PMID- 34648947 OWN - NLM STAT- MEDLINE DCOM- 20220203 LR - 20230102 IS - 1556-1380 (Electronic) IS - 1556-0864 (Print) IS - 1556-0864 (Linking) VI - 17 IP - 1 DP - 2022 Jan TI - Impact of Joint Lung Cancer Screening and Cessation Interventions Under the New Recommendations of the U.S. Preventive Services Task Force. PG - 160-166 LID - S1556-0864(21)03208-1 [pii] LID - 10.1016/j.jtho.2021.09.011 [doi] AB - INTRODUCTION: In 2021, the U.S. Preventive Services Task Force (USPSTF) revised its lung cancer screening recommendations expanding its eligibility. As more smokers become eligible, cessation interventions at the point of screening could enhance the benefits. Here, we evaluate the effects of joint screening and cessation interventions under the new recommendations. METHODS: A validated lung cancer natural history model was used to estimate lifetime number of low-dose computed tomography screens, percentage ever screened, lung cancer deaths, lung cancer deaths averted, and life-years gained for the 1960 U.S. birth cohort aged 45 to 90 years (4.5 million individuals). Screening occurred according to the USPSTF 2013 and 2021 recommendations with varying uptake (0%, 30%, 100%), with or without a cessation intervention at the point of screening with varying effectiveness (15%, 100%). RESULTS: Screening 30% of the eligible population according to the 2021 criteria with no cessation intervention (USPSTF 2021, 30% uptake, without cessation intervention) was estimated to result in 6845 lung cancer deaths averted and 103,725 life-years gained. These represent 28% and 34% increases, respectively, relative to screening according to the 2013 guidelines (USPSTF 2013, 30% uptake, without cessation intervention). Adding a cessation intervention at the time of the first screen with 15% effectiveness (USPSTF 2021, 30% uptake, with cessation intervention with 15% effectiveness) was estimated to result in 2422 additional lung cancer deaths averted (9267 total, approximately 73% increase versus USPSTF 2013, 30% uptake, without cessation intervention) and 322,785 life-years gained ( approximately 318% increase). Screening 100% of the eligible according to the 2021 guidelines with no cessation intervention (USPSTF 2021, 100% uptake, without cessation intervention) was estimated to result in 23,444 lung cancer deaths averted ( approximately 337% increase versus USPSTF 2013, 30% uptake, without cessation intervention) and 354,330 life-years gained ( approximately 359% increase). Adding a cessation intervention with 15% effectiveness (USPSTF 2021, 100% uptake, with cessation intervention with 15% effectiveness) would result in 31,998 lung cancer deaths averted ( approximately 497% increase versus USPSTF 2013, 30% uptake, without cessation intervention) and 1,086,840 life-years gained ( approximately 1309% increase). CONCLUSIONS: Joint screening and cessation interventions would result in considerable lung cancer deaths averted and life-years gained. Adding a one-time cessation intervention of modest effectiveness (15%) results in comparable life-years gained as increasing screening uptake from 30% to 100% because while cessation decreases mortality from many causes, screening only reduces lung cancer mortality. This simulation indicates that incorporating cessation programs into screening practice should be a priority as it can maximize overall benefits. CI - Copyright (c) 2021 International Association for the Study of Lung Cancer. All rights reserved. FAU - Meza, Rafael AU - Meza R AD - Department of Epidemiology, University of Michigan, Ann Arbor, Michigan. Electronic address: rmeza@umich.edu. FAU - Cao, Pianpian AU - Cao P AD - Department of Epidemiology, University of Michigan, Ann Arbor, Michigan. FAU - Jeon, Jihyoun AU - Jeon J AD - Department of Epidemiology, University of Michigan, Ann Arbor, Michigan. FAU - Taylor, Kathryn L AU - Taylor KL AD - Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia. FAU - Mandelblatt, Jeanne S AU - Mandelblatt JS AD - Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia. FAU - Feuer, Eric J AU - Feuer EJ AD - Division of Cancer Control & Population Sciences, National Cancer Institute, Bethesda, Maryland. FAU - Lowy, Douglas R AU - Lowy DR AD - Office of the Director, National Cancer Institute, Bethesda, Maryland. LA - eng GR - U01 CA253858/CA/NCI NIH HHS/United States GR - U01 CA199284/CA/NCI NIH HHS/United States GR - U01 CA199218/CA/NCI NIH HHS/United States GR - R01 CA207228/CA/NCI NIH HHS/United States GR - R35 CA197289/CA/NCI NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20211012 PL - United States TA - J Thorac Oncol JT - Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer JID - 101274235 SB - IM CIN - J Thorac Oncol. 2022 Jan;17(1):13-15. PMID: 34930605 MH - *Early Detection of Cancer MH - Humans MH - Lung MH - *Lung Neoplasms/diagnosis/prevention & control MH - Mass Screening MH - Tomography, X-Ray Computed PMC - PMC8692396 MID - NIHMS1749087 OTO - NOTNLM OT - CISNET OT - Cesssation interventions within lung screening OT - Deaths averted OT - Life-years gained OT - Lung cancer screening OT - Simulation modeling COIS- The authors report not conflict of interests. EDAT- 2021/10/15 06:00 MHDA- 2022/02/04 06:00 PMCR- 2023/01/01 CRDT- 2021/10/14 20:14 PHST- 2021/07/27 00:00 [received] PHST- 2021/09/15 00:00 [revised] PHST- 2021/09/20 00:00 [accepted] PHST- 2021/10/15 06:00 [pubmed] PHST- 2022/02/04 06:00 [medline] PHST- 2021/10/14 20:14 [entrez] PHST- 2023/01/01 00:00 [pmc-release] AID - S1556-0864(21)03208-1 [pii] AID - 10.1016/j.jtho.2021.09.011 [doi] PST - ppublish SO - J Thorac Oncol. 2022 Jan;17(1):160-166. doi: 10.1016/j.jtho.2021.09.011. Epub 2021 Oct 12.