title: Examining whether lung screening changes risk perceptions: National Lung Screening Trial participants at 1-year follow-up.
abstract: BACKGROUND
  The National Lung Screening Trial (NLST) research team reported reduced lung cancer mortality among current and former smokers with a minimum 30 pack-year history who were screened with spiral computed tomography scans compared with chest x-rays. The objectives of the current study were to examine, at 1-year follow-up: 1) risk perceptions of lung cancer and smoking-related diseases and behavior change determinants, 2) whether changes in risk perceptions differed by baseline screening result; and 3) whether changes in risk perceptions affected smoking behavior.
  
  
  METHODS
  A 25-item risk perception questionnaire was administered to a subset of participants at 8 American College of Radiology Imaging Network/NLST sites before initial and 1-year follow-up screens. Items assessed risk perceptions of lung cancer and smoking-related diseases, cognitive and emotional determinants of behavior change, and knowledge of smoking risks.
  
  
  RESULTS
  Among 430 NLST participants (mean age, 61.0 years; 55.6% men; 91.9% white), half were current smokers at baseline. Overall, risk perceptions and associated cognitive and emotional determinants of behavior change did not change significantly from prescreen trial enrollment to 1-year follow-up and did not differ significantly by screening test result. Changes in risk perceptions were not associated with changes in smoking status (9.7% of participants quit, and 6.6% relapsed) at 1-year follow-up.
  
  
  CONCLUSIONS
  Lung screening did not change participants' risk perceptions of lung cancer or smoking-related disease. A negative screening test, which was the most common screening result, did not appear to decrease risk perceptions nor provide false reassurance to smokers.
authors.affiliation: Mongan Institute for Health Policy, Harvard Medical School, Boston, MA 02114, USA. epark@partners.org
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.forename: Ilana F
authors.initials: IF
authors.lastname: Gareen
authors.forename: Amanda
authors.initials: A
authors.lastname: Jain
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Ostroff
authors.forename: Fenghai
authors.initials: F
authors.lastname: Duan
authors.forename: Jorean D
authors.initials: JD
authors.lastname: Sicks
authors.forename: William
authors.initials: W
authors.lastname: Rakowski
authors.forename: Michael
authors.initials: M
authors.lastname: Diefenbach
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
mesh_terms: D000368:Aged; D001294:Attitude to Health; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010465:Perception; D012307:Risk Factors; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology; D036542:Tomography, Spiral Computed