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OP36 Decisions about smoking in patients screened with the early cdt-lung test for the early detection of lung cancer: a qualitative study

Young, Ben; Vedhara, Kavita; Robertson, John; das Nair, Roshan

OP36 Decisions about smoking in patients screened with the early cdt-lung test for the early detection of lung cancer: a qualitative study Thumbnail


Authors

Ben Young

Kavita Vedhara

ROSHAN NAIR Roshan.dasnair@nottingham.ac.uk
Professor of Clinical Psychology and Neuropsychology



Abstract

Background:
Routine screening for lung cancer in high risk groups (characterised by age and smoking history) is recommended in the USA and may be implemented elsewhere. It is unclear whether being screened for lung cancer promotes smoking cessation or conversely provides false reassurance and a ‘license to smoke’. This study aimed to understand how experiences of lung cancer screening influence individual decision making about smoking.

Methods:
Thirty one people in Scotland, aged 51–74, took part in semi-structured interviews. They had been screened with the EarlyCDT-Lung Test (13 positive result; 18 negative) as part of the Early Cancer Detection Test–Lung Cancer Scotland (ECLS) Study and were long-term smokers when screened. Verbatim transcripts were analysed using thematic analysis.

Results:
Interpretations of test results was a key theme, but were often inaccurate, for example a negative result interpreted as an ‘all-clear’ from lung cancer and a positive result as meaning lung cancer will definitely develop. There was no clear pattern in decisions made about smoking in response to positive or negative test results. Emotional response to those interpretations was an overarching theme in decisions about smoking. Emotions included fear, shock, upset, worry, anxiety, guilt, relief, reassurance and indifference. Other themes included changes in perceived risk of smoking-related disease, a feeling that now is the time to stop smoking, interpersonal family influences and avoidance of thoughts about smoking. Of those who had stopped smoking, some cited screening experiences as the sole reason and some cited screening along with other coinciding factors. Cues to change were experienced at different stages of the screening process and not always immediately following a test result. Some participants indicated they underwent screening in order to try and stop smoking. Others expressed little or no desire to stop. In general, lung cancer screening was experienced as a unique opportunity, which sometimes prompted successful or unsuccessful attempts to stop smoking.

Conclusion:
Lung cancer screening can be a ‘teachable moment’ for smoking behaviour change. Emotional responses to test results, which can be misinterpreted, were an important theme but behavioural responses varied according to the individual. Findings should be considered within the context of a group of predominantly life-long smokers undergoing a novel blood screening test, who might already have increased motivation to stop smoking. Lung cancer screening presents an opportunity to engage high risk smokers in cessation support but our findings suggest such support may need to be available flexibly to be most effective.

In collaboration with the ECLS study team.

Citation

Young, B., Vedhara, K., Robertson, J., & das Nair, R. (in press). OP36 Decisions about smoking in patients screened with the early cdt-lung test for the early detection of lung cancer: a qualitative study. Journal of Epidemiology and Community Health, 71(Supp 1), Article A19. https://doi.org/10.1136/jech-2017-SSMAbstracts.36

Journal Article Type Article
Acceptance Date May 16, 2017
Online Publication Date Sep 2, 2017
Deposit Date Jan 25, 2018
Publicly Available Date Jan 25, 2018
Journal Journal of Epidemiology and Community Health
Print ISSN 0143-005X
Electronic ISSN 1470-2738
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 71
Issue Supp 1
Article Number A19
DOI https://doi.org/10.1136/jech-2017-SSMAbstracts.36
Public URL https://nottingham-repository.worktribe.com/output/880823
Publisher URL http://jech.bmj.com/content/71/Suppl_1/A19.1
Contract Date Jan 25, 2018

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