Psychological issues related to the use of spiral CT for lung cancer early detection

Although the NCI is presently investigating whether enhanced detection of lung tumors via spiral CT reduces lung cancer mortality, use of this technology for lung cancer screening is already widespread in the US. Few data are available concerning level of interest in, or awareness of, spiral CT for lung cancer screening, correlates of participation in screening, or potential reactions to screening results (i.e. smoking cessation) among high-risk individuals. One-hundred-and-seventy-two current or former smokers with no personal cancer history were queried about their awareness of spiral CT for lung cancer screening, received information about the procedure, and completed a survey that assessed interest in screening, correlates of screening interest (i.e. demographic, health, psychological), and expected effects of screening results on smoking. Seventy-seven percent of respondents were unaware of spiral CT for lung cancer screening and 62% expressed high interest in screening. Screening interest was positively related to screening self-efficacy, knowledge of asymptomatic illness, and perceived lung cancer risk. In the face of a positive scan, 52% of smokers said that they would quit, 43% said they would consider quitting, and 3% would continue smoking. If the scan was negative, 19% of smokers said that they would quit, 61% said they would consider quitting, and 20% would continue smoking. Finally, 59% of smokers were interested in smoking cessation counseling, with screening. These findings can help guide the design of psychological interventions to promote the utilization of spiral CT for early lung cancer detection as well as the development of protocols to promote behavior change within lung cancer screening programs, should future studies indicate that spiral CT screening can effectively reduce the overall lung cancer mortality rate.