Lung Cancer Screening, Cancer Treatment, and Addressing the Continuum of Health Risks Caused by Tobacco

2016 ◽  
pp. 223-229 ◽  
Author(s):  
Graham W. Warren ◽  
Jamie S. Ostroff ◽  
John R. Goffin
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Cancer Treatment ◽  
Tobacco Use ◽  
Health Risks ◽  
Lung Cancer Screening ◽  
Adverse Outcomes ◽  
Evidence Based ◽  
Patients With Cancer ◽  
Preventable Risk Factor

Tobacco use is the largest preventable risk factor for the development of several cancers, and continued tobacco use by patients with cancer and survivors of cancer causes adverse outcomes. Worldwide tobacco control efforts have reduced tobacco use and improved health outcomes in many countries, but several countries continue to suffer from increased tobacco use and associated adverse health effects. Continued tobacco use by patients undergoing cancer screening or treatment results in continued risk for cancer-related and noncancer-related health conditions. Although integrating tobacco assessment and cessation support into lung cancer screening and cancer care is well justified and feasible, most patients with cancer unfortunately do not receive evidence-based tobacco cessation support. Combining evidence-based methods of treating tobacco addiction, such as behavioral counseling and pharmacotherapy, with practical clinical considerations in the setting of lung cancer screening and cancer treatment should result in substantial improvements in access to evidence-based care and resultant improvements in health risks and cancer treatment outcomes.

Implementation of an Evidence-Based Tobacco Use Treatment Intervention in the Context of Lung Cancer Screening

2018 ◽  
Author(s):  
Jamie S. Ostroff ◽  
Donna Shelley
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Tobacco Use ◽  
Lung Cancer Screening ◽  
Helical Computed Tomography ◽  
Evidence Based ◽  
Treatment Interventions ◽  
Smoking Cessation Treatment ◽  
Tobacco Treatment

Lung cancer screening using low-dose helical computed tomography is now recommended for early detection of lung cancer. This case study provides an overview of a study that is testing the effectiveness of tobacco treatment interventions for high-risk smokers seeking lung cancer screening and examining factors that may influence implementation process and sustainability for delivering effective models of smoking cessation treatment in lung cancer screening settings. The focus of the case study is a description of how and why two implementation frameworks were applied to evaluate the implementation outcomes and additional multilevel factors (i.e., organization and intervention characteristics) that may influence effective implementation of evidence-based tobacco use treatment interventions in the context of lung cancer screening. Ultimately, implementation of high-quality tobacco treatment in lung cancer screening settings is likely to further reduce tobacco-related cancer morbidity and mortality.

Tobacco and Lung Cancer: Risks, Trends, and Outcomes in Patients with Cancer

2013 ◽  
pp. 359-364 ◽  
Author(s):  
Graham W. Warren ◽  
K. Michael Cummings
Keyword(s):  
Lung Cancer ◽  
Tobacco Use ◽  
Cancer Mortality ◽  
Tobacco Cessation ◽  
Lung Cancer Screening ◽  
Lung Cancer Mortality ◽  
Second Primary ◽  
Cancer Risks ◽  
Patients With Cancer ◽  
Increased Risk

Tobacco use, primarily associated with cigarette smoking, is the largest preventable cause of cancer mortality, responsible for approximately one-third of all cancer deaths. Approximately 85% of lung cancers result from smoking, with an additional fraction caused by secondhand smoke exposure in nonsmokers. The risk of lung cancer is dose dependent, but can be dramatically reduced with tobacco cessation, especially if the person discontinues smoking early in life. The increase in lung cancer incidence in different countries around in the world parallels changes in cigarette consumption. Lung cancer risks are not reduced by switching to filters or low-tar/low-nicotine cigarettes. In patients with cancer, continued tobacco use after diagnosis is associated with poor therapeutic outcomes including increased treatment-related toxicity, increased risk of second primary cancer, decreased quality of life, and decreased survival. Tobacco cessation in patients with cancer may improve cancer treatment outcomes, but cessation support is often not provided by oncologists. Reducing the health related effects of tobacco requires coordinated efforts to reduce exposure to tobacco, accurately assess tobacco use in clinical settings, and increase access to tobacco cessation support. Lung cancer screening and coordinated international tobacco control efforts offer the promise to dramatically reduce lung cancer mortality in the coming decades.

Tobacco Use in Non-Eligible Participants in a Lung Cancer Screening Program

CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. 1301A
Author(s):  
Niloofar Taghizadeh ◽  
Kathryn Taylor ◽  
Remon Tadros ◽  
Paul MacEachern ◽  
Rommy Koetzler ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Tobacco Use ◽  
Screening Program ◽  
Lung Cancer Screening ◽  
Cancer Screening Program ◽  
Lung Cancer Screening Program

scholarly journals Low Provider Knowledge Is Associated With Less Evidence-Based Lung Cancer Screening

2019 ◽  
Vol 17 (4) ◽  
pp. 339-346 ◽  
Author(s):  
Jennifer A. Lewis ◽  
Heidi Chen ◽  
Kathryn E. Weaver ◽  
Lucy B. Spalluto ◽  
Kim L. Sandler ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Lung Cancer Screening ◽  
System Level ◽  
Smoking History ◽  
Secondary Outcome ◽  
Evidence Based ◽  
The Past ◽  
High Knowledge ◽  
Provider Knowledge

Background: Despite widespread recommendation and supportive policies, screening with low-dose CT (LDCT) is incompletely implemented in the US healthcare system. Low provider knowledge of the lung cancer screening (LCS) guidelines represents a potential barrier to implementation. Therefore, we tested the hypothesis that low provider knowledge of guidelines is associated with less provider-reported screening with LDCT. Patients and Methods: A cross-sectional survey was performed in a large academic medical center and affiliated Veterans Health Administration in the Mid-South United States that comprises hospital and community-based practices. Participants included general medicine providers and specialists who treat patients aged >50 years. The primary exposure was LCS guideline knowledge (US Preventive Services Task Force/Centers for Medicare & Medicaid Services). High knowledge was defined as identifying 3 major screening eligibility criteria (55 years as initial age of screening eligibility, smoking status as current or former smoker, and smoking history of ≥30 pack-years), and low knowledge was defined as not identifying these 3 criteria. The primary outcome was self-reported LDCT order/referral within the past year, and the secondary outcome was screening chest radiograph. Multivariable logistic regression evaluated the adjusted odds ratio (aOR) of screening by knowledge. Results: Of 625 providers recruited, 407 (65%) responded, and 378 (60.5%) were analyzed. Overall, 233 providers (62%) demonstrated low LCS knowledge, and 224 (59%) reported ordering/referring for LDCT. The aOR of ordering/referring LDCT was less among providers with low knowledge (0.41; 95% CI, 0.24–0.71) than among those with high knowledge. More providers with low knowledge reported ordering screening chest radiographs (aOR, 2.7; 95% CI, 1.4–5.0) within the past year. Conclusions: Referring provider knowledge of LCS guidelines is low and directly proportional to the ordering rate for LDCT in an at-risk US population. Strategies to advance evidence-based LCS should incorporate provider education and system-level interventions to address gaps in provider knowledge.

scholarly journals Association of invitation to lung cancer screening and tobacco use outcomes in a VA demonstration project

2019 ◽  
Vol 16 ◽  
pp. 101023 ◽  
Author(s):  
Steven S. Fu ◽  
Anne C. Melzer ◽  
Angela E. Fabbrini ◽  
Kathryn L. Rice ◽  
Barbara Clothier ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Screening ◽  
Tobacco Use ◽  
Lung Cancer Screening ◽  
Demonstration Project
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