A new study suggests that Medicare could spend billions of dollars on screening (拍片检查) smokers for lung cancer that would be better spent on helping them quit and keeping others from starting.
The new study indicated that screening more often supported smokers' beliefs that they could safely continue to smoke. Most participants remained smoking because they believed screening could catch cancer early before it would threaten their lives.
"They compared how hard it was to quit smoking with how easy it was to be screened," said Steven B. Zeliadt, the lead author of the study. "They engaged in magical thinking that now there's this wonderful painless external test that can save lives."
He and seven colleagues conducted the study of 37 current smokers who were offered lung cancer screening at Department of Veteran Affairs. After being screened and told the results, they were interviewed about their smoking-related health beliefs. For about half of those, cancer was not found. "Screening lowered their motivation for quitting," the team reported in July in JAMA Internal Medicine. The participants focused only on lung cancer, ignoring other potential harm of smoking.
A national study published four years ago found that annual CT screening for lung cancer three years in a row could reduce deaths among heavy smokers by about 20 percent. In an interview, Dr. Russell P. Harris, a preventive medicine specialist at the UNC-Chapel Hill, noted that "Screening is being believed by people as an alternative to stopping smoking. But stopping smoking would have huge benefits for the individual and society." Furthermore, smoking causes many other cancers.
Dr. Harris agreed that rather than screening, money is better spent on smoking prevention. He suggested providing free stop-smoking aids, sponsoring anti-smoking advertising and raising taxes on tobacco products and the age at which people are allowed to buy them.
