The combination of a nurse-led smoking cessation intervention plus lung cancer screening could be an effective screening strategy for certain patient populations in China, according to a recent study published in the International Journal of Nursing Studies.
This approach was identified as the optimal strategy for current smokers or quitters in the past 15 years who were >45 years old and had at least a 20-pack/year smoking history, the study showed.
“The guidelines recommend that smoking cessation intervention could be given simultaneously with lung cancer screening to amplify the health benefit,” the study researchers wrote. “However, little is known about the efficacy of nurse-led smoking cessation intervention combined with lung cancer screening in the Chinese population.”
To learn more, researchers compared different screening strategies—as well as the benefits and costs—on a diverse group of patients. Using nationally representative data, the researchers simulated 500,000 people aged 40-74 years old. The patients had varying starting ages and smoking packs/year. The researchers tried to predict incremental cost-effectiveness ratio and net health benefits under different cessation/screening strategies.
Screening compared with nurse-led smoking cessation had lower incremental cost-effectiveness ratios. The largest net health benefits and probability of cost-effectiveness were both in the strategies that combined smoking cessation and screening in patients >45 years old with at least a 20-pack/year smoking history.
“When separately analyzing the impact of key variables of the screening inclusion criteria on the results, we found that the older the starting screening age, the smaller the cost and effectiveness,” the researchers wrote. “Similarly, when other variables were equal, the cost and effectiveness diminished as smoking duration increased.”
Among the strategies that used screening without smoking cessation intervention, the best net health benefit was in patients ≥50 years old with a 20-pack/year smoking history.
“Nurses are integrated throughout all aspects of lung cancer screening, functioning as the program coordinator, system navigator, patient educator, research partner, and health practitioner,” the researchers wrote. “The results of this study suggested that nurse-led smoking cessation intervention should be provided in conjunction with lung cancer screening, which just offers a peculiar opportunity of a teachable moment for smoking cessation intervention.”
Cost-effectiveness of lung cancer screening combined with nurse-led smoking cessation intervention: a population-based microsimulation study.