Mongan Institute for Health Policy, Harvard Medical School, Boston, MA 02114, USA.
Cancer. 2013 Apr 1;119(7):1306-13. doi: 10.1002/cncr.27925. Epub 2012 Dec 20.
The National Lung Screening Trial (NLST) research team reported reduced lung cancer mortality among current and former smokers with a minimum 30 pack-year history who were screened with spiral computed tomography scans compared with chest x-rays. The objectives of the current study were to examine, at 1-year follow-up: 1) risk perceptions of lung cancer and smoking-related diseases and behavior change determinants, 2) whether changes in risk perceptions differed by baseline screening result; and 3) whether changes in risk perceptions affected smoking behavior.
A 25-item risk perception questionnaire was administered to a subset of participants at 8 American College of Radiology Imaging Network/NLST sites before initial and 1-year follow-up screens. Items assessed risk perceptions of lung cancer and smoking-related diseases, cognitive and emotional determinants of behavior change, and knowledge of smoking risks.
Among 430 NLST participants (mean age, 61.0 years; 55.6% men; 91.9% white), half were current smokers at baseline. Overall, risk perceptions and associated cognitive and emotional determinants of behavior change did not change significantly from prescreen trial enrollment to 1-year follow-up and did not differ significantly by screening test result. Changes in risk perceptions were not associated with changes in smoking status (9.7% of participants quit, and 6.6% relapsed) at 1-year follow-up.
Lung screening did not change participants' risk perceptions of lung cancer or smoking-related disease. A negative screening test, which was the most common screening result, did not appear to decrease risk perceptions nor provide false reassurance to smokers.
国家肺癌筛查试验（NLST）研究团队报告称，与胸部 X 光检查相比，在有最低 30 包年吸烟史的当前和曾经吸烟者中，使用螺旋 CT 扫描筛查可降低肺癌死亡率。本研究的目的是在 1 年随访时检查：1）肺癌和与吸烟有关的疾病的风险认知和行为改变决定因素，2）风险认知的变化是否因基线筛查结果而异；3）风险认知的变化是否影响吸烟行为。
在 8 个美国放射学院成像网络/NLST 站点的一部分参与者在初始和 1 年随访筛查之前进行了 25 项风险感知问卷调查。项目评估了肺癌和与吸烟有关的疾病的风险感知、行为改变的认知和情感决定因素以及吸烟风险的知识。
在 430 名 NLST 参与者（平均年龄 61.0 岁；55.6%为男性；91.9%为白人）中，一半在基线时为当前吸烟者。总体而言，从参加试验前到 1 年随访，风险认知以及与行为改变相关的认知和情感决定因素没有显著变化，也没有因筛查测试结果而异。风险认知的变化与 1 年随访时的吸烟状况变化无关（9.7%的参与者戒烟，6.6%的参与者复吸）。
肺癌筛查并未改变参与者对肺癌或与吸烟有关的疾病的风险认知。最常见的筛查结果阴性筛查测试似乎并未降低风险认知，也没有给吸烟者带来错误的安慰。
