For Patients, Lung Cancer Screening Reason to Continue Smoking

Early lung cancer screening may negatively impact smoking cessation efforts, according to a study published in JAMA Internal Medicine.

Researchers from the VA Puget Sound Health Care System, University of Washington, Fred Hutchinson Cancer Research Center, Swedish Medical Group, and Swedish Medical Center in Seattle, performed an ancillary study to the launch of a lung cancer screening program to determine if views on smoking cessation were affected by the availability of routine early lung cancer screening. The study took place from May 29 to September 22, 2014.

A total of 45 semi-structured qualitative interviews about health beliefs related to smoking and lung cancer screening were administered by phone to 37 current smokers who had been offered lung cancer screening.

The researchers found that while receiving a diagnosis of lung cancer does prompt most smokers to consider their smoking habit and its relationship to their health, 49% of the patients in the study (17 of 35 patients) said that early screening lowered their concern and motivation to quit smoking. Reported misconceptions included:

• Undergoing an imaging test yields the same health benefits as smoking cessation

• Everyone who participates in screening will benefit

• Screening and additional screening as needed offers protection from lung cancer[[{"type":"media","view_mode":"media_crop","fid":"40206","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_3148405701657","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4092","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"©atichart wongubon/Shutterstock.com","typeof":"foaf:Image"}}]]

• Findings from screenings have saved lives by catching cancer early when indeterminate findings are identified that can be monitored rather than immediately treated

• A cancer-free screening test result indicates that they are among the lucky ones who will avoid the harms of smoking

The researchers concluded that how clinicians speak to their patients about early lung cancer screening can have a significant effect on the patients’ interpretations of the need for smoking cessation. “Health care professionals should be aware that the opportunity for early detection of lung cancer may be interpreted as a way of avoiding the harms of smoking,” they wrote. “To promote cessation, discussions should focus on the emotional response to screening rather than clinical details (eg, nodule size) and address misperceptions about the value of early detection so that screening does not lower motivation to quit smoking.”