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Prev Med. 2019 Apr;121:24-32. doi: 10.1016/j.ypmed.2019.02.016. Epub 2019 Feb 10.

Combining smoking cessation interventions with LDCT lung cancer screening: A systematic review.

Author information

1
The Pulmonary Center, Boston University School of Medicine, Boston, MA, United States of America. Electronic address: jmi@bu.edu.
2
The Pulmonary Center, Boston University School of Medicine, Boston, MA, United States of America.
3
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, United States of America; Division of Pulmonary & Critical Care Medicine, Oregon Health & Science University, Portland, OR, United States of America.
4
The Pulmonary Center, Boston University School of Medicine, Boston, MA, United States of America; Center for Healthcare Organization & Implementation Research, ENRM VA Hospital, Bedford, MA, United States of America.

Abstract

Providing smoking cessation treatment with annual low dose CT (LDCT) screening offers an opportunity to reduce smoking-related morbidity and mortality. However, the optimal approach for delivering cessation interventions in the LDCT screening context is unknown. We searched for randomized controlled trials and observational studies with a control group testing a smoking cessation intervention among adults undergoing LDCT screening through May 1, 2018 using MEDLINE, the Cochrane Library, Web of Science, EMBASE, PsycINFO, and ClinicalTrials.gov. Two reviewers independently reviewed each study to assess eligibility and extracted information using pre-specified protocols for included studies. Given significant differences in the interventions in each study, meta-analyses for the included studies could not be performed. Of 2513 identified studies, 9 met inclusion criteria. Five of the included studies were randomized controlled trials while 4 were observational studies with a control group. Studies were of varying quality, but overall were of poor to fair quality with significant potential for bias and limited generalizability. Based on the available studies, there was insufficient data to suggest a particular approach to smoking cessation counseling in the LDCT screening setting. While no studies compared combined pharmacotherapy and counseling to counseling alone or compared the various pharmacologic agents, we identified several studies underway investigating new approaches during LDCT screening. The optimal strategy for smoking cessation in patients undergoing LDCT screening remains unclear. Future studies should focus on evaluating effectiveness and implementation of combined counseling and pharmacotherapy to optimize smoking cessation during LDCT screening.

KEYWORDS:

Cancer screening; Lung cancer; Smoking cessation

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