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Gregory J. Riely, MD, PhD

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Does E-Cigarette Use Impact Lung Cancer Screening Uptake?

By: Julia Cipriano, MS
Posted: Tuesday, July 30, 2024

In JAMA Network Open, Chung Yin Kong, PhD, of Icahn School of Medicine at Mount Sinai, New York, and colleagues reported an independent association between electronic cigarette (e-cigarette) use and lower lung cancer screening uptake. These results from a cross-sectional study, which particularly pertain to individuals who had quit smoking combustible cigarettes, highlight the importance of raising awareness and rectifying misconceptions of e-cigarette use.

“Former smokers who use e-cigarettes remain at increased risk of lung cancer and should be targeted by interventions to improve adherence to lung cancer screening,” the investigators noted.

Using the 2022 Behavioral Risk Factor Surveillance System, the investigators identified 22,713 individuals with a history of smoking cigarettes who were eligible for lung cancer screening per the revised 2021 U.S. Preventive Services Task Force recommendations. Of this population, 26.7% underwent lung cancer screening, and 14.6% were up to date with such testing.

Individuals who underwent lung cancer screening were found to be older, more likely to have a lower income and comorbidities, less likely to be uninsured, have had a routine checkup in the past year, report poor general health, and reside in the U.S. Northeast. According to the investigators, compared with those who did not undergo lung cancer screening, this population also had a higher pack-year history of smoking, had recently quit or attempted to quit smoking within the past year, and was more likely to report never using e-cigarettes.

After the investigators adjusted for confounders, current vs never e-cigarette users demonstrated 21% lower odds of having undergone lung cancer screening; similar trends were observed in former smokers. An analysis stratified by the time since last lung cancer screening found these current vs never users of e-cigarettes to have 33% lower odds of being up to date with such screening. The investigators reported similar findings among former smokers who use e-cigarettes; they had 46% lower odds of being up to date with lung cancer screening.

Disclosure: Dr. Kong reported no conflicts of interest. For full disclosures of the other study authors, visit jamanetwork.com.


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