Heiden Brendan T, Engelhardt Kathryn E, Cao Chao, Meyers Bryan F, Puri Varun, Cao Yin, Kozower Benjamin D
Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA.
Cancer Epidemiol. 2022 Feb;76:102079. doi: 10.1016/j.canep.2021.102079. Epub 2021 Dec 8.
The United States Preventative Services Taskforce recently updated lung cancer screening guidelines for U.S. adults with high-risk smoking histories. This has generated a previously undescribed patient population in which the prevalence of cigarette and e-cigarette use has not been described.
We performed a cross-sectional study using population-based data from the Behavioral Risk Factor Surveillance System (2017-2018). We defined lung cancer screening eligibility as adults 50-80 years old with ≥ 20 pack-year smoking history who were currently smoking or quit within the last 15 years. We assessed several smoking-related outcomes including current cigarette use, ever e-cigarette use, and current e-cigarette use among respondents.
Among 7541 screening-eligible adults, current cigarette use was reported by 3604 (47.8%) participants. Ever and current e-cigarette use were reported by 3003 (39.8%) and 670 (8.9%) participants, respectively. Compared to individuals who were previously eligible for screening, individuals newly eligible for screening (i.e., between 50 and 55 years old with a 20-30 pack-year smoking history) were more likely to currently smoke (aOR 1.828, 95% CI 1.649-2.026, p < 0.001). While newly eligible respondents were more likely to report a history of ever using an e-cigarette (aOR 1.144, 95% CI 1.034-1.266, p = 0.009), current e-cigarette use was similar in this group compared to those individuals who were previously screening-eligible (aOR 1.014, 95% CI 0.844-1.219, p = 0.88).
Cigarette and e-cigarette exposure are common among U.S. adults who are eligible for lung cancer screening. Expanded USPSTF criteria will capture a patient population with greater exposure to both of these products.
美国预防服务工作组最近更新了针对有高危吸烟史的美国成年人的肺癌筛查指南。这产生了一个此前未被描述过的患者群体，其中香烟和电子烟的使用情况尚未得到描述。
我们使用行为危险因素监测系统（2017 - 2018年）的基于人群的数据进行了一项横断面研究。我们将肺癌筛查资格定义为年龄在50 - 80岁、吸烟史≥20包年且目前仍在吸烟或在过去15年内戒烟的成年人。我们评估了几个与吸烟相关的结果，包括受访者当前的香烟使用情况、曾经使用电子烟的情况以及当前使用电子烟的情况。
在7541名符合筛查条件的成年人中，3604名（47.8%）参与者报告当前吸烟。分别有3003名（39.8%）和670名（8.9%）参与者报告曾经和当前使用电子烟。与之前符合筛查条件的个体相比，新符合筛查条件的个体（即年龄在50至55岁、吸烟史为20 - 30包年）当前吸烟的可能性更高（调整后比值比1.828，95%置信区间1.649 - 2.026，p < 0.001）。虽然新符合条件的受访者报告曾经使用电子烟的历史的可能性更高（调整后比值比1.144，95%置信区间1.034 - 1.266，p = 0.009），但该组当前使用电子烟的情况与之前符合筛查条件的个体相似（调整后比值比1.014，95%置信区间0.844 - 1.219，p = 0.88）。
在美国有资格进行肺癌筛查的成年人中，香烟和电子烟暴露情况很常见。扩大后的美国预防服务工作组标准将涵盖更多接触这两种产品的患者群体。
