Advertisement

Lung

, Volume 190, Issue 6, pp 621–628 | Cite as

Overwhelming Support Among Urban Irish COPD Patients for Lung Cancer Screening by Low-Dose CT Scan

  • M. Pallin
  • S. Walsh
  • M. F. O’Driscoll
  • C. Murray
  • A. Cahalane
  • L. Brown
  • M. Carter
  • P. Mitchell
  • T. J. McDonnell
  • M. W. Butler
Article

Abstract

Purpose

The National Lung Screening Trial (NLST) has renewed interest in low-dose computed tomography (LDCT) screening for lung cancer. Smokers may be less receptive toward LDCT screening, however, compared with never smokers. The views of patients with COPD, a particularly high-risk group, toward LDCT screening for lung cancer are currently unknown. We therefore evaluated attitudes of patients with COPD toward LDCT screening for lung cancer.

Methods

Interviews with Irish patients with COPD who satisfied NLST eligibility criteria were conducted in clinical settings using a questionnaire based on that of a comparable study of U.S. current/former smokers of unspecified disease status.

Results

A total of 142 subjects had a mean age of 65.09 ± 6.07 years (46.4 % were male, mean pack years 54.5 ± 33.3, mean FEV1 59.16 ± 23 %); 97.8 % had an identifiable usual source of healthcare. Compared with data from a U.S. cohort of current/former smokers, a higher proportion of Irish COPD smokers: believed that they were at risk for lung cancer (63.6 vs. 15.7 %); believed that early detection improved chances of survival (90 vs. 51.2 %); were willing to consider LDCT screening (97.9 vs. 78.6 %); were willing to pay for a LDCT scan (68.6 vs. 36.2 %); and were willing to accept treatment recommendations arising (95.7 vs. 56.2 %; p < 0.0001 for all comparisons).

Conclusions

Urban Irish smokers with COPD who would be eligible for LDCT screening are almost universally in favor of being screened and treated for screening-detected lung cancers. This readily accessible high-risk population should be actively targeted in future screening programs.

Keywords

Chronic obstructive pulmonary disease Lung cancer Screening Low-dose computed tomography Attitudes 

Notes

Acknowledgments

This study was conducted in St Vincent’s University Hospital and St Michael’s Hospital Dun Laoghaire in Dublin, Ireland. The authors thank the patients who took the time to complete the survey.

Conflict of interest

The authors report that there are no financial or nonfinancial conflicts of interest related to this study.

References

  1. 1.
    Detterbeck FC, Boffa DJ, Tanoue LT (2009) The new lung cancer staging system. Chest 136:260–271PubMedCrossRefGoogle Scholar
  2. 2.
    Sant M, Allemani C, Santaquilani M, Knijn A, Marchesi F, Capocaccia R (2009) EUROCARE-4. Survival of cancer patients diagnosed in 1995–1999. Results and commentary. Eur J Cancer 45:931–991PubMedCrossRefGoogle Scholar
  3. 3.
    Nair A, Hansell DM (2011) European and North American lung cancer screening experience and implications for pulmonary nodule management. Eur Radiol 21:2445–2454PubMedCrossRefGoogle Scholar
  4. 4.
    Warner E, Jotkowitz A, Maimon N (2010) Lung cancer screening—Are we there yet? Eur J Intern Med 21:6–11PubMedCrossRefGoogle Scholar
  5. 5.
    Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM et al (2011) Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 365:395–409PubMedCrossRefGoogle Scholar
  6. 6.
    Silvestri GA, Nietert PJ, Zoller J, Carter C, Bradford D (2007) Attitudes towards screening for lung cancer among smokers and their non-smoking counterparts. Thorax 62:126–130PubMedCrossRefGoogle Scholar
  7. 7.
    Wilson JM, Jungner YG (1968) Principles and practice of mass screening for disease. Bol Oficina Sanit Panam 65:281–393PubMedGoogle Scholar
  8. 8.
    Adcock IM, Caramori G, Barnes PJ (2011) Chronic obstructive pulmonary disease and lung cancer: new molecular insights. Respiration 81:265–284PubMedCrossRefGoogle Scholar
  9. 9.
    Ben-Zaken Cohen S, Pare PD, Man SF, Sin DD (2007) The growing burden of chronic obstructive pulmonary disease and lung cancer in women: examining sex differences in cigarette smoke metabolism. Am J Respir Crit Care Med 176:113–120PubMedCrossRefGoogle Scholar
  10. 10.
    de Torres JP, Bastarrika G, Wisnivesky JP, Alcaide AB, Campo A, Seijo LM et al (2007) Assessing the relationship between lung cancer risk and emphysema detected on low-dose CT of the chest. Chest 132:1932–1938PubMedCrossRefGoogle Scholar
  11. 11.
    Punturieri A, Szabo E, Croxton TL, Shapiro SD, Dubinett SM (2009) Lung cancer and chronic obstructive pulmonary disease: needs and opportunities for integrated research. J Natl Cancer Inst 101:554–559PubMedCrossRefGoogle Scholar
  12. 12.
    Purdue MP, Gold L, Jarvholm B, Alavanja MC, Ward MH, Vermeulen R (2007) Impaired lung function and lung cancer incidence in a cohort of Swedish construction workers. Thorax 62:51–56PubMedCrossRefGoogle Scholar
  13. 13.
    Tockman MS, Anthonisen NR, Wright EC, Donithan MG (1987) Airways obstruction and the risk for lung cancer. Ann Intern Med 106:512–518PubMedGoogle Scholar
  14. 14.
    Turner MC, Chen Y, Krewski D, Calle EE, Thun MJ (2007) Chronic obstructive pulmonary disease is associated with lung cancer mortality in a prospective study of never smokers. Am J Respir Crit Care Med 176:285–290PubMedCrossRefGoogle Scholar
  15. 15.
    Wasswa-Kintu S, Gan WQ, Man SF, Pare PD, Sin DD (2005) Relationship between reduced forced expiratory volume in one second and the risk of lung cancer: a systematic review and meta-analysis. Thorax 60:570–575PubMedCrossRefGoogle Scholar
  16. 16.
    Young RP, Hopkins RJ (2011) CT screening for lung cancer. Thorax [EPub]Google Scholar
  17. 17.
    Jaklitsch MT, Jacobson FL, Austin JH, Field JK, Jett JR, Keshavjee S et al (2012) The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg 144:33–38PubMedCrossRefGoogle Scholar
  18. 18.
    National Comprehensive Cancer Network (2011) NCCN guidelines version 1.2012 lung cancer screening. http://www.nccn.org/professionals/physician_gls/pdf/lung_screening.pdf. Accessed 5 Oct 2012
  19. 19.
    Centers for Disease Control and Prevention (2010) Behavioural risk factor surveillance system questionnaire. http://www.cdc.gov/brfss/questionnaires/pdf-ques/2010brfss.pdf. Accessed 5 Oct 2012
  20. 20.
    McDaid DWM, Maresso A, Mossialos E (2009) Ireland: Health system review. Health Syst in Transit 11:1–268Google Scholar
  21. 21.
    U.S. Preventive Services Task Force (2004) Lung cancer screening: recommendation statement. Ann Intern Med 140:738–739Google Scholar
  22. 22.
    Bach PB, Silvestri GA, Hanger M, Jett JR (2007) Screening for lung cancer: ACCP evidence-based clinical practice guidelines, 2nd edn. Chest 132:69S–77SPubMedCrossRefGoogle Scholar
  23. 23.
    Jett JR, Midthun DE (2011) Screening for lung cancer: for patients at increased risk for lung cancer, it works. Ann Intern Med 155:540–542PubMedGoogle Scholar
  24. 24.
    Manser RL, Irving LB, Stone C, Byrnes G, Abramson M, Campbell D (2004) Screening for lung cancer. Cochrane Database Syst Rev CD001991Google Scholar
  25. 25.
    Wilde Mathews A (2011) WellPoint to cover lung CT scans for heavy smokers http://blogs.wsj.com/health/2011/12/01/wellpoint-to-cover-lung-ct-scans-for-heavy-smokers/. Accessed 5 Oct 2012
  26. 26.
    Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD (2009) COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J 34:380–386PubMedCrossRefGoogle Scholar
  27. 27.
    Bechtel JJ, Kelley WA, Coons TA, Klein MG, Slagel DD, Petty TL (2005) Lung cancer detection in patients with airflow obstruction identified in a primary care outpatient practice. Chest 127:1140–1145PubMedCrossRefGoogle Scholar
  28. 28.
    de Torres JP, Marin JM, Casanova C, Cote C, Carrizo S, Cordoba-Lanus E et al (2011) Lung cancer in patients with chronic obstructive pulmonary disease– incidence and predicting factors. Am J Respir Crit Care Med 184:913–919PubMedCrossRefGoogle Scholar
  29. 29.
    Castleberry AW, Smith D, Anderson C, Rotter AJ, Grannis FW Jr (2009) Cost of a 5-year lung cancer survivor: symptomatic tumour identification vs proactive computed tomography screening. Br J Cancer 101:882–896PubMedCrossRefGoogle Scholar
  30. 30.
    Whynes DK (2008) Could CT screening for lung cancer ever be cost effective in the United Kingdom? Cost Eff Resour Alloc 6:5PubMedCrossRefGoogle Scholar
  31. 31.
    Mahadevia PJ, Fleisher LA, Frick KD, Eng J, Goodman SN, Powe NR (2003) Lung cancer screening with helical computed tomography in older adult smokers: a decision and cost-effectiveness analysis. JAMA 289:313–322PubMedCrossRefGoogle Scholar
  32. 32.
    Patel D, Akporobaro A, Chinyanganya N, Hackshaw A, Seale C, Spiro SG et al (2011) Attitudes to participation in a lung cancer screening trial: a qualitative study. Thorax [Epub]Google Scholar
  33. 33.
    Schnoll RA, Bradley P, Miller SM, Unger M, Babb J, Cornfeld M (2003) Psychological issues related to the use of spiral CT for lung cancer early detection. Lung Cancer 39:315–325PubMedCrossRefGoogle Scholar
  34. 34.
    Montes U, Seijo LM, Campo A, Alcaide AB, Bastarrika G, Zulueta JJ (2007) Factors determining early adherence to a lung cancer screening protocol. Eur Respir J 30:532–537PubMedCrossRefGoogle Scholar
  35. 35.
    Keighley MR, O’Morain C, Giacosa A, Ashorn M, Burroughs A, Crespi M et al (2004) Public awareness of risk factors and screening for colorectal cancer in Europe. Eur J Cancer Prev 13:257–262PubMedCrossRefGoogle Scholar
  36. 36.
    Klabunde CN, Schenck AP, Davis WW (2006) Barriers to colorectal cancer screening among Medicare consumers. Am J Prev Med 30:313–319PubMedCrossRefGoogle Scholar
  37. 37.
    van den Bergh KA, Essink-Bot ML, van Klaveren RJ, de Koning HJ (2009) Informed participation in a randomised controlled trial of computed tomography screening for lung cancer. Eur Respir J 34:711–720PubMedCrossRefGoogle Scholar
  38. 38.
    Gimeno-Garcia AZ, Quintero E, Nicolas-Perez D, Jimenez-Sosa A (2011) Public awareness of colorectal cancer and screening in a Spanish population. Public Health 125:609–615PubMedCrossRefGoogle Scholar
  39. 39.
    Hahn EJ, Rayens MK, Hopenhayn C, Christian WJ (2006) Perceived risk and interest in screening for lung cancer among current and former smokers. Res Nurs Health 29:359–370PubMedCrossRefGoogle Scholar
  40. 40.
    Ayanian JZ, Cleary PD (1999) Perceived risks of heart disease and cancer among cigarette smokers. JAMA 281:1019–1021PubMedCrossRefGoogle Scholar
  41. 41.
    Finney Rutten LJ, Blake KD, Hesse BW, Augustson EM, Evans S (2011) Illness representations of lung cancer, lung cancer worry, and perceptions of risk by smoking status. J Cancer Educ 26:747–753PubMedCrossRefGoogle Scholar
  42. 42.
    Halpern MT, Warner KE (1994) Differences in former smokers’ beliefs and health status following smoking cessation. Am J Prev Med 10:31–37PubMedGoogle Scholar
  43. 43.
    McCoy SB, Gibbons FX, Reis TJ, Gerrard M, Luus CA, Sufka AV (1992) Perceptions of smoking risk as a function of smoking status. J Behav Med 15:469–488PubMedCrossRefGoogle Scholar
  44. 44.
    Park ER, Ostroff JS, Rakowski W, Gareen IF, Diefenbach MA, Feibelmann S et al (2009) Risk perceptions among participants undergoing lung cancer screening: baseline results from the National Lung Screening Trial. Ann Behav Med 37:268–279PubMedCrossRefGoogle Scholar
  45. 45.
    Price JH, Everett SA (1994) Perceptions of lung cancer and smoking in an economically disadvantaged population. J Community Health 19:361–375PubMedCrossRefGoogle Scholar
  46. 46.
    Strecher VJ, Kreuter MW, Kobrin SC (1995) Do cigarette smokers have unrealistic perceptions of their heart attack, cancer, and stroke risks? J Behav Med 18:45–54PubMedCrossRefGoogle Scholar
  47. 47.
    Beydoun HA, Beydoun MA (2008) Predictors of colorectal cancer screening behaviors among average-risk older adults in the United States. Cancer Causes Control 19:339–359PubMedCrossRefGoogle Scholar
  48. 48.
    Guessous I, Dash C, Lapin P, Doroshenk M, Smith RA, Klabunde CN (2010) Colorectal cancer screening barriers and facilitators in older persons. Prev Med 50:3–10PubMedCrossRefGoogle Scholar
  49. 49.
    Licker MJ, Widikker I, Robert J, Frey JG, Spiliopoulos A, Ellenberger C et al (2006) Operative mortality and respiratory complications after lung resection for cancer: impact of chronic obstructive pulmonary disease and time trends. Ann Thorac Surg 81:1830–1837PubMedCrossRefGoogle Scholar
  50. 50.
    McGarvey LP, John M, Anderson JA, Zvarich M, Wise RA (2007) Ascertainment of cause-specific mortality in COPD: operations of the TORCH Clinical Endpoint Committee. Thorax 62:411–415PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • M. Pallin
    • 1
  • S. Walsh
    • 1
  • M. F. O’Driscoll
    • 2
  • C. Murray
    • 1
  • A. Cahalane
    • 1
  • L. Brown
    • 1
  • M. Carter
    • 1
  • P. Mitchell
    • 1
  • T. J. McDonnell
    • 1
    • 2
  • M. W. Butler
    • 1
    • 3
    • 4
  1. 1.Department of Respiratory MedicineSt Vincent’s University HospitalDublinIreland
  2. 2.Department of Respiratory MedicineSt Michael’s HospitalDun LaoghaireIreland
  3. 3.University College DublinDublinIreland
  4. 4.UCD School of Medicine & Medical Science, Education & Research CentreSt. Vincent’s University HospitalDublin 4Ireland

Personalised recommendations