Minnix Jennifer Anne, Karam-Hage Maher, Blalock Janice A, Cinciripini Paul M
Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Transl Lung Cancer Res. 2018 Jun;7(3):272-280. doi: 10.21037/tlcr.2018.05.03.
Lung cancer is the leading cause of cancer-related death in the United States (U.S.) and is the second most common non-skin cancer among men and women, accounting for about 30% of cancer-related deaths. There is clear and accumulating evidence that continued tobacco use has multiple adverse effects on cancer treatment outcomes, including greater probability of recurrence, second primary malignancies, reduced survival, greater symptom burden, and poorer quality of life (QOL). Recent findings suggest an avenue to significantly mitigate the impact of smoking on lung cancer mortality rates through the use of low-dose computed tomography (LDCT) lung cancer screening. Based on the reviewed evidence (type B), the U.S. Preventive Services Task Force (USPSTF) guidelines of 2015 recommend screening combined with smoking cessation interventions for high-risk heavy smokers and recent quitters. These practice changes offer opportunities to develop novel smoking cessation strategies tailored to highly specific settings that aim to amplify the survivorship gains expected from screening alone. However, there is a paucity of research and data that speaks to the feasibility and efficacy of providing smoking cessation treatment specifically within the context of the LDCT lung cancer screening environment. While some studies have attempted to characterize the parameters within which smoking cessation interventions should be implemented in this context, further research is needed to explore relevant factors such as the format, components, and timing of interventions, as well as the influence of risk perceptions and results of the screening itself on motivation and ability to quit smoking.
肺癌是美国癌症相关死亡的主要原因，是男性和女性中第二常见的非皮肤癌，约占癌症相关死亡的30%。有明确且不断积累的证据表明，持续吸烟对癌症治疗结果有多种不利影响，包括复发可能性增加、出现第二原发性恶性肿瘤、生存率降低、症状负担加重以及生活质量较差。最近的研究结果表明，通过使用低剂量计算机断层扫描（LDCT）肺癌筛查，有可能显著减轻吸烟对肺癌死亡率的影响。基于所审查的证据（B类），美国预防服务工作组（USPSTF）2015年的指南建议，对高危重度吸烟者和近期戒烟者进行筛查并结合戒烟干预措施。这些实践变革为制定针对高度特定环境的新型戒烟策略提供了机会，旨在扩大仅通过筛查预期获得的生存收益。然而，针对在LDCT肺癌筛查环境中专门提供戒烟治疗的可行性和有效性的研究和数据很少。虽然一些研究试图确定在这种情况下实施戒烟干预措施应具备的参数，但仍需要进一步研究来探索相关因素，如干预措施的形式、组成部分和时机，以及风险认知和筛查结果本身对戒烟动机和能力的影响。
