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戒烟对肺癌高危人群早期筛查的有效性:截至2022年1月的随机对照试验系统评价与荟萃分析

Effectiveness of smoking cessation on the high-risk population of lung cancer with early screening: a systematic review and meta-analysis of randomized controlled trials until January 2022.

作者信息

Huang Simin, Tang Oufeng, Zheng Xutong, Li Hui, Wu Yuxin, Yang Liu

机构信息

School of Nursing, Fujian University of Traditional Chinese Medicine-Fuzhou, Fuzhou, China.

Department of Anesthesiology, West China Hospital of Sichuan University/West China School of Nursing, Sichuan University-Chengdu, Chengdu, China.

出版信息

Arch Public Health. 2023 Jun 3;81(1):101. doi: 10.1186/s13690-023-01111-5.

Abstract

BACKGROUND

Lung cancer has always been the malignant tumor with the highest incidence rate. Smoking is the most important risk factor for lung cancer. Although potential positive effects of smoking cessation interventions on the high-risk population of lung cancer have been observed, evidence of its definitive effect remains uncertain. This study aimed to summarize the evidence related to the effects and safety of smoking cessation interventions for the high-risk population of lung cancer.

METHODS

A systematic literature search was conducted through the following seven databases: PubMed, Embase, Web of Science, CENTRAL, CINAHL, PsycINFO, and Science Direct. Screening and assessment for risk of bias were conducted by two independent reviewers. Meta-analysis was performed for the 7-day-point prevalence of smoking abstinence and continuous smoking abstinence using RevMan 5.3 software.

RESULTS

Meta-analysis results show that in the 7-day-point prevalence of smoking abstinence (by patient-reported outcome): individualized intervention was significantly higher than that of the standard care [RR = 1.46, 95%CI = (1.04,2.06), P < 0.05]. Moreover, the smoking cessation interventions were significantly elevated than that of standard care [RR = 1.58, 95%CI = (1.12, 2.23), P < 0.05] within 1-6 month follow-up time. In line with the findings in cigarette smoking, the continuous smoking abstinence of E-cigarettes (biochemical verified): E-cigarettes were significantly higher than that of the standard care [RR = 1.51, 95%CI = (1.03, 2.21), P < 0.05], and within 1-6 month follow-up time, the smoking cessation interventions were significantly greater than that of standard care [RR = 1.51, 95%CI = (1.03, 2.21), P < 0.05]. Publication bias was detected possibly.

CONCLUSIONS

The results of this systematic review show that smoking cessation intervention is effective for long-term lung cancer high-risk smokers who participate in early screening, of which E-cigarettes are the best, followed by individual smoking cessation.

TRIAL REGISTRATION

A review protocol was developed and registered in the International Prospective Register of Systematic Reviews (PROSPERO).

TRIAL REGISTRATION

CRD42019147151. Registered 23 June 2022.

摘要

背景

肺癌一直是发病率最高的恶性肿瘤。吸烟是肺癌最重要的危险因素。尽管已观察到戒烟干预措施对肺癌高危人群有潜在的积极影响,但其确切效果的证据仍不确定。本研究旨在总结与肺癌高危人群戒烟干预措施的效果和安全性相关的证据。

方法

通过以下七个数据库进行系统的文献检索:PubMed、Embase、Web of Science、CENTRAL、CINAHL、PsycINFO和Science Direct。由两名独立的评审员进行偏倚风险的筛选和评估。使用RevMan 5.3软件对7天戒烟点患病率和持续戒烟情况进行荟萃分析。

结果

荟萃分析结果显示,在7天戒烟点患病率(通过患者报告结果)方面:个体化干预显著高于标准护理[RR = 1.46,95%CI =(1.04,2.06),P < 0.05]。此外,在1 - 6个月的随访期内,戒烟干预措施显著高于标准护理[RR = 1.58,95%CI =(1.12,2.23),P < 0.05]。与吸烟情况的研究结果一致,电子烟持续戒烟(经生化验证):电子烟显著高于标准护理[RR = 1.51,95%CI =(1.03,2.21),P < 0.05],且在1 - 6个月的随访期内,戒烟干预措施显著高于标准护理[RR = 1.51,95%CI =(1.03,2.21),P < 0.05]。可能检测到发表偏倚。

结论

本系统评价的结果表明,戒烟干预措施对参与早期筛查的长期肺癌高危吸烟者有效,其中电子烟效果最佳,其次是个体戒烟。

试验注册

制定了一项综述方案并在国际系统评价前瞻性注册库(PROSPERO)中注册。

试验注册

CRD42019147151。于2022年6月23日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2432/10239152/de7c32ad8efb/13690_2023_1111_Fig1_HTML.jpg

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