Lung cancer screening may increase the likelihood of smoking cessation

Reference

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. Thorax 2017;72(10):912-918.

Synopsis

The UK Lung Cancer Screening Trial recruited 4055 participants aged 50 years to 75 years at high risk of lung cancer according to a validated risk score. The participants were randomized to receive screening with low-dose computed tomography or no screening. They were asked about tobacco use at baseline, and were classified as current smokers, ex-smokers, or never smokers. The participants were contacted 2 weeks later to complete a psychosocial questionnaire (short-term follow-up), which was sent again at an unspecified time in the future (long-term follow-up). Data were imputed if missing. All participants were offered smoking cessation advice at the time of enrollment. Approximately 40% were current smokers (n = 1544), and at the short-term follow-up significantly more in the screening group had reported that they had quit smoking (adjusted odds ratio [aOR] 2.4; 95% CI 1.6 - 3.6). In absolute terms, 9.9% quit in the screened group and 4.6% in the control group at this initial follow-up (number needed to scan [NNS] to result in 1 person quitting = 20). This was also true at the long-term follow-up (aOR 1.6; 1.2 - 2.2), and the absolute effect was similar (15% vs 10%; NNS = 20). A sensitivity analysis using only complete cases found similar results at the short-term follow-up, but no significant difference at long-term follow-up. The effect was stronger among participants who had an initial positive screening result (aOR 2.9 [1.8 - 4.5] for short-term follow-up; aOR 2.3 [1.6 - 3.2] for long-term follow-up).