Smokers who receive abnormal results using computed tomography to screen for lung cancer are more likely to quit

According to a new study, smokers who receive multiple abnormal results using computed tomography (CT) to screen for lung cancer are more likely to quit, suggesting an opportunity for doctors to motivate smokers to quit smoking.

The study appears in the May 15, 2005 issue of CANCER, a peer-reviewed journal of the American Cancer Society, and finds smokers who receive one or more abnormal results on the screening test are increasingly likely to quit and remain abstinent from smoking over three years.

Because up to 70 percent of smokers undergoing screening say they want to quit, many researchers have been interested in using cancer screening results as an opportunity to motivate smokers to quit. Previous studies have found smokers recently diagnosed with medical conditions are more interested in, and successful at, quitting.

Studies of low-dose, fast, spiral chest CT have supported its use as a potential "teachable moment" to motivate a smoker to quit. A previous study published in CANCER indicated a single, annual CT lung cancer screening did not increase smoking cessation rates. Therefore, perhaps, multiple abnormal findings may provide a psychological push for a smoker to quit.

Seeking to test that hypothesis, investigators led by James R. Jett, M.D. and Stephen J. Swensen, M.D. at the Mayo Clinic in Rochester, MN followed 926 baseline smokers and 594 former smokers who received three consecutive annual spiral CT scan screenings for lung cancer.

According to Matthew M. Clark, Ph.D., a psychologist working with the investigative team, they found that the more abnormal screenings a smoker received, the more likely they were to quit and remain smoke free at the end of three years. After the third annual follow-up visit, 42 percent of baseline smokers who had three abnormal scans were abstinent from smoking, compared to 28 percent who had two abnormal scans and 24 percent and 20 percent who had one or no abnormal scans, respectively. Factors that contributed to smoking abstinence among baseline smokers were older age, worse baseline pulmonary function, and previous year abnormal CT findings.

Explaining the results, the authors conclude, "multiple lung CT scans may enhance primary and secondary prevention efforts by potentially providing increased interaction with health care providers, increased cognitions about one's own cancer risk, and reinforcement for smoking abstinence with lung CT scan screening."