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Michael K. Gould

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    P2.11 - Screening and Early Detection (ID 178)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Screening and Early Detection
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.11-19 - Effects of Incorporating a Lung Cancer Screening Educational Intervention into Tobacco Cessation Counseling (Now Available) (ID 669)

      10:15 - 18:15  |  Author(s): Michael K. Gould

      • Abstract
      • Slides


      Lung cancer screening (LCS) with low-dose computed tomography (LDCT) reduces lung cancer mortality in high-risk patients, but most of those eligible are not referred for screening, and most eligible smokers are not aware about LCS. Tobacco cessation counseling may be an opportune time to educate smokers about LCS, but it is unclear whether providing such information is effective in improving LCS utilization and what effects it may have on success of tobacco cessation.


      We randomized 1281 smokers age 55-80 who underwent tobacco cessation services between January 2016 and February 2018 in a large integrated health care system to view a web-based educational video about LCS (n=1026) or to receive usual care (n=255). We analyzed results according to both intention-to-treat as well as a pre-planned subset analysis of participants who completed the video. A survey on perceptions of LCS was included at the completion of the video and this was analyzed as well. We then compared the utilization of chest CT scan (any chest CT or specifically LDCT for LCS) in both groups of participants during a specified 90 day follow-up period and modeled the incidence rate ratios (IRR) for participants who completed the video and all invited to view the video compared with controls.


      In the intervention arm, 191 (14.9%) patients watched part of the video, and 136 (10.6%) of participants completed watching the video. The video was well received by those completing it. Overall, 47(4.6%) of participants in the intervention group underwent chest CT and 31 (3.0%) underwent LDCT compared with 12 (4.7%, p=0.082) and 7 (2.8%, p=0.30) in the control group during a 90 day follow-up. Among participants who completed watching the video, 18 (13.2%, p=0.033 compared with control) underwent chest CT and 10 (7.4%) underwent LDCT during follow-up (p= 0.003 compared with control). IRR for participants completing the video was 2.01 (95% CI 1.06-3.82, p=0.03) for LDCT compared with control, and 2.15 (95% CI 1.30-3.55, p=0.003) for chest CT compared with control.


      These data suggest that a lung cancer screening educational intervention may be effective in improving utilization of LDCT in eligible smokers at the time of tobacco cessation counseling. Our study was limited by relatively low response rate to viewing the educational video. We plan to study the optimal way to deliver LCS education in the setting of tobacco cessation. Further research on the effect of lung cancer screening education on the effectiveness of tobacco cessation interventions is also needed.

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