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1.
Lung Cancer ; 139: 41-46, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31726252

RESUMO

OBJECTIVES: The impact of lung cancer screening on smoking is unclear, especially in deprived populations who are underrepresented in screening trials. The aim of this observational cohort study was to investigate whether a community-based lung cancer screening programme influenced smoking behaviour and smoking attitude in socio-economically deprived populations. MATERIAL AND METHODS: Ever-smokers, age 55-74, registered at participating General Practices were invited to a community-based Lung Health Check (LHC). This included an assessment of respiratory symptoms, lung cancer risk (PLCOm2012), spirometry and signposting to stop smoking services. Those at high risk (PLCOM2012≥1.51%) were offered annual low-dose CT screening over two rounds. Self-reported smoking status and behaviour were recorded at the LHC and again 12 months later, when attitudes to smoking were also assessed. RESULTS: 919 participants (51% women) were included in the analysis (77% of attendees); median deprivation rank in the lowest decile for England. At baseline 50.3% were current smokers. One-year quit rate was 10.2%, quitting was associated with increased baseline symptoms (adjOR 2.62, 95% CI 1.07-6.41; p = 0.035) but not demographics or screening results. 55% attributed quitting to the LHC. In current smokers, 44% reported the LHC had made them consider stopping, 29% it made them try to stop and 25% made them smoke less whilst only 1.7% and 0.7% said it made them worry less about smoking or think it acceptable to smoke. CONCLUSIONS: Our data suggest a community-based lung cancer screening programme in deprived areas positively impacts smoking behaviour, with no evidence of a 'licence to smoke' in those screened.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Detecção Precoce de Câncer/psicologia , Neoplasias Pulmonares/diagnóstico , Educação de Pacientes como Assunto , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar/efeitos adversos , Idoso , Estudos de Coortes , Feminino , Seguimentos , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/psicologia , Masculino , Pessoa de Meia-Idade , Motivação , Áreas de Pobreza , Prognóstico
2.
Thorax ; 74(12): 1176-1178, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31481631

RESUMO

Manchester's 'Lung Health Check' pilot utilised mobile CT scanners in convenient retail locations to deliver lung cancer screening to socioeconomically disadvantaged communities. We assessed whether screening location was an important factor for those attending the service. Location was important for 74.7% (n=701/938) and 23% (n=216/938) reported being less likely to attend an equivalent hospital-based programme. This preference was most common in current smokers (27% current smokers vs 19% former smokers; AdjOR 1.46, 95% CI 1.03 to 2.08, p=0.036) and those in the lowest deprivation quartile (25% lowest quartile vs 17.6% highest quartile; AdjOR 2.0, 95% CI 1.24 to 3.24, p=0.005). Practical issues related to travel were most important in those less willing to attend a hospital-based service, with 83.3% citing at least one travel related barrier to non-attendance. A convenient community-based screening programme may reduce inequalities in screening adherence especially in those at high risk of lung cancer in deprived areas.


Assuntos
Atenção à Saúde/organização & administração , Detecção Precoce de Câncer/métodos , Neoplasias Pulmonares/diagnóstico por imagem , Preferência do Paciente/estatística & dados numéricos , Idoso , Serviços de Saúde Comunitária/organização & administração , Detecção Precoce de Câncer/estatística & dados numéricos , Inglaterra , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento/organização & administração , Pessoa de Meia-Idade , Unidades Móveis de Saúde/organização & administração , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Projetos Piloto , Fumar/psicologia , Fatores Socioeconômicos , Tomografia Computadorizada por Raios X
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