Attending community-based lung cancer screening influences smoking behaviour in deprived populations
Attending community-based lung cancer screening influences smoking behaviour in deprived populations
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DOI：
10.1016/j.lungcan.2019.10.025
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发表时间：
2020-01-01
期刊：
影响因子：
5.3
通讯作者：
Crosbie, Philip A. J.
中科院分区：
文献类型：
--
作者：
Balata, Haval;Traverse-Healy, Liam;Crosbie, Philip A. J.
目的：肺癌筛查对吸烟的影响尚不清楚，特别是在筛查试验中代表性不足的贫困人群中。这项观察性队列研究的目的是调查是否以社区为基础的肺癌筛查计划影响吸烟行为和吸烟态度在社会经济贫困population.Material和方法：经常吸烟者，年龄55-74，登记在参与的一般做法被邀请到一个以社区为基础的肺部健康检查（LHC）。这包括评估呼吸道症状、肺癌风险（PLCOm 2012）、肺量测定和戒烟服务标志。高危人群（PLCOm 2012>= 1.51%）每年接受两轮低剂量CT筛查。自我报告的吸烟状况和行为记录在LHC，并再次12个月后，当吸烟的态度也assessed.Results：919名参与者（51%的妇女）被列入分析（77%的与会者）;中位数剥夺排名在最低的十分之一为英格兰。基线时，50.3%的患者目前吸烟。1年戒烟率为10.2%，戒烟与基线症状增加相关（adjOR 2.62，95% CI 1.07-6.41; p = 0.035），但与人口统计学或筛选结果无关。55%的人将退出归因于LHC。在目前的吸烟者中，44%的人报告说LHC使他们考虑戒烟，29%的人报告说LHC使他们尝试戒烟，25%的人报告说LHC使他们减少吸烟，而只有1.7%和0.7%的人报告说LHC使他们减少了对吸烟的担忧或认为吸烟是可以接受的。我们的数据表明，在贫困地区开展以社区为基础的肺癌筛查项目对吸烟行为有积极影响，没有证据表明这些人有“吸烟许可证”。
Objectives: The impact of lung cancer screening on smoking is unclear, especially in deprived populations who are underrepresented in screening trials. The aim of this observational cohort study was to investigate whether a community-based lung cancer screening programme influenced smoking behaviour and smoking attitude in socio-economically deprived populations.Material and Methods: Ever-smokers, age 55-74, registered at participating General Practices were invited to a community-based Lung Health Check (LHC). This included an assessment of respiratory symptoms, lung cancer risk (PLCOm2012), spirometry and signposting to stop smoking services. Those at high risk (PLCOm2012 >= 1.51%) were offered annual low-dose CT screening over two rounds. Self-reported smoking status and behaviour were recorded at the LHC and again 12 months later, when attitudes to smoking were also assessed.Results: 919 participants (51% women) were included in the analysis (77% of attendees); median deprivation rank in the lowest decile for England. At baseline 50.3% were current smokers. One-year quit rate was 10.2%, quitting was associated with increased baseline symptoms (adjOR 2.62, 95% CI 1.07-6.41; p = 0.035) but not demographics or screening results. 55% attributed quitting to the LHC. In current smokers, 44% reported the LHC had made them consider stopping, 29% it made them try to stop and 25% made them smoke less whilst only 1.7% and 0.7% said it made them worry less about smoking or think it acceptable to smoke.Conclusions: Our data suggest a community-based lung cancer screening programme in deprived areas positively impacts smoking behaviour, with no evidence of a 'licence to smoke' in those screened.