Division of Primary Care, Floor 13, Tower Building, University Park, University of Nottingham, Nottingham, UK.
School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, Belfast, Northern Ireland.
J Public Health (Oxf). 2019 Sep 30;41(3):600-608. doi: 10.1093/pubmed/fdy158.
Lung cancer screening can reduce lung cancer mortality by 20%. Screen-detected abnormalities may provide teachable moments for smoking cessation. This study assesses impact of pulmonary nodule detection on smoking behaviours within the first UK trial of a novel auto-antibody test, followed by chest x-ray and serial CT scanning for early detection of lung cancer (Early Cancer Detection Test-Lung Cancer Scotland Study).
Test-positive participants completed questionnaires on smoking behaviours at baseline, 1, 3 and 6 months. Logistic regression compared outcomes between nodule (n = 95) and normal CT groups (n = 174) at 3 and 6 months follow-up.
No significant differences were found between the nodule and normal CT groups for any smoking behaviours and odds ratios comparing the nodule and normal CT groups did not vary significantly between 3 and 6 months. There was some evidence the nodule group were more likely to report significant others wanted them to stop smoking than the normal CT group (OR across 3- and 6-month time points: 3.04, 95% CI: 0.95, 9.73; P = 0.06).
Pulmonary nodule detection during lung cancer screening has little impact on smoking behaviours. Further work should explore whether lung cancer screening can impact on perceived social pressure and promote smoking cessation.
肺癌筛查可使肺癌死亡率降低 20%。筛查出的异常情况可能为戒烟提供教育机会。本研究评估了在英国首例新型自身抗体检测肺癌早期检测试验-苏格兰肺癌研究中，对胸部 X 线和连续 CT 扫描进行肺癌早期检测时，肺结节检测对吸烟行为的影响。
检测呈阳性的参与者在基线、1、3 和 6 个月时完成了关于吸烟行为的问卷。在 3 个月和 6 个月的随访中，通过逻辑回归比较了结节（n=95）和正常 CT 组（n=174）的结果。
在任何吸烟行为方面，结节组和正常 CT 组之间均未发现显著差异，比较结节组和正常 CT 组的比值比在 3 个月和 6 个月之间也没有显著差异。有一些证据表明，与正常 CT 组相比，结节组更有可能报告有重要他人希望他们戒烟（3 个月至 6 个月时间点的比值比：3.04，95%CI：0.95，9.73；P=0.06）。
肺癌筛查中肺结节的检出对吸烟行为影响不大。进一步的研究应探索肺癌筛查是否会影响感知到的社会压力并促进戒烟。
