Impact of Lung Cancer Screening Results on Smoking Cessation
Impact of Lung Cancer Screening Results on Smoking Cessation
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DOI：
10.1093/jnci/dju084
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发表时间：
2014-06-01
影响因子：
10.3
通讯作者：
Taylor, Kathryn L.
中科院分区：
文献类型：
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作者：
Tammemaegi, Martin C.;Berg, Christine D.;Taylor, Kathryn L.
背景肺癌筛查计划可能会为参与者提供降低吸烟率的机会。方法利用全国肺筛查试验(NLST；2002-2009)中肺癌筛查研究参与者的数据，建立多元纵向回归模型，预测研究开始时吸烟者(n=15 489，不包括随访期患肺癌者)的年戒烟情况。分析了试验期间肺癌筛查结果与戒烟的相关性。所有假设检验均采用双侧P值。结果在校正分析中，戒烟与前一年筛查中观察到的异常数量密切相关(P<；.0001)。与那些有正常筛查的人相比，如果他们前一年的筛查有重大异常且对肺癌没有可疑(优势比[OR]=0.811；95%可信区间[CI]=0.722至0.912；P<；.001)，或有肺癌可疑但与以前的筛查比较稳定(OR=0.785；95%CI=0.706至0.872；P<；.001)，或有肺癌可疑且与以前的筛查相比是新的或改变的(OR=0.663；P<；.001)，则吸烟者的可能性较低。95%CI=0.607至0.724；P<；.001)。在最后一次筛查后的5年内，吸烟患病率存在差异。结论戒烟与筛查发现的异常在统计学上显著相关。将有效的戒烟计划整合到筛查计划中，应该会进一步降低与吸烟相关的发病率和死亡率。
Background Lung cancer screening programs may provide opportunities to reduce smoking rates among participants. This study evaluates the impact of lung cancer screening results on smoking cessation.Methods Data from Lung Screening Study participants in the National Lung Screening Trial (NLST; 2002-2009) were used to prepare multivariable longitudinal regression models predicting annual smoking cessation in those who were current smokers at study entry (n = 15 489, excluding those developing lung cancer in follow-up). The associations of lung cancer screening results on smoking cessation over the trial period were analyzed. All hypothesis testing used two sided P values.Results In adjusted analyses, smoking cessation was strongly associated with the amount of abnormality observed in the previous year's screening (P < .0001). Compared with those with a normal screen, individuals were less likely to be smokers if their previous year's screen had a major abnormality that was not suspicious for lung cancer (odds ratio [OR] = 0.811; 95% confidence interval [CI] = 0.722 to 0.912; P < .001), was suspicious for lung cancer but stable from previous screens (OR = 0.785; 95% CI = 0.706 to 0.872; P < .001), or was suspicious for lung cancer and was new or changed from the previous screen (OR = 0.663; 95% CI = 0.607 to 0.724; P < .001). Differences in smoking prevalence were present up to 5 years after the last screen.Conclusions Smoking cessation is statistically significantly associated with screen-detected abnormality. Integration of effective smoking cessation programs within screening programs should lead to further reduction in smoking-related morbidity and mortality.