Adding Smoking Cessation to Lung Screening Can Reduce Mortality and Increase Life Years in Lung Cancer Patients

Smoking cessation interventions in conjunction with existing lung cancer screening would reduce lung cancer mortality by 14% and increased life-years by 81%, according to a study published in the Journal of Thoracic Oncology.

Annual lung cancer screening with low-dose computed tomography (LDCT) is recommended for adults aged 55-80 with a greater than 30 pack-year smoking history who currently smoke or quit within the previous 15 years. Since about 50% of screen-eligible individuals are still current smokers, cessation interventions at the point of screening are recommended. However, information about the short- and long-term effects of joint screening and cessation interventions is limited.

In this study, researchers used an established lung cancer simulation model to project the impact of smoking cessation interventions with screenings and overall mortality for the 1950 and 1960 US birth-cohorts. Overall, two million individual smoking and life histories were generated per cohort. Subsequently, simulated individuals were screened annually according to current guidelines and different assumptions of screening uptake rates.

According to the results of the study, point-of-screening smoking cessation interventions would greatly reduce lung cancer mortality and delay overall deaths compared to lung cancer screening alone. For example, under a 30% screening increase scenario, adding a cessation intervention at the time of the first screen with a 10% success probability for the 1950 birth-cohort would further reduce lung cancer deaths by 14% and increase life-years gained by 81% compared with screening alone.

“Smoking cessation interventions have the potential to greatly enhance the impact of lung cancer screening programs,” the research authors wrote. “Evaluation of specific interventions, including costs and feasibility of implementation and dissemination, are needed to determine the best possible strategies and realize the full promise of lung cancer screening.”