Incorporating lung cancer screening education into tobacco cessation group counseling
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Division of Thoracic Surgery, City of Hope, Duarte, United States
Department of Preventive Medicine, Kaiser Permanente, Riverside, United States
Department of Population Sciences, City of Hope, Duarte, United States
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, United States
Dan J. Raz   

Division of Thoracic Surgery, City of Hope, 1500 E. Duarte Rd, Duarte, CA 91010, United States
Publication date: 2020-02-12
Submission date: 2019-10-18
Final revision date: 2019-12-06
Acceptance date: 2019-12-09
Tob. Prev. Cessation 2020;6(February):12
Lung cancer screening (LCS) with low-dose computed tomography (LDCT) reduces lung cancer mortality, yet few people who are eligible for LCS get screened. In the present study, we studied the feasibility of tobacco cessation counselors to inform about LCS during tobacco cessation group counseling.

Four tobacco cessation counselors at two different facilities offering group tobacco cessation counseling were trained to administer an educational intervention about LCS. The intervention was administered to 25 participants during May 2019 who completed surveys that assessed how much the information provided helped with understanding various aspects of lung cancer screening including benefits, risks, eligibility criteria, and insurance coverage. The intervention also provided information on how to learn more about LCS and assessed the acceptability of the information.

The median score for understanding of all components of the intervention was 5 (‘completely understand’). Most participants (92%) felt that the information provided about LCS was the right amount. Most participants (72%) were aged 55–80 years, the age range for LCS eligibility. Four participants (16%) reported undergoing LCS in the past. When we reanalyzed the subset of participants who reported no prior LCS, the results of surveys were similar.

Our findings suggest that it is feasible to train tobacco cessation counselors to educate smokers, attending group tobacco cessation counseling classes, also about LCS. The education provided in this study was both understood and well received by the large majority of smokers surveyed. Further study is needed to understand the effect of LCS education on utilization of LDCT among smokers enrolled in tobacco cessation counseling.

We thank the tobacco cessation counselors who participated in this study: Catherine Chanady, Latyce Moyo, Sarah Delcourt, Andile Ndlela and Katie Wical.
The authors have each completed and submitted an ICMJE form for disclosure of potential conflicts of interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. D. J. Raz reports financial activities outside the submitted word.
This study was funded through a grant from the Lung Cancer Research Foundation (DR).
Not commissioned; externally peer reviewed.
American Cancer Society. Cancer Facts & Figures 2016. Accessed October 18, 2019.
The International Early Lung Cancer Action Program Investigators. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med. 2006;355(17):1763-1771. doi:10.1056/nejmoa060476
National Lung Screening Trial Research Team, Aberle DR, Adams AM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395-409. doi:10.1056/nejmoa1102873
Moyer VA, U. S. Preventive Services Task Force. Screening for lung cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. doi:10.7326/m13-2771
Wood DE, Kazerooni EA, Baum SL, et al. Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2018;16(4):412-441. doi:10.6004/jnccn.2018.0020
Pinsky PF, Berg CD. Applying the National Lung Screening Trial eligibility criteria to the US population: what percent of the population and of incident lung cancers would be covered? J Med Screen. 2012;19(3):154-156. doi:10.1258/jms.2012.012010
Raz DJ, Wu GX, Consunji M, et al. Perceptions and utilization of lung cancer screening among primary care physicians. J Thorac Oncol. 2016;11(11):1856-1862. doi:10.1016/j.jtho.2016.06.010
Raz DJ, Dunham R, Tiep B, et al. Augmented meaningful use criteria to identify patients eligible for lung cancer screening. Ann Thorac Surg. 2014;98(3):996-1002. doi:10.1016/j.athoracsur.2014.04.105
Zeliadt SB, Heffner JL, Sayre G, et al. Attitudes and Perceptions About Smoking Cessation in the Context of Lung Cancer Screening. JAMA Intern Med. 2015;175(9):1530-1537. doi:10.1001/jamainternmed.2015.3558
Ostroff JS, Buckshee N, Mancuso CA, et al. Smoking cessation following CT screening for early detection of lung cancer. Prev Med. 2001;33(6):613-621. doi:10.1006/pmed.2001.0935
Tammemagi MC, Berg CD, Riley TL, et al. Impact of lung cancer screening results on smoking cessation. J Natl Cancer Inst. 2014;106(6):dju084. doi:10.1093/jnci/dju084
Taylor KL, Cox LS, Zincke N, et al. Lung cancer screening as a teachable moment for smoking cessation. Lung Cancer. 2007;56(1):125-134. doi:10.1016/j.lungcan.2006.11.015
Davis KC, Alexander RLJ, Shafer P, et al. The Dose-Response Relationship Between Tobacco Education Advertising and Calls to Quitlines in the United States, March-June, 2012. Prev Chronic Dis. 2015;12:E191. doi:10.5888/pcd12.150157
Raz DJ, Wu G, Nelson RA, et al. Perceptions and Utilization of Lung Cancer Screening Among Smokers Enrolled in a Tobacco Cessation Program. Clin Lung Cancer. 2019;20(1):e115-e122. doi:10.1016/j.cllc.2018.09.013
Steliga MA, Yang P. Integration of smoking cessation and lung cancer screening. Transl Lung Cancer Res. 2019;8(Suppl 1):S88-S94. doi:10.21037/tlcr.2019.04.02
Cadham CJ, Jayasekera JC, Advani SM, et al. Smoking cessation interventions for potential use in the lung cancer screening setting: A systematic review and meta-analysis. Lung Cancer. 2019;135:205-216. doi:10.1016/j.lungcan.2019.06.024
Tremblay A, Taghizadeh N, Huang J, et al. A Randomized Controlled Study of Integrated Smoking Cessation in a Lung Cancer Screening Program. J Thorac Oncol. 2019;14(9):1528-1537. doi:10.1016/j.jtho.2019.04.024
Meltzer LR, Unrod M, Simmons VN, et al. Capitalizing on a teachable moment: Development of a targeted self-help smoking cessation intervention for patients receiving lung cancer screening. Lung Cancer. 2019;130:121-127. doi:10.1016/j.lungcan.2019.02.014
Iaccarino JM, Duran C, Slatore CG, et al. Combining smoking cessation interventions with LDCT lung cancer screening: A systematic review. Prev Med. 2019;121:24-32. doi:10.1016/j.ypmed.2019.02.016
Joseph AM, Rothman AJ, Almirall D, et al. Lung Cancer Screening and Smoking Cessation Clinical Trials. SCALE (Smoking Cessation within the Context of Lung Cancer Screening) Collaboration. Am J Respir Crit Care Med. 2018;197(2):172-182. doi:10.1164/rccm.201705-0909ci
Clinical Practice Guideline Treating Tobacco Use and Dependence 2008 Update Panel, Liaisons, and Staff. A clinical practice guideline for treating tobacco use and dependence: 2008 update. A U.S. Public Health Service report. Am J Prev Med. 2008;35(2):158-176. doi:10.1016/j.amepre.2008.04.009
van der Aalst CM, van Klaveren RJ, van den Bergh KA, et al. The impact of a lung cancer computed tomography screening result on smoking abstinence. Eur Respir J. 2011;37(6):1466-1473. doi:10.1183/09031936.50035410