Combining telephone smoking cessation programs and lung screening could maximize health benefits and reduce costs

Integrating telephone smoking cessation and lung screening programs not only has the potential to maximize long-term health benefits, but it can also be cost-effective in the long run, according to a study conducted by the University of Michigan. term.

We hope the results will inform discussions about integrating cost-effective cessation approaches for smokers undergoing lung cancer screening.

Pianpian Cao, lead author, researcher, department of epidemiology, UM School of Public Health

Cao and colleagues used data from a nationwide randomized trial led by researchers at the Georgetown Lombardi Comprehensive Cancer Center to assess the short- and long-term societal cost-effectiveness of interventions, including telephone counseling with replacement therapy. of nicotine in people undergoing lung cancer screening. . They used a well-established model developed by the Cancer Intervention and Surveillance Modeling Network to project the lifetime impact of the program to conduct an economic analysis of these withdrawal interventions.

According to the researchers, the cost of delivering the programs was $380 and $144 per person for the eight-week and three-week protocol, respectively, while the dropout rates were 7.14% and 5.96% . They also found differences in “quality-adjusted life years,” or QALYs, a measure of the value of health outcomes often used in economic evaluations of health interventions.

While the three-week program was less expensive per person than the eight-week approach, the latter was the most cost-effective, with an incremental cost-effectiveness ratio of $4,029 per quality-adjusted life year compared to the program of three weeks.

Investigators say this is the first study to conduct an economic evaluation of a large national clinical trial of a telephone counseling intervention for smokers at the time of lung cancer screening and to use this data to project lifetime costs and effects.

According to early recommendations from the US Task Force on Preventive Services, about 8 million people in the United States are eligible for testing and about half of them are current smokers. The task force recently updated the recommendations, but data to guide the implementation of smoking cessation programs are still limited.

“Screening can be a teachable moment, offering the opportunity to motivate people who currently smoke to quit, but so far the data to guide the implementation of smoking cessation programs in screening settings lung cancer are limited,” said the study’s lead author, Professor Rafael Meza. of Epidemiology and Global Public Health at UM’s School of Public Health.

“These results provide important evidence for the value of smoking cessation in lung cancer screening and underscore the need for continued reimbursement policies supporting this approach for the millions of smokers eligible for screening in the United States. “

Due to the limited scope of the study, the results should be considered a conservative estimate of net benefits, the researchers say. The analysis did not include enough racial/ethnic minorities to assess the effects of subgroups. Additionally, adherence to lung cancer screenings varies significantly by state and race, differences that need to be assessed in future studies.

“That being said, the results strongly support the implementation of telephone counseling and other effective withdrawal interventions in lung cancer screening,” Cao said.

The study appears in this month’s Journal of the National Cancer Institute. It was supported by the National Cancer Institute of the National Institutes of Health.


Journal reference:

A randomized trial of telephone smoking cessation treatment for lung cancer screening

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