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New Research: Using Lung Cancer Screening As An Opportunity to Help Smokers Quit

, by Stephanie R. Land, Ph.D.

A computed tomography (CT) scan shows a large tumor in the patient's left lung.

Credit: Wikimedia, CC BY-SA 2.0

Smoking causes about 30 percent of all cancer deaths in the United States. Recent medical recommendations are expected to dramatically increase the number of heavy smokers who undergo annual screening for lung cancer. These screening appointments represent an important point where clinicians and other members of the health care team can help patients stop the behavior that brought them in for screening in the first place.

And so the question is not whether clinicians should help people being screened for lung cancer quit smoking. Rather, the question is how best to help them quit.

NCI has released a new funding announcement to help answer this question by stimulating research on optimal cigarette smoking cessation approaches delivered in conjunction with lung cancer screening.

The U.S. Preventive Services Task Force (USPSTF) now recommends that current or former heavy smokers aged 55 to 80 undergo annual screening for lung cancer with low-dose helical computed tomography (LDCT). Under the Affordable Care Act, USPSTF prevention recommendations of grade A or B (such as the recommendation for lung cancer screening with LDCT) must be covered by all private health insurance plans.

In addition, the Centers for Medicare and Medicaid Services recently changed its coverage of lung cancer screening based on findings from the NCI-funded National Lung Screening Trial, which showed that LDCT screening was associated with a 20 percent reduction in lung cancer mortality among heavy smokers.

Stephanie R. Land, Ph.D., Program Director and Statistician, Tobacco Control Research Branch, Behavioral Research Program

Credit: Stephanie R. Land, Ph.D.

Unfortunately, providing cessation guidance to patients who smoke is not yet a universal component of cancer screening programs. And although traditional cessation literature or advice may be available, the best approach for LDCT clinics to help this particular population quit, regardless of their screening test result, is not clear.

Under this Request for Applications (RFA), NCI intends to commit $4.5 million in fiscal year 2016 to fund up to six grants. The studies funded by these awards will evaluate the key components and characteristics of an effective smoking cessation intervention delivered in conjunction with a screening appointment and/or optimal strategies for incorporating existing evidence-based smoking cessation intervention(s) into a variety of LDCT screening settings, from large academic hospitals to community health centers.

As the program director administering this research initiative, I’ll be hosting a teleconference for prospective investigators on August 4 at 2:00 p.m. EDT. In addition, we’ve developed a website to address frequently asked questions about this RFA. Instructions for the teleconference are posted on the website.

No matter how long somebody has been smoking, quitting immediately lowers their risk. And we know that lung cancer screening provides a crucial opportunity to deliver cessation services to current smokers. By supporting these grants, NCI hopes to identify feasible approaches for providing these services, helping as many people as possible to lower their cancer risk.

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