Regular cancer screenings can lower the risk of death from lung cancer, but they aren’t enough to reduce the risk of developing lung cancer for people who smoke.
In Australia around 12,434 new cases of lung cancer are diagnosed each year, while in the United States more than 234,000 people will be diagnosed this year. However, while many people are aware that smoking is one of the leading causes of lung cancer, most are confused when it comes to the actual benefits and limitations of lung cancer screenings.
New research published in the Annals of the American Thoracic Society Journal by the VA Center of Innovation for Veteran-Centered and Value-Driven Care found just 7 per cent of smokers could correctly answer questions about smoking and lung cancer screening. The questions were as followed:
1. Does having a lung cancer screening test decrease your chances of getting lung cancer? (Correct answer: No.)
2. Which disease is the leading cause of death in Americans who smoke cigarettes? (Correct answer: Heart disease [a list of diseases was provided].)
3. True or false: If nothing abnormal or suspicious is found on your lung cancer screening test, it means you are safe from lung cancer for at least 12 months. (Correct answer: False.)
4. True or false: All nodules or spots found in the lungs eventually grow over time to be life-threatening. (Correct answer: False.)
5. For people over-55 who are current smokers, which is more likely to prevent the most premature deaths – lung cancer screening or quitting smoking? (Correct answer: Quitting smoking.)
Authors and researchers of the paper believe there needs to be more emphasis on the importance of quitting smoking, rather than relying on screenings to protect smokers against cancer.
“A screening test does not provide a snapshot of lung health or how much damage smoking has done so far,” Steve Zeliadt, VA Puget Sound and University of Washington School of Public Health researcher told Starts at 60. “It only lets radiologists see if there are currently any suspicious cancerous lesions, which need to be removed through surgery or treatment to improve outcomes.”
Lesions can occur at any time and getting a lung check-up each year increases the chance they’ll be found quicker and treated more easily. Having said that, quitting smoking reduces the risk of cancerous lesions developing in the first place and can also reduce the risk of other health conditions including stroke and heart attack.
“One of the findings from our work in lung cancer is that long-term smokers have struggled many times with quitting and know how hard it is to quit,” Zeliadt said. “Anything that serves as an alternative to that challenge is enticing. There is a lot of cognitive dissonance that happens with an unhealthy behaviour that may explain why some smokers can attach unrealistic expectations to screening.”
It’s also important to realise that, even for smokers over the age of 60, giving up cigarettes can still have a positive impact on overall lung health and even increase the likelihood of living longer compared to someone who continues to smoke into later life.
“Population studies indicate that quitting smoking, even over the age of 60, can reduce risks of dying from all tobacco-related diseases by as much as 90 per cent,” Zeliadt added. “Also, some very compelling evidence comes from studies of patients at any age who are diagnosed with lung cancer who quit at the time of diagnosis. Their survival is often years longer than those who do not quit, highlighting that quitting at any age improves lung cancer outcomes.”
While other lifestyle changes and health behaviours can also be helpful, quitting smoking is the best way to protect against lung cancer. Avoiding second hand smoke can be beneficial, while regular exercise and a healthy diet can also reduce the risk.
“There is evidence that heavy alcohol use is associated with some cancers, including oesophageal and colon cancer, and may increase risk of lung cancer, so avoiding heavy alcohol use is also recommended as a protective measure against lung cancer,” Zeliadt noted.
While giving up smoking can be extremely difficult, it’s important to know that there is help available. Even after failed attempts to quit, it’s important to try again. Speak to a health professional or GP for effective ways to quit and to book a lung cancer screening test.