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Impact of low-dose CT screening on smoking cessation among high-risk participants in the UK Lung Cancer Screening Trial
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  • Published on:
    The impact of CT screening on the motivation of smoking cessation: A double-edged sword?
    • Jian Ping Zhou, Pulmonologist Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China.
    • Other Contributors:
      • Xian Wen Sun, Pulmonologist
      • Qing Yun Li, Pulmonologist

    Recently, Kate Brain and colleagues1 reported in the Thorax a randomized controlled trial concerning the favorable effect of CT lung cancer screening on the smoking cessation motivation. The study proved that implementation of a lung cancer screening program offered opportunities of smoking cessation for high risk smokers. Furthermore, this trial suggested that CT lung screening should be integrated into the smoking cessation interventions.
    Although inspiring, the study was not specifically designed to test the effect of lung screening on smokers who received negative screening results. Lacking the comparison between negative and positive ones, we should be cautious in drawing the final conclusion with the findings only from those with positive results of CT scan.
    As we all known, results of CT screening include three categories, namely positive, negative and indeterminate. There has been increasing evidence suggesting that CT lung screening may offer a ‘license to smoke’ for active smokers who have negative results2. For those with indeterminate results, the trend towards increased smoking cessation was not significant though3. In fact, a large number of heavy smokers have no sign of lung cancer in the CT scan in clinical practice, which might make these smokers feel more comfortable to continue smoking. Thus, more attention should be paid to those without positive scanning results. there are several demographic predictors of increased likelihood and motivatio...

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    Conflict of Interest:
    None declared.
  • Published on:
    Lung cancer screening needs smoking cessation programme
    • Manfred Neuberger, professor of environmental health and medicine Medical University of Vienna, Center of Public Health

    A quit rate of 21% in controls and 24% in screened persons show that CT screening is a poor motivation to quit. The authors emphasize that the quit rate was 30% in patients with a positive result on CT who needed additional clinical investigation, however, the quit rate was only 15% in persons receiving a negative CT result. This shows that CT screening lowers the motivation to quit if a negative result (expected for the majority) nourishes misperceptions. Zeliadt et al. ( JAMA Intern Med 2015; 175:1530-7) found that in 49% these beliefs were reinforced and potentially exacerbated by screening and lowered the motivation to participate in smoking cessation programs. Therefore CT screening for lung cancer without accompanying smoking cessation program could be harmful.

    Conflict of Interest:
    None declared.