Abstract
BackgroundAs genetic tests become cheaper, the possibility of their widespread availability must be considered. This study involves a risk score for lung cancer in smokers that is roughly 50% genetic (50% clinical criteria). The risk score has been shown to be effective as a smoking cessation motivator in hospital recruited subjects (not actively seeking cessation services).MethodsThis was an RCT set in a United Kingdom National Health Service (NHS) smoking cessation clinic. Smokers were identified from medical records. Subjects that wanted to participate were randomised to a test group that was administered a gene-based risk test and given a lung cancer risk score, or a control group where no risk score was performed. Each group had 8 weeks of weekly smoking cessation sessions involving group therapy and advice on smoking cessation pharmacotherapy and follow-up at 6 months. The primary endpoint was smoking cessation at 6 months. Secondary outcomes included ranking of the risk score and other motivators.Results67 subjects attended the smoking cessation clinic. The 6 months quit rates were 29.4%, (10/34; 95% CI 14.1–44.7%) for the test group and 42.9% (12/28; 95% CI 24.6–61.2%) for the controls. The difference is not significant. However, the quit rate for test group subjects with a “very high” risk score was 89% (8/9; 95% CI 68.4–100%) which was significant when compared with the control group (p = 0.023) and test group subjects with moderate risk scores had a 9.5% quit rate (2/21; 95% CI 2.7–28.9%) which was significantly lower than for above moderate risk score 61.5% (8/13; 95% CI 35.5–82.3; p = 0.03).ConclusionsOnly the sub-group with the highest risk score showed an increased quit rate. Controls and test group subjects with a moderate risk score were relatively unlikely to have achieved and maintained non-smoker status at 6 months.ClinicalTrials.gov ID NCT01176383 (date of registration: 3 August 2010)
Highlights
As genetic tests become cheaper, the possibility of their widespread availability must be considered
Patient characteristics 109 patients were randomised to test group or control group but 42 failed to attend and enrol. This was before test group recruits were offered the gene test which was not done until the first smoking cessation session
The mean age and age range were similar in both test and control groups: 49.7 years and 49.0 years in the test group and control group, respectively
Summary
As genetic tests become cheaper, the possibility of their widespread availability must be considered. This study involves a risk score for lung cancer in smokers that is roughly 50% genetic (50% clinical criteria). The risk score has been shown to be effective as a smoking cessation motivator in hospital recruited subjects (not actively seeking cessation services). They conducted a controlled trial using this risk score for smoking cessation motivation. They recruited smokers who were recently discharged from hospital but who were not actively planning to quit smoking or enrolling in a smoking cessation programme. When compared with a 5% quit rate for the control group and with previous studies using telephone counselling alone [13], the absolute figures for smoking cessation with this risk score was 20–25% higher [14]
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