Effect of CT screening on smoking habits at 1-year follow-up in the Danish Lung Cancer Screening Trial (DLCST)
Effect of CT screening on smoking habits at 1-year follow-up in the Danish Lung Cancer Screening Trial (DLCST)
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DOI：
10.1136/thx.2008.102475
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发表时间：
2009-05-01
期刊：
影响因子：
10
通讯作者：
Dossing, M.
中科院分区：
文献类型：
--
作者：
Ashraf, H.;Tonnesen, P.;Dossing, M.
背景资料：低剂量CT筛查肺癌对吸烟习惯的影响尚未在大型随机对照试验中报道。方法：本研究评估了丹麦肺癌筛查试验（DLCST）中低剂量CT筛查对吸烟习惯的影响，该试验为期5年，随机对照试验包括4104例受试者; 2052例受试者接受了每年一次的低剂量CT扫描（CT组），2052例受试者未接受任何干预（对照组）。参与者是健康的当前和以前的吸烟者（戒烟后> 4周），烟草消费量> 20包年。在基线和年度筛选时确定吸烟习惯。使用呼出的一氧化碳水平验证吸烟状态。肺功能测试，尼古丁依赖和戒烟动机进行了评估。戒烟率和复发率确定在1年的后续为所有subjects.Results：在1年的戒烟率在吸烟者中分别为11.9%的CT组和11.8%的对照组（P=0.95）。CT组和对照组中既往吸烟者的复发率分别为10.0%和10.5%（p=0.81）。重要预测因素（p < 0.05）戒烟的主要因素是：戒烟动机高、依赖性低、1秒用力呼气量与用力肺活量的比值低、吸烟年限低、年龄大、戒烟时间长和CT检查结果需要3个月重复CT扫描。总体而言，CT组和对照组在1年随访时的戒烟率相似，净戒烟率为6.0%。在最初CT结果需要3个月后重复扫描的受试者中，戒烟率较高，复发率较低。
Background: The effect of low-dose CT screening for lung cancer on smoking habits has not been reported in large randomised controlled trials.Methods: This study evaluated the effect on smoking habits of screening with low-dose CT at 1-year follow up in the Danish Lung Cancer Screening Trial (DLCST), a 5-year randomised controlled trial comprising 4104 subjects; 2052 subjects received annual low-dose CT scan (CT group) and 2052 received no intervention (control group). Participants were healthy current and former smokers (> 4 weeks since smoking cessation) with a tobacco consumption of > 20 pack years. Smoking habits were determined at baseline and at annual screening. Smoking status was verified using exhaled carbon monoxide levels. Lung function tests, nicotine dependency and motivation to quit smoking were assessed. Quit rates and relapse rates were determined at 1-year follow-up for all subjects.Results: At 1 year the quit rates among smokers were 11.9% in the CT group and 11.8% in the control group (p=0.95). Relapse rates for former smokers were 10.0% and 10.5% in the CT and control groups, respectively (p=0.81). Significant predictors (p < 0.05) for smoking cessation were: high motivation to quit, low dependency, low ratio of forced expiratory volume in 1 s to forced vital capacity, low pack years, higher age, longer period of abstinence and CT findings necessitating 3-month repeat CT scans.Conclusions: Overall, quit rates were similar in the CT and control group at 1-year follow-up, with a net quit rate of 6.0%. Quit rates were higher and relapse rate lower among subjects with initial CT findings that necessitated a repeat scan 3 months later.