Impact of lung cancer screening results on smoking cessation

J Natl Cancer Inst. 2014 May 28;106(6):dju084. doi: 10.1093/jnci/dju084. Print 2014 Jun.


Background: Lung cancer screening programs may provide opportunities to reduce smoking rates among participants. This study evaluates the impact of lung cancer screening results on smoking cessation.

Methods: Data from Lung Screening Study participants in the National Lung Screening Trial (NLST; 2002-2009) were used to prepare multivariable longitudinal regression models predicting annual smoking cessation in those who were current smokers at study entry (n = 15489, excluding those developing lung cancer in follow-up). The associations of lung cancer screening results on smoking cessation over the trial period were analyzed. All hypothesis testing used two sided P values.

Results: In adjusted analyses, smoking cessation was strongly associated with the amount of abnormality observed in the previous year's screening (P < .0001). Compared with those with a normal screen, individuals were less likely to be smokers if their previous year's screen had a major abnormality that was not suspicious for lung cancer (odds ratio [OR] = 0.811; 95% confidence interval [CI] = 0.722 to 0.912; P < .001), was suspicious for lung cancer but stable from previous screens (OR = 0.785; 95% CI = 0.706 to 0.872; P < .001), or was suspicious for lung cancer and was new or changed from the previous screen (OR = 0.663; 95% CI = 0.607 to 0.724; P < .001). Differences in smoking prevalence were present up to 5 years after the last screen.

Conclusions: Smoking cessation is statistically significantly associated with screen-detected abnormality. Integration of effective smoking cessation programs within screening programs should lead to further reduction in smoking-related morbidity and mortality.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Early Detection of Cancer*
  • Female
  • Humans
  • Logistic Models
  • Lung Neoplasms / ethnology
  • Lung Neoplasms / etiology
  • Lung Neoplasms / mortality
  • Lung Neoplasms / prevention & control*
  • Male
  • Mass Screening*
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Smoking / adverse effects
  • Smoking / epidemiology*
  • Smoking / ethnology
  • Smoking Cessation / ethnology
  • Smoking Cessation / statistics & numerical data*
  • Tobacco Smoke Pollution / statistics & numerical data
  • United States / epidemiology


  • Tobacco Smoke Pollution