Annals of translational medicine
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Smoking behavior may have a substantial influence on the overall effect of lung cancer screening. Non-randomized studies of smoking behavior during screening have indicated that computer tomography (CT) screening induces smoking cessation. Randomized studies have further elaborated that this effect has to do with participation in screening alone and not dependent on the CT scan. ⋯ Also low smoking dependency and high motivation to quit smoking at baseline predicted smoking abstinence in screening trials. Lung cancer screening therefore seems to be a teachable moment for smoking cessation. Targeted smoking cessation counselling should be an integrated part of future lung cancer screening trials.
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Implementation of lung cancer CT screening programs will increase the incidence of pulmonary nodules and require multidisciplinary efforts for devising appropriate treatment plans. The role of the thoracic surgeon is paramount in leading the discussion and shaping the treatment strategies. Management of CT screen-detected lung nodules differ from conventional lung cancer nodules given their smaller size, varied histologies and potentially indolent growth. Here we present a brief overview of the thoracic surgeon's perspective on the clinical evaluation, diagnostic tests and surgical approach to these nodules in the setting of a comprehensive lung cancer screening program.