◽  
Author(s):  
Tristan Snowsill ◽  
Huiqin Yang ◽  
Ed Griffin ◽  
Linda Long ◽  
Jo Varley-Campbell ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cost Effectiveness ◽  
Usual Care ◽  
Cancer Mortality ◽  
Meta Analysis ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Clinical Effectiveness ◽  
Cost Effective ◽  
Cochrane Library

BackgroundDiagnosis of lung cancer frequently occurs in its later stages. Low-dose computed tomography (LDCT) could detect lung cancer early.ObjectivesTo estimate the clinical effectiveness and cost-effectiveness of LDCT lung cancer screening in high-risk populations.Data sourcesBibliographic sources included MEDLINE, EMBASE, Web of Science and The Cochrane Library.MethodsClinical effectiveness – a systematic review of randomised controlled trials (RCTs) comparing LDCT screening programmes with usual care (no screening) or other imaging screening programmes [such as chest X-ray (CXR)] was conducted. Bibliographic sources included MEDLINE, EMBASE, Web of Science and The Cochrane Library. Meta-analyses, including network meta-analyses, were performed. Cost-effectiveness – an independent economic model employing discrete event simulation and using a natural history model calibrated to results from a large RCT was developed. There were 12 different population eligibility criteria and four intervention frequencies [(1) single screen, (2) triple screen, (3) annual screening and (4) biennial screening] and a no-screening control arm.ResultsClinical effectiveness – 12 RCTs were included, four of which currently contribute evidence on mortality. Meta-analysis of these demonstrated that LDCT, with ≤ 9.80 years of follow-up, was associated with a non-statistically significant decrease in lung cancer mortality (pooled relative risk 0.94, 95% confidence interval 0.74 to 1.19). The findings also showed that LDCT screening demonstrated a non-statistically significant increase in all-cause mortality. Given the considerable heterogeneity detected between studies for both outcomes, the results should be treated with caution. Network meta-analysis, including six RCTs, was performed to assess the relative clinical effectiveness of LDCT, CXR and usual care. The results showed that LDCT was ranked as the best screening strategy in terms of lung cancer mortality reduction. CXR had a 99.7% probability of being the worst intervention and usual care was ranked second. Cost-effectiveness – screening programmes are predicted to be more effective than no screening, reduce lung cancer mortality and result in more lung cancer diagnoses. Screening programmes also increase costs. Screening for lung cancer is unlikely to be cost-effective at a threshold of £20,000/quality-adjusted life-year (QALY), but may be cost-effective at a threshold of £30,000/QALY. The incremental cost-effectiveness ratio for a single screen in smokers aged 60–75 years with at least a 3% risk of lung cancer is £28,169 per QALY. Sensitivity and scenario analyses were conducted. Screening was only cost-effective at a threshold of £20,000/QALY in only a minority of analyses.LimitationsClinical effectiveness – the largest of the included RCTs compared LDCT with CXR screening rather than no screening. Cost-effectiveness – a representative cost to the NHS of lung cancer has not been recently estimated according to key variables such as stage at diagnosis. Certain costs associated with running a screening programme have not been included.ConclusionsLDCT screening may be clinically effective in reducing lung cancer mortality, but there is considerable uncertainty. There is evidence that a single round of screening could be considered cost-effective at conventional thresholds, but there is significant uncertainty about the effect on costs and the magnitude of benefits.Future workClinical effectiveness and cost-effectiveness estimates should be updated with the anticipated results from several ongoing RCTs [particularly the NEderlands Leuvens Longkanker Screenings ONderzoek (NELSON) screening trial].Study registrationThis study is registered as PROSPERO CRD42016048530.FundingThe National Institute for Health Research Health Technology Assessment programme.

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