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Current smokers less likely to undergo cancer screenings than nonsmokers
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Current smokers are less likely to meet recommendations for breast, prostate and colorectal cancer screenings than people who have never smoked, according to results from a recent study published in JAMA Network Open.
“In addition to lung cancer, smoking has been linked to cancer risk at additional sites, including the colorectal tract and cervix, with emerging evidence on other cancer types,” Nina N. Sanford, MD, assistant professor in the department of radiation oncology at the University of Texas Southwestern, and colleagues wrote. “Thus, although smoking cessation remains the most critical cancer prevention behavior, individuals who smoke may potentially derive the greatest benefit from improved cancer screening to detect occult disease at an earlier stage.”
To evaluate cancer screening patterns among those who never smoked, those who formerly smoked and those who currently smoke, researchers used data from the 2010, 2013 and 2015 National Health Interview Survey. The study sample included adults aged 18 years and older who never reported a cancer diagnosis. The study’s primary endpoint was receipt of cancer screening, including colonoscopy, mammography, PSA testing and Papanicolaou test per U.S. Preventive Services Task Force guidelines.
Among the 83,176 participants included in the study, 51,014 (61.3%) were never smokers, 17,235 (20.7%) were former smokers and 14,927 (17.9%) were current smokers. Current smokers had a lower annual family income, were less educated and were more likely to be uninsured compared with former and never smokers.
Current smokers were less likely than never smokers to have received a colonoscopy (43.8% vs 57.7%; adjusted OR = 0.74; 95%CI, 0.68-0.82), mammogram (88.8% vs 93.3%; aOR = 0.7; 95% CI, 0.57-0.87) or PSA test (46.1% vs 60.8%; aOR = 0.76; 95% CI, 0.64-0.9).
Current smokers who had received a screening test were less likely than former smokers to have a colonoscopy (92.1% vs 95.1%; aOR = 0.75; 95% CI, 0.59 0.96), mammography (62.4% vs 79.4%; aOR = 0.52; 95% CI, 0.45-0.6) or Papanicolaou test (80.9% vs 90.8%; aOR = 0.61; 95% CI, 0.56-0.67) within the recommended timeline.
Compared with never smokers, former smokers were more likely to undergo a colonoscopy, mammography and Papanicolaou test than never smokers but not PSA screening.
“Our findings suggest physicians need to be aware of this disparity, which may affect a group of individuals with a baseline higher risk for several cancer types,” Sanford and colleagues wrote. “We recommend a concerted effort from the medical community to identify barriers to screening among smokers to implement strategies to increase acceptance and uptake of cancer screening within this population.”– by Erin Michael
Disclosures: Sanford reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.