Many smokers appear confused about the benefits of getting lung cancer screenings, says a study by the VA Center of Innovation for Veteran-Centered and Value-Driven Care in Seattle.

When the researchers asked five questions about smoking and screenings, the results showed most patients are confused about the benefits of getting checked. Specifically, too many consider the screenings a “protection” from cancer.

"Quitting smoking is by far the most important thing a person can do to prevent lung cancer as well as a host of other diseases caused by tobacco use, and it's important that this message doesn't get lost in the discussion of lung cancer screening," said Dr. Jaimee L. Heffner, lead author on the paper appearing in the Annals of the American Thoracic Society.
Studies have shown that screening former or current smokers with low-dose computed tomography (LDCT) gives a 15 to 20 percent lower risk of dying from lung cancer versus standard chest X-ray.

The researchers asked 83 smokers post-LDCT five questions to test their knowledge about lung cancer and found only 7 percent got them all right. They were:

1. Does having a lung cancer screening test decrease your chances of getting lung cancer? (Correct answer: No.) Wrong answer from 39 percent.

2. Which disease is the leading cause of death in Americans who smoke cigarettes? (Correct answer: Heart disease.) Wrong answer from 66 percent.

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.) Wrong answer from 39 percent.

4. True or false: All nodules or spots found in the lungs eventually grow over time to be life threatening. (Correct answer: False.) Wrong answer from 49 percent.

5. For people over age 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.) Wrong answer from 47 percent.

The number of wrong answers to the last question, said researchers, illustrates “just how wide a gap exists between the expectations and the reality of lung cancer screening benefits among some groups of current smokers,” the researchers pointed out.

The source of the confusion, they say, is that, although LDCT screening can cut smokers' mortality rates, it doesn't do a thing to the odds of getting the disease.

Quitting is the “single most effective way to do that,” noted the scientists, stressing that, “our findings suggest that messages about benefits and limitations of LDCT for lung cancer screening are either not being provided or are not being actively received and/or recalled.”

LDCT was in the news in May, when a coalition urged CMS clarification on low dose CT guidance.

The American College of Radiology (ACR) and other partner groups sent a formal letter to the U.S. Centers for Medicare and Medicaid Services (CMS) requesting that it confirm that Medicare will reimburse for CT lung cancer screening at Independent Diagnostic Testing Facilities (IDTF).

“CT lung cancer screening can save more lives than any cancer screening test in history, but patients are not hearing about this test from their doctors,” said Dr. Ella Kazerooni, ACR Lung Cancer Screening Committee Chair, in a statement. “Medicare is not adequately covering these exams. This noncompliance and practical non-coverage is contributing to unnecessary deaths due to lack of screening.”

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