By Carly Rogers

Smoking rates are down nationally, but so are discussions among physicians and smokers about lung cancer screening, PHHP researchers have found. However, the study also found these patient-physician conversations did not affect current smokers’ intent or attempts to quit.

Lung cancer is the leading cause of cancer-related death in the United States. For active smokers, lung cancer screening can reduce cancer-related mortality by 20 percent. But the study found screening may have no benefits for individuals who do not smoke frequently or are younger than 55 years old, the recommended age to start yearly screenings.

The researchers expected to find that if patients who smoke engage in a discussion about lung cancer screening with their physicians, they will be more motivated to quit. However, the study showed physician-patient discussions were not associated with any changes in smokers’ behavior.

“These results are surprising because we actually want to see an increase in this discussion among smokers who have a high risk of lung cancer, and for this discussion to modify patients’ smoking behavior,” said Jinhai “Stephen” Huo, Ph.D., M.D., Ms.PH., an assistant professor in the department of health services research, management and policy and the study’s principal investigator.

Patient-physician discussions are an opportunity to persuade current smokers to modify or abandon their smoking habits, said Huo. Study data, however, showed that receiving a lung cancer screening did not significantly impact the desire to quit smoking. This suggests that a simple discussion or being screened may not build lasting motivation for current smokers to quit or modify their smoking habits.

The study also found the rates of discussions about lung cancer screenings between physicians and patients who smoke or have a history of smoking decreased from 6.7 percent in 2012 to 4.2 percent in 2014 and 4.3 percent in 2017 — three years that followed a national event promoting lung cancer screening.

Researchers say the burden of lung cancer will be reduced by developing communication strategies for promoting beneficial lung cancer screenings among those who are eligible and strategies for improving the quality of these discussions.

“Physicians should let smokers know that lung cancer screening using a low-dose CT scan is not an alternative to smoking cessation, and make smoking cessation resources available for all smokers during the discussion about lung cancer screening,” said Huo.

For the study, Huo and his colleagues analyzed data from the National Cancer Institute’s Health Information National Trends Survey, or HINTS, in 2012, 2014 and 2017 — which altogether included 9,433 respondents. In 2011, the National Lung Screening Trial, the largest trial of lung cancer screening ever conducted, demonstrated that low-dose CT scans reduced lung cancer mortality by 20 percent. In 2013, the United States Preventive Services Task Force issued a recommendation for annual lung cancer screening for those who meet certain criteria. In 2015, the Centers for Medicare & Medicaid Services released a lung cancer screening Medicare policy.

Huo’s study, which was published in the journal Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, was supported by the UF Health Cancer Center Research Pilot Grant through the Florida Consortium of National Cancer Institute Centers Program at UF.