Literature Review: The Effects of Smoking on Lung Cancer Rates among Adults in New York

Student Name

University

Professor

Course

Date

Part A: Introduction

Smoking and lung cancer have been known to go hand in hand. The basic assumption has always been that smoking is the main cause of lung cancer. Studies have proven that this connection is indeed very significant. The focus of this paper goes beyond this relationship and looks at the contribution of gender differences in regard to smoking and lung cancer and the factors involved in screening and cessation. This paper incorporates three studies to gain a better perspective on gender, screening, and cessation with respect to smoking and lung cancer. Through comparison and contrast of the studies, the paper is able to gather insight into various aspects other than the link between smoking and cessation. Lung cancer is a major health problem with devastating outcomes, which means that it is imperative that at-risk individuals incorporate preventive and corrective measures to protect themselves.

Part B: Literature Review

This literature study aims to synthesize the results of three studies into a coherent picture of the cost-effectiveness of cancer screening with and without smoking cessation therapies. With an acknowledged cost-effectiveness criterion of $109,000 per QALY gained, the first research by Villanti et al. (2013) revealed that yearly repeat lung cancer tests in a high-risk cohort of individuals aged 50–64 were very cost-effective. A second research by Sharma et al. (2018) demonstrated that the cost-effectiveness of the screening was enhanced by an increase in the Care quality saved when smoking cessation therapies were linked with the yearly screening program. Thirdly, O'Keeffe et al. (2018) observed that the impact of smoking on lung cancer risk is the same in both sexes.

The assessment of cost-utility analysis of lung cancer screening and the paybacks on integrating smoking cessation interventions was performed by Villanti et al. (2013). This study aimed to assess whether LDCT screening for lung cancer among commercially insured individuals between 50 and 64 years at high risk for this disorder is turning out to be cost-effective. The authors also strived to quantify the extra payback of integrating smoking cessation solutions within lung cancer screening programs. The authors analyzed their study in 2012, assuming that all existing smokers and half of the prior smoker population aged between 50 and 64 years were eligible for screening, with the minimum being set at least thirty packs across years of smoking. The researchers used data from National Health Interview Survey on cigarette smoking conditions for individuals between 45 and 64 years who were making 30% of active smokers across the United States at the time. The cancer treatment costs were acquired from New York's taxpayer database, which provided information including physician, hospital, drug, and ancillary costs eligible for insurer reimbursement. They used qualitative research methods to build up on the prior simulation model to determine the utility cost of yearly, recurring LDCT screenings for the last 15 years within an assumed high-risk population of 18 million adults aged between 50 and 64 years. It specifically involved those who have consumed over 30 packs within their smoking history. The authors' findings indicate that the recurring yearly lung cancer screening within the high-risk population has been effective. Providing smoking cessation strategies within the yearly screening program has increased the cost-effectiveness of the disorder by between 40 and 45%.

Similar to the study by Villanti et al. (2013), Sharma et al. (2018) also covered cancer screening and cessation. They conducted a study on using a smoking cessation quitline to promote lung cancer screening. The goal of their study was to compare two alternatives to dispense information concerning lung cancer screening. This included a quitline, a mailed brochure pinned with in-depth messaging facilitated by a quitline coach. Therefore, the authors focused on assessing the strategy that will be effective and have a significant impact on the participants searching for information about lung cancer screening. The authors thus hypothesized that the individuals who received the brochure would report having spoken to their insurance company or physician and compare it to those who only received the brochure and made no contact. The authors recruited their research participants in 2018, and the target population came from residents residing in New York State but outside Niagara and Erie counties. The authors performed a randomized trial involving New York State Smokers Quitline respondents to determine the impact of disseminating a brochure comprising information on benefits, risks, and costs related to lung cancer screening compared to a brochure supplemented with phone-based and in-depth messaging. The research findings identified that the educational brochure was an effective and affordable strategy for dispensing information regarding lung cancer screening.

While the two prior studies looked at cancer screening and cessation, the research by O'Keeffe et al. (2018) focused on the role of gender in regard to smoking and lung cancer. The goal of the researchers was to compare the potential of smoking causing lung cancer in men and women. The study utilized a systematic review and meta-analysis design to examine whether smoking has a similar impact on men and women. The search strategy entailed the collection of data from two databases (PubMed and EMBASE) over a period of 17 years that spanned from January 1999 to April 2016. The search criteria involved the use of select keywords, which were 'tobacco/smoking', 'cancer', 'sex', and 'cohort studies.' Other studies were retrieved from a systematic review that was published before 1999. The reference lists also factored in the search for relevant sources. Three authors played roles in screening the resources to determine the most suitable for inclusion in the study. The choice of cohort studies was based on coverage of smoking and lung cancer in relation to sex-specific risk. In total, there were 29 studies that covered seven million persons and more than 50,000 cases of lung cancer. Meta-analysis was accrued out on the selected studies. Men and women were classified according to the degree of light, moderate, and heavy smoking. The outcomes showed a similarity between the impact of smoking on lung cancer in both men and women.

Articles Similarities

Methodology

Villanti et al. (2013), Sharma et al. (2018), and O'Keeffe et al. (2018) employed qualitative research methodologies to analyze the feasibility of lung cancer screening and the paybacks of incorporating smoking cessation therapies. Specifically, the authors utilized data from the NHIS to assess the utility cost of annual, recurrent LDCT examinations for the previous 15 years within an imagined significant population of 18 million persons aged above 50 to 64 years. They also utilized data from the NYC taxpayer databases to analyze the cancer therapy expenses. The researchers of all three studies did their study between 2012 through 2018, respectively. Villanti et al. (2013) and Sharma et al. (2018) both utilized data from the NHIS, whereas O'Keeffe et al. (2018) used statistics from Smokers Quitline in New York.

Findings

  Smoking is a significant cause of lung cancer, according to studies by Villanti et al. (2013), Sharma et al. (2018), and O'Keeffe et al. (2018). The researchers of all three studies concluded that lung screening test reduces the chance of lung cancer mortality. They also discovered that quitting smoking programs may boost the financial efficiency of lung cancer screenings.

Recommendation

For persons aged 50 to 64 who have smoked for more than 30 pack-years, yearly lung cancer screening is advised by Villanti et al. (2013), Sharma et al. (2018), and O'Keeffe et al. (2018). Additionally, they conclude that when combined with tobacco cessation therapies, lung screening test is even more cost-effective. It is specifically suggested in the Villanti et al. (2013) and Sharma et al. (2018) study that smoking cessation therapies be coupled with yearly lung cancer testing to increase the cost-effectiveness of the screening program. Similar findings are drawn in the study of O'Keeffe et al. (2018) that quitting smoking is crucial for lowering lung cancer-related morbidity and death.

Articles Differences

Methodology

While Sharma et al. (2018) utilized a randomized experiment to examine the efficacy of a quitline versus brochures in encouraging lung cancer tests, Villanti et al. (2013) used a simulation model to evaluate the cost-effectiveness of testing for lung cancer. The link between smoke and lung cancer risk in both men and women was investigated in the research by O'Keeffe et al. (2018) using data across 99 prospective studies. Villanti et al. (2013) and Sharma et al. (2018) focussed on the expenditure and the benefits of incorporating smoking cessation programs, respectively. O'Keeffe et al. (2018) assessed the gender disparities in lung cancer and cigarette smoking connection. While Sharma et al. (2018) and O'Keeffe et al. (2018) selected their respondents from New York State, Villanti et al. (2013) recruited their study subjects from the United States.

Findings

According to the results of all three studies, smoking increases the risk of lung cancer in both sexes. However, the researchers of the O'Keeffe et al. (2018) study concluded that there was no proof that women were at a higher risk of developing lung cancer from smoking than males. According to Villanti et al. (2013), including smoking cessation measures in the routine screening program boosted the disorder's cost-effectiveness by 40–45%. The study's authors considered the instructional booklet to be an efficient and cost-effective method of disseminating information about lung cancer screening (Sharma et al.,2018).

Recommendations

According to research published in 2013 by Villanti et al., adults aged 50–64 who have smoked for 30 or more pack-years should be screened for lung cancer every year. According to Sharma et al. (2018), individuals who smoke and receive LCS should get smoking cessation therapy. According to O'Keeffe et al. (2018), tobacco control programs that discourage both sexes from smoking while simultaneously enticing people to give up the habit should continue to be a top focus.

Part C: Discussion

The discussion offers an overview of the challenge of cancer in the world and the respective mitigation strategies to reduce cancer prevalence. Globally, over 2.2 million people are diagnosed with lung cancer, with smoking being the primary cause. According to Villanti et al. (2013), the USA alone records over 236,740 new cases yearly, and the government must develop a long-lasting solution. Of the affected population, over 130,180 die of the disease annually, making lung cancer the second deadliest disease on the earth. The researcher, therefore, investigated the cost-effective way of introducing lung cancer screening among the most vulnerable age without smoking cessation therapy. The research discovered that there is no difference between the sexes when comparing the number of cancer cases resulting from smoking. Regardless of the age or sex of a patient, screening is found to be the most effective way of controlling the disease because when a person knows the cancer condition, it is easier to plan for the treatment and get treated before the situation deteriorates further. The most vulnerable age is 50-64 years, while the less vulnerable population includes periods below that and those who have never smoked. It is imperative to note that although cancer f one of the deadliest diseases for humanity, regular screening and putting up measures to stop smoking are the antidote to lower its prevalence and reduce dangers among people.

Mitigation

Medical research has been unable to establish a sure way that may be utilized in preventing and mitigating lung cancer. However, there are numerous ways that each individual may need to practice as a way of lowering the risk of developing lung cancer. For individuals who have never smoked, there is a need to ensure that they avoid starting, which helps in ensuring that they keep their lungs healthy, which lowers the risk of developing lung cancer (Villanti et al., 2013). For smokers, it is important to stop smoking. Smokers may need to consult a healthcare professional for stop-smoking aids and strategies that they leverage to quit smoking. Secondhand smoke is also a major cause of lung cancer. Therefore, individuals who work or live with a smoker should urge him/her to smoke outside or quit. It is essential to avoid areas where people usually smoke, such as restaurants and bars. More importantly, non-smokers should avoid carcinogens at their workplace, including avoiding exposure to toxic chemicals. Above all, people who seek to keep lung cancer at bay should ensure that they exercise regularly and eat a diet full of vegetables and fruits.

Recommendations

For those who have already developed smoking-related lung cancer, I recommend quitting smoking as soon as possible. If a patient with lung cancer continues to smoke during radiotherapy or chemotherapy, their rate of survival is severely compromised compared to those who quit smoking. This is because continued smoking after an individual is diagnosed with lung cancer is associated with such effects as reduced cancer treatment efficacy, impaired healing, increased risk for cancer recurrence, diminished general quality of life, impaired healing, and decreased survival. I believe that government has a role to play in significantly lowering smoking levels and hence, lowering the risk of lung cancer in the population. This includes diverse measures such as a total ban on tobacco promotion and advertising, stern restrictions on smoking in workplaces and public places, sustained increase in taxes on tobacco products together with policies towards curbing smuggling, health education campaigns related to smoking cessation, multiple warnings on tobacco products, and increased regulations on standards required in tobacco products based on health department insights rather than being set by stakeholders in the tobacco industry. After an early diagnosis of cancer, quitting smoking can go a long way in helping victims survive longer as it serves to prevent the disease from becoming worse or delays the return of cancer. In addition to quitting smoking, smoking-related cancer patients should consider such treatment alternatives as targeted therapy, radiation therapy, chemotherapy, surgery, or a combination of the alternatives.

Part D: Conclusion

Lung cancer affects millions of people in the US and across the globe. It is a problem that keeps affecting the masses, given the numerous new lung cancer cases diagnosed yearly. Smoking is evidently the main causal factor in the development and progression of this disease. From the research, demographics do not play a significant role in influencing lung cancer from smoking which means just about anyone is at risk as long they have a smoking habit. The impetus is to engage in ways to mitigate the problem. In order to enhance the protection of individuals from the adverse impacts of lung cancer, it is essential that awareness, screening, and smoking cessation therapies are promoted amongst the population of individuals who smoke.

References

Villanti, A. C., Jiang, Y., Abrams, D. B., & Pyenson, B. S. (2013). A cost-utility analysis of lung cancer screening and the additional benefits of incorporating smoking cessation interventions. PloS one, 8(8), e71379. https://doi.org/10.1371/journal.pone.0071379

Sharma, A., Bansal-Travers, M., Celestino, P., Fine, J., Reid, M. E., Hyland, A., & O’Connor, R. (2018). Using a smoking cessation quitline to promote lung cancer screening. American journal of health behavior, 42(6), 85-100. https://www.ingentaconnect.com/content/png/ajhb/2018/00000042/00000006/art00009

O’Keeffe, L. M., Taylor, G., Huxley, R. R., Mitchell, P., Woodward, M., & Peters, S. A. (2018). Smoking as a risk factor for lung cancer in women and men: a systematic review and meta-analysis.  BMJ open, 8(10), e021611. http://dx.doi.org/10.1136/bmjopen-2018-021611