Smokers Vague on Benefits of Lung Cancer Screening

Highlights:

• People undergoing lung cancer screening assume that the tests can prevent them from getting the disease, when it only detects tumor early
• Quitting smoking is the only way to reduce the risk of developing lung cancer
• Smokers have to be educated on the real reason behind regular screening

People at risk of lung cancer are mistaken about the benefits and limitations of regular lung cancer screenings, according to a study by the Veterans Affairs (VA) Center of Innovation for Veteran-Centered and Value-Driven Care in Seattle. Tobacco use via smoking is by far the leading risk factor for lung cancer causing nearly 80% of lung cancer. The risk is many times higher for smokers than for non-smokers and increases proportionally with the number of cigarettes and years of smoking.

Light cigarettes have the same amount of risk as regular cigarettes. Cigar and pipe smoking are equally capable of causing lung cancer.

Advertisement

Use of Low-dose Computed Tomography

Regular cancer screenings using low-dose computed tomography (LDCT) have been implemented nationwide in the United States and in VA since 2011; the reason being periodic screening had benefits of lowering the chance of death from lung cancer through early detection. However, patients screened in VA medical center recently were confused about how the screening helps them.

Many of them who were smokers were under the assumption that screening could reduce their risk of developing lung cancer rather than quitting smoking.

In light of these findings, Dr. Jaimee L. Heffner, lead author on the paper, emphasized that it was important to communicate to patients the importance of quitting rather than just relying on screenings to protect them from cancer.

"Quitting smoking is by far the most important thing a person can do to prevent lung cancer as well as a host of other diseases caused by tobacco use, and it's important that this message doesn't get lost in the discussion of lung cancer screening," he said. Heffner, with the Fred Hutchinson Cancer Research Center in Seattle, collaborated with the VA team on the study. The study appeared in the Annals of the American Thoracic Society.

In an earlier National Lung Screening Trial in 2011, the National Cancer Institute (part of the National Institutes of Health) had screened more than 53,000 current or former heavy smokers for lung cancer using either an LDCT or a standard chest X-ray.

In an LDCT, multiple X-rays are taken of the entire chest; what we get in the end is a comprehensive detailed image of the lungs compared to a standard single chest X-ray.

The smokers had a 15 to 20 percent lower risk of dying from lung cancer when they used the LDCT machine compared to the standard chest X-ray owning to the fact that an LDCT presents a complete picture of the chest and lungs, and gives doctors a chance to catch and treat lung cancer more effectively than the old method.

The current study wanted to test patients' actual knowledge about lung cancer and its screening as it was unclear how well patients understand the benefits and limitations of LDCT scans.

Advertisement

Details of the Study

The participants (smokers) first underwent an LDCT screening at one of four Veterans Affairs medical centers.

After the scan, the researchers surveyed 83 smokers and asked them a series of questions about smoking and lung cancer screening.

Each participant was asked five questions -

1. Does your chance of getting lung cancer decrease if you have a lung cancer screening (Correct answer: No.)

2.Which disease causes the most number of deaths in Americans who are smokers? (Correct answer: Heart disease.)

3.Are you safe from lung cancer for at least 12 months if nothing abnormal or suspicious is found on your lung cancer screening test? True or false (Correct answer: False.)

4. True or false: Do all nodules or spots found in the lungs grow to be dangerous later on in life? (Correct answer: False.)

5.Does lung cancer screening prevent the most premature deaths for people over ages 55 that are current smokers, or does quitting smoking (Correct answer: Quitting smoking.)

Advertisement

Results of the Study

• Only 7 percent of patients answered all five questions correctly
• Almost all participants got at least one answer wrong
• The percentage of people who answered questions 1, 2, 3, and 4 wrong was 39, 66, 39, and 49 percent respectively
• Nearly half (47%) of the patients got the last question wrong; they thought lung cancer screenings protected them against death better than quitting smoking

The research team also quizzed participants on basic health literacy and found out that the participants with lower general knowledge about health and medicine were the ones who answered more questions wrong on the screening survey.

The patients are under the impression that lung cancer screenings are more protective against cancer than what they actually are."Our results illustrate just how wide a gap exists between the expectations and the reality of lung cancer screening benefits among some groups of current smokers," they write.

The authors suggest a couple of reasons for misinterpreting the real purpose of a screening test. Smokers might be confusing cancer mortality (chances of dying from lung cancer) and the risk associated with it (chances of getting cancer because of smoking). The second reason could be psychological – smokers who might not want to quit believe that lung cancer screenings have a protective value equal to quitting.

An earlier study conducted by the same researchers in 2015 had found that some of the smokers had lowered motivation to stop because they believed that the tests protected them from the harms of smoking.

The team thinks that VA needs to take more efforts to make patients understand what the LDCT screenings tell them and what they do not. They explain, "Our findings suggest that messages about benefits and limitations of LDCT for lung cancer screening are either not being provided or are not being actively received and/or recalled."

Healthcare providers should regularly check the patients’ knowledge during the decision-making process to overcome this hurdle.

References :

1. Smokers hazy on actual benefits of lung cancer screenings - (https://www.research.va.gov/currents/0718-Smokers-hazy-on-actual-benefits-of-lung-cancer-screenings.cfm)
2. Lung Cancer  - (https://www.cancer.org/cancer/lung-cancer.html)

Source-Medindia