Smoking-Cessation Interventions After Lung Cancer Screening Guideline Change

Li, Jiang; Chung, Sukyung; Martinez, Meghan; Luft, Harold S.

doi:10.1016/j.amepre.2020.01.031

Cited by 10 publications

(16 citation statements)

References 37 publications

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“…Although smoking cessation interventions documented in the electronic medical record increased after the 2013 USPSTF LCS guidelines, only 34% of adults eligible for LCS post-guidelines received any sort of smoking cessation intervention from their health care provider. 5 The Optimizing Lung Screening (OaSiS) cluster randomized trial will evaluate strategies to implement smoking cessation interventions during LCS. 35 A meta-analysis of smoking cessation interventions to use during LCS found that counseling and pharmacotherapy increased cessation at 12 months.…”

Section: Confidence Intervalsmentioning

confidence: 99%

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Assessment and Counseling Gaps Among Former Smokers Eligible for Lung Cancer Screening in US Adults

2022

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Background Lung cancer screening (LCS) for former and current smokers requires that current smokers are counseled on tobacco treatment. In the USA, over 4 million former smokers are estimated to be eligible for LCS based on self-report for “not smoking now.” Tobacco use and exposure can be measured with the biomarker cotinine, a nicotine metabolite reflecting recent exposure. Objective To examine predictors of tobacco use and exposure among self-reported former smokers eligible for LCS. Design Cross-sectional study using the 2013–2018 National Health and Nutrition Examination Survey. Participants Former smokers eligible for LCS (n = 472). Main Measures Recent tobacco use was defined as reported tobacco use in the past 5 days or a cotinine level above the race/ethnic cut points for tobacco use. Recent tobacco exposure was measured among former smokers without recent tobacco use and defined as having a cotinine level above 0.05 ng/mL. Key Results One in five former smokers eligible for LCS, totaling 1,416,485 adults, had recent tobacco use (21.4%, 95% confidence interval (CI) 15.8%, 27.0%), with about a third each using cigarettes, e-cigarettes, or other tobacco products. Among former smokers without recent tobacco use, over half (53.0%, 95% CI: 44.6%, 61.4%) had cotinine levels indicating recent tobacco exposure. Certain subgroups had higher percentages for tobacco use or exposure, especially those having quit within the past 3 years or living with a household smoker. Conclusions Former smokers eligible for LCS should be asked about recent tobacco use and exposure and considered for cotinine testing. Nearly 1.5 million “former smokers” eligible for LCS may be current tobacco users who have been missed for counseling. The high percentage of “passive smokers” is at least double that of the general nonsmoking population. Counseling about the harms of tobacco use and exposure and resources is needed.

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Section: Confidence Intervalsmentioning

confidence: 99%

“…4 After the initial 2014 USPSTF guidelines, smoking cessation interventions documented in the electronic medical record increased among eligible current smokers from 30.1 to 34.0%. 5,6 While recommendations are clear for current smokers who present for LCS, 7 the guidelines for counseling former smokers are not well defined.…”

Section: Introductionmentioning

confidence: 99%

Assessment and Counseling Gaps Among Former Smokers Eligible for Lung Cancer Screening in US Adults

2022

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“…Also, a higher frequency of the appearance of GGN was observed in smokers than in nonsmoker over a mean period of 5.5 years (33). More importantly, in the last decade, increased evidence has been provided to show that smoking cessation plus regular annual chest CT screening may reduce the risk of lung cancer (34)(35)(36). While it remains unclear whether smoking cessation after diagnosis of GGNs alters the clinical behavior of GGNs, smoking cessation could have substantial benefits for patients with GGNs.…”

Section: Risk Factors Contributing To Malignant Ground-glass Nodulementioning

confidence: 99%

Adding predictive and diagnostic values of pulmonary ground-glass nodules on lung cancer via novel non-invasive tests

Ding

Zhao

et al. 2022

Front. Med.

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Pulmonary ground-glass nodules (GGNs) are highly associated with lung cancer. Extensive studies using thin-section high-resolution CT images have been conducted to analyze characteristics of different types of GGNs in order to evaluate and determine the predictive and diagnostic values of GGNs on lung cancer. Accurate prediction of their malignancy and invasiveness is critical for developing individualized therapies and follow-up strategies for a better clinical outcome. Through reviewing the recent 5-year research on the association between pulmonary GGNs and lung cancer, we focused on the radiologic and pathological characteristics of different types of GGNs, pointed out the risk factors associated with malignancy, discussed recent genetic analysis and biomarker studies (including autoantibodies, cell-free miRNAs, cell-free DNA, and DNA methylation) for developing novel diagnostic tools. Based on current progress in this research area, we summarized a process from screening, diagnosis to follow-up of GGNs.

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“…The interviews were one part of a larger mixed-methods study on the implementation of LCS-LDCT at Sutter Health with results reported elsewhere. 7,14 We developed interview guides for both patients and providers based on ndings from the quantitative analyses of this mixed-methods study (see Appendix for guides). Provider interviews asked about knowledge of LCS-LDCT, attitudes toward screening guidelines, perspectives and experiences using LCS-LDCT as a screening test for lung cancer, tobacco cessation counseling efforts, SDM, and the best ways to help patients make decisions on LCS-LDCT.…”

Section: Setting and Recruitmentmentioning

confidence: 99%

Provider and Patient Perspectives to Improve Lung Cancer Screening with Low-Dose Computed Tomography 5 years after Medicare Coverage: A Qualitative Study

Martinez

Stults

2022

Preprint

Self Cite

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Lung cancer remains the leading cause of cancer-related deaths for both men and women in the U.S. despite the availability of preventive cancer screening for high-risk smokers. This qualitative study of patients and providers from a large ambulatory healthcare system in northern California explored perceptions of lung cancer screening with low-dose computed tomography (LCS-LDCT) 5 years after Medicare coverage to identify modifiable targets to improve the implementation of LCS-LDCT. Between 2019 and 2020, interviews were conducted with 10 primary care physicians and 30 patients from three groups (completed LCS-LDCT, scan ordered but not completed, eligible but no order) using semi-structured interview guides. Providers and patients expressed that they were both aware and supportive of LCS-LDCT but reported little to no shared decision making nor use of a decision aid despite being Medicare requirements. Respondents suggested improvements to LCS-LDCT including incorporating a nurse navigator into the process to ease the burden on providers and provide additional education and counselling about screening and support for tobacco cessation to patients. Given recently expanded guidelines from the U.S. Preventive Service Task Force for LCS-LDCT screening, and the expectation that these new guidelines may be covered by Medicare in the near future, it is important for healthcare systems to understand provider and patient perceptions to further improve the implementation of LCS-LDCT to ultimately reduce lung cancer mortality.

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Smoking-Cessation Interventions After Lung Cancer Screening Guideline Change

Cited by 10 publications

References 37 publications

Assessment and Counseling Gaps Among Former Smokers Eligible for Lung Cancer Screening in US Adults

Assessment and Counseling Gaps Among Former Smokers Eligible for Lung Cancer Screening in US Adults

Adding predictive and diagnostic values of pulmonary ground-glass nodules on lung cancer via novel non-invasive tests

Provider and Patient Perspectives to Improve Lung Cancer Screening with Low-Dose Computed Tomography 5 years after Medicare Coverage: A Qualitative Study

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