Lung cancer screening recommendations
issued in 2013 by the United States Preventive Services Task Force suggest that
adults aged 55-80 who have smoked long enough to have accumulated a
minimum of 30 pack-years (i.e., one pack per day for 30 years, or two
packs per day for 15 years, etc.) should have an annual low-dose CT lung
cancer screening test.
The idea is to intervene early enough that
disease spotted on the screening can be effectively treated. In the
U.S., lung cancer is the leading cancer killer in both men and women -
almost 160,000 Americans were expected to die from lung cancer in 2016,
according to the American Lung Association.
‘Telephone-based smoking cessation counseling given to smokers shortly after undergoing lung cancer screening can be effective at helping people stop smoking.’
In the first successful randomized trial of its kind, researchers
have provided preliminary evidence that telephone-based smoking
cessation counseling given to smokers shortly after undergoing lung
cancer screening can be effective at helping people stop smoking.
"We found that at this teachable moment - a time when smokers are
thinking about their health and may be ready to make a change -
offering help makes a difference, and may help save lives," says the
study's lead researcher, Kathryn L. Taylor, a behavioral scientist
and a professor of oncology at Georgetown Lombardi Comprehensive Cancer
The study, led by researchers at Georgetown Lombardi, was conducted
with 92 participants at three centers - MedStar Georgetown University
Hospital in Washington, DC, Hackensack University Medical Center in New Jersey, and Lahey Hospital and Medical Center in Massachusetts.
"Millions of current smokers are now eligible for lung cancer
screening, so this setting represents an important opportunity to exert a
large public health impact on cessation among smokers who are at very
high risk for multiple tobacco-related disorders," she says. "This is a
great way to engage smokers who have not sought out cessation help."
These study findings were so promising that investigators have been
funded through NIH to conduct a much larger study of telephone-based
cessation counseling. It will enroll 1,300 patients at five medical
Taylor points out that the NIH has said that effective smoking
cessation programs should be a part of screening programs, and has
funded several groups of researchers to develop effective strategies.
In this preliminary study, 92 people about to undergo lung cancer
screening agreed to receive either telephone counseling or standard of
care (a list of free and low-cost cessation resources). Once
participants received their screening results, they were randomized to
one of the two groups, each with 46 participants.
Each group had an
equal number of participants with abnormal screening findings,
indicating possible precancerous lesions or chronic obstructive
pulmonary disease (COPD). Each group also contained an equal number of
participants with minor abnormalities on their screen, as well as those
with normal results. None of the participants were diagnosed with lung
Participants in the telephone-counseling group were given their
first session after finding out their screening results. Over the next
three months, six 10-15 minute sessions were conducted. At the end of
the study, a nicotine saliva test was given to participants who said
they had quit in order to confirm their abstinence.
Researchers found that eight (17%) people in the telephone
counseling group had verifiably quit, compared to two (4%) in the
"If this preliminary study is replicated, telephone counseling has
the potential to improve cessation in a setting that reaches a large
number of hard-to-reach, long-term smokers who are at very high risk for
multiple tobacco-related diseases," Taylor says.
Charlotte Hagerman, who along with Taylor, offered the telephone
counseling to participants, describes the counseling as "a motivational
intervention. Everyone acknowledged that smoking is very harmful to
their health, but some people thought it was too late to change their
fate. Counseling helped them understand that it is not too late."
Population-based studies have shown that older smokers who quit can have an increased life expectancy, Taylor says.
Hagerman says there were also a number of participants who "were
ready to quit, and were very excited to receive the help we were
offering. I found this very gratifying, and felt that what we were doing
was important and mattered to people," says Hagerman, who was trained
as a tobacco treatment specialist for the study.
"More than 50% of participants said in their first interview
that they were not ready to quit, yet some of these people did quit.
This finding indicates that it is important to offer the cessation
intervention to everyone who undergoes lung cancer screening, and not
only those who are already considering quitting. This is exactly what we
hope for - to be able to reach the people who are not already planning
to quit on their own," says Taylor.