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I.A. Yang



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    MO11 - Screening and Epidemiology (ID 131)

    • Event: WCLC 2013
    • Type: Mini Oral Abstract Session
    • Track: Imaging, Staging & Screening
    • Presentations: 1
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      MO11.02 - Validation of electronic nose exhaled breath VOC profile in discriminating between subjects with early stage lung cancer and healthy ever smokers. (ID 2574)

      16:15 - 17:45  |  Author(s): I.A. Yang

      • Abstract
      • Presentation
      • Slides

      Background
      Early diagnosis of lung cancer is associated with a better survival. The measurement of volatile organic compounds (VOCs) in exhaled breath using an electronic nose may prove to be a novel, effective and simple technique for screening and diagnosing lung cancer. The aim was to test the validity of the VOC profile in discriminating subjects with early stage lung cancer (I and II) (ESLC) from healthy ever smokers (HS).

      Methods
      243 subjects: 54 ESLC and 189 HS provided a breath sample after tidally breathing through an inspiratory port filter for 5 minutes. It was analysed using a 32 sensor Cyranose 320 (Smiths Detection). Subjects were divided into training (n=159) and independent test set (n=84) groups. Canonical discrimination analyses were performed to determine significance of difference between subject groups and calculate cross validated accuracy (CVV) of the groups using leave one out classification method. Area under the curve (AUC) of Receiver Operating Characteristic Curves were also determined (SPSS V17.0).

      Results
      Validation of the training VOC profile model using an independent test group showed 79% accuracy (p=0.001) in distinguishing ESLC (n=20) from HS (n=64). (AUC 0.933). There was no significant difference in age, lung function and smoking history between the training and test groups.

      Conclusion
      Exhaled breath VOC profile model to discriminate between ESLC subjects and HS was validated in an independent group with a high accuracy. A clinically high sensitivity of the VOC profile model to discriminate between ESLC and HS can be achieved by selecting an appropriate cut point. The cyranose has potential to be a clinically useful diagnostic and screening tool for early stage lung cancer.

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    P1.23 - Poster Session 1 - Tobacco Control, Prevention and Chemoprevention (ID 162)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Prevention & Epidemiology
    • Presentations: 1
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      P1.23-002 - A randomized controlled trial of brief counselling intervention and audio materials for smoking cessation in a low-dose CT screening study (ID 2959)

      09:30 - 16:30  |  Author(s): I.A. Yang

      • Abstract

      Background
      Smoking cessation is a highly cost-effective health intervention. Embedding a smoking cessation program within a lung cancer screening program may significantly enhance the cost-effectiveness of screening. Smokers enrolling in Low-dose CT screening studies are motivated to quit but the best strategy to aid smoking cessation is not yet defined.

      Methods
      Population: smokers enrolled in a LDCT screening study, age 60-74years, with >=30 pack-year smoking history. Smokers could enrol at any time during the LDCT study. Intervention: single face-to-face counselling session on the day of attendance for LDCT screening plus audio cessation advice (on mp3 player) plus written quit materials. The individualised counselling session was given by a thoracic physician using motivational interview techniques. Control: written quit materials only. Outcome: point prevalence self-reported smoking cessation at 1 year, confirmed with exhaled CO measurement (ECO) where available; ≥10ppm level indicating non-abstinence.

      Results
      Fifty-four participants were randomized (control group n=26, intervention group n=28). There were no statistically significant differences between groups in age, sex, pack-years smoking, baseline CT scan findings, nicotine dependence score, self-belief in ability to quit (on a scale of 1-5, higher score indicating stronger belief) or education level although the intervention group reported a higher number of cigarettes smoked per day (table 1). Baseline LDCT scans were reported as positive if one or more non-calcified nodules >=4mm diameter were detected. The mean duration of interview was 26 minutes. Overall, ten participants (18.6%) reported smoking cessation (five had ECO confirmation and five did not have ECO testing); two patients (3.7%, one from each group) had missing data and were assumed to be continuing smokers; the remainder reported continued smoking. There was no difference in self-reported cessation between the intervention and control groups (17.8% vs 19.2% respectively).

      Table 1
      Control Intervention p value
      Women 10 10 ns
      Men 16 18 ns
      Education Up to High School 13 13 ns
      Teriary 13 15 ns
      Age, years, mean 64 64 ns
      Age started smoking, years 16 17 ns
      Cigarette consumption per day, n 23 30 0.03
      Pack years smoking, mean 61 64 ns
      FEV1 % predicted, mean 92 90 ns
      Fagerstrom nicotine dependence score, mean 4.9 5.2 ns
      Baseline CT Scan report Negative 12 10 ns
      Positive 14 18 ns
      Self-belief in ability to quit 3.7 3.4 ns

      Conclusion
      The 18% quit rate in this study is higher than reported background rates however the brief intervention provided did not increase quit rates above that of the control group. Smokers in this study reported moderate to high levels of nicotine dependence with extensive smoking histories, and, although motivated to quit, may require more intensive assistance to support smoking cessation.