Computed tomography (CT) lung scans do not falsely reassure patients who smoke and are at high-risk for lung cancer to continue smoking and may increase their motivation to quit, according to a study published in Thorax.
Smoking is one of the biggest preventive risk factors for lung cancer. Previous studies demonstrated that the addition of a CT scan could play a role in smoking cessation, particularly in patients with a positive CT screening, but concerns that a negative screening may encourage patients to continue smoking persist.
The researchers identified 1546 baseline smokers among 4055 patients who were at high risk for lung cancer and randomized them 1:1 to receive CT screening or usual care without screening.
Patients who had a CT screening had a 2-week smoking cessation rate of 10% vs 5% in nonscreened patients. At a 2-year follow-up, patients who had undergone CT scan had a smoking cessation rate of 15% vs 10% for nonscreened patients.
Analysis of the intent-to-treat (ITT) population demonstrated that the likelihood of quitting was significantly higher for patients who received CT scans in the short term (adjusted odds ratio [aOR], 2.38; 95% CI, 1.56-3.64; P <.001) and also in the long term (aOR, 1.60; 95% CI, 1.17-2.18; P =.003) vs patients who did not receive CT scans.
Patients who required further clinical interventions were also more likely to quit (aOR, 2.29; 95% CI, 1.62-3.22; P =.007) vs patients who had a negative CT screening (aOR, 2.43; 95% CI, 1.54-3.84; P <.001).
The addition of CT scans may have value as an additional measure to counseling and pharmacotherapy for patients who are motivated to quit smoking. The investigators concluded that “successful integration of evidence-based strategies for smoking cessation with stratified lung cancer screening could be a prudent use of limited health care resources, translating into major health benefits for all smoking-related diseases.”
1. 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 [published online July 27, 2017]. Thorax. doi: 10.1136/thoraxjnl-2016-209690