Smoking cessation results in a clinical lung cancer screening program.
BACKGROUND
Lung cancer screening may provide a "teachable moment" for promoting smoking cessation. This study assessed smoking cessation and relapse rates among individuals undergoing follow-up low-dose chest computed tomography (CT) in a clinical CT lung screening program and assessed the influence of initial screening results on smoking behavior.


METHODS
Self-reported smoking status for individuals enrolled in a clinical CT lung screening program undergoing a follow-up CT lung screening exam between 1st February, 2014 and 31st March, 2015 was retrospectively reviewed and compared to self-reported smoking status using a standardized questionnaire at program entry. Point prevalence smoking cessation and relapse rates were calculated across the entire population and compared with exam results. All individuals undergoing screening fulfilled the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology: Lung Cancer Screening v1.2012(®) high-risk criteria and had an order for CT lung screening.


RESULTS
A total of 1,483 individuals underwent a follow-up CT lung screening exam during the study interval. Smoking status at time of follow-up exam was available for 1,461/1,483 (98.5%). A total of 46% (678/1,461) were active smokers at program entry. The overall point prevalence smoking cessation and relapse rates were 20.8% and 9.3%, respectively. Prior positive screening exam results were not predictive of smoking cessation (OR 1.092; 95% CI, 0.715-1.693) but were predictive of reduced relapse among former smokers who had stopped smoking for 2 years or less (OR 0.330; 95% CI, 0.143-0.710). Duration of program enrollment was predictive of smoking cessation (OR 0.647; 95% CI, 0.477-0.877).


CONCLUSIONS
Smoking cessation and relapse rates in a clinical CT lung screening program rates are more favorable than those observed in the general population. Duration of participation in the screening program correlated with increased smoking cessation rates. A positive exam result correlated with reduced relapse rates among smokers recently quit smoking.
Patient Advocate, Lung Cancer Screening Program Consultant, Lahey Hospital & Medical Center, Burlington, USA.
Andrea K
AK
Borondy Kitts
Department of Radiation Oncology, Lahey Hospital & Medical Center, Burlington, USA.
Andrea B
AB
McKee
Patient Navigator, Lahey Hospital & Medical Center, Burlington, USA.
Shawn M
SM
Regis
Department of Radiology, Lahey Hospital & Medical Center, Burlington, USA.
Christoph
C
Wald
Interventional Radiology, Lahey Hospital & Medical Center, Burlington, USA.
Sebastian
S
Flacke
Thoracic Imaging, Lahey Hospital & Medical Center, Burlington, USA.
Brady J
BJ
McKee
Smoking cessation; cancer screening tests; lung cancer; multislice computed tomography (multislice CT)