Moldovanu Dana, de Koning Harry J, van der Aalst Carlijn M
Department of Public Health, Erasmus MC - University Medical Center Rotterdam, Rotterdam, the Netherlands.
Transl Lung Cancer Res. 2021 Feb;10(2):1099-1109. doi: 10.21037/tlcr-20-899.
Randomized-controlled trials have confirmed substantial reductions in lung cancer mortality with low-dose computed tomography (LDCT) screening. Evidence on how to integrate smoking cessation support in lung cancer screening is however scarce. This represents a significant gap in the literature, as a combined strategy of lung cancer screening and smoking cessation greatly reduces the mortality risk due to lung cancer and other related comorbidities. In this review, a literature search in MEDLINE, Embase, Web of Science, the Cochrane Central Register of Controlled Trials and Google Scholar was performed to identify randomized-controlled and observational studies investigating the effect of lung cancer screening trials and integrated cessation interventions on smoking cessation. Of the 236 identified records, we included 32 original publications. Smoking cessation rates in lung cancer screening trials are promising. Especially findings suspicious for lung cancer and referral to a physician might function as a teachable moment to motivate smoking abstinence in current smokers or recent quitters. More intensive, personalized and multi-modality smoking cessation interventions delivered by a clinician appear to be the most successful in influencing smoking behavior. While it is evident that smoking cessation should be incorporated in lung cancer screening, further research is required to ascertain the optimal treatment type, modality, timing, and content of communication including the incorporation of CT results to motivate health behavior change.
随机对照试验已证实，低剂量计算机断层扫描（LDCT）筛查可大幅降低肺癌死亡率。然而，关于如何在肺癌筛查中纳入戒烟支持的证据却很少。这是文献中的一个重大空白，因为肺癌筛查和戒烟的联合策略可大大降低因肺癌及其他相关合并症导致的死亡风险。在本综述中，我们在MEDLINE、Embase、科学网、Cochrane对照试验中央注册库和谷歌学术中进行了文献检索，以识别调查肺癌筛查试验和综合戒烟干预对戒烟效果的随机对照研究和观察性研究。在识别出的236条记录中，我们纳入了32篇原始出版物。肺癌筛查试验中的戒烟率很有前景。特别是对肺癌可疑的检查结果以及转诊给医生，可能会成为促使当前吸烟者或近期戒烟者戒烟的契机。临床医生提供的更强化、个性化和多模式的戒烟干预似乎在影响吸烟行为方面最为成功。虽然显然应将戒烟纳入肺癌筛查，但仍需进一步研究以确定最佳的治疗类型、方式、时机以及沟通内容，包括纳入CT结果以促进健康行为改变。
