by Schuyler Griffin, LCSW-A, UNC Tobacco Treatment Program
November provides several opportunities to broach the topic of lung cancer screening with your patients. Thursday, November 21 is the Great American Smoke Out, and Lung Cancer Awareness Month runs through the end of the month.
What is Lung Cancer Screening?
Low-dose CT scans (LDCT) are used to screen for lung cancer. Currently, the United States Preventative Services Task Force (USPSTF) recommends lung cancer screening for patients between the ages of 50-80 with a 20 pack-year history, including those who quit in the last 15 years. Being aware of these guidelines makes it easier to discuss with your patients. Patients may ask you about the benefits and risks of screening.
As a Tobacco Treatment Specialist (TTS), you should encourage patients to discuss the benefits and risks in detail with their provider; however, as a TTS, you can still provide an overview. The primary benefit of lung cancer screening is early detection, as lung cancer is treatable in early stages. The risks involve low-dose radiation exposure as well as potential false positives from the screening, which can lead to additional--and sometimes invasive--tests.
When and How Do I Talk to my Patients about Lung Cancer Screening?
Below are three examples of when and how lung cancer screening may come up with a patient and examples of how you might approach these conversations:
During the Intake Process
The initial intake provides a natural moment to discuss lung cancer screening. As the TTS, you will gather information like age and pack-years smoked. Once you consider their eligibility based on USPSTF criteria, you may bring it up to the patient.
Example: “I see that you have been smoking about a pack a day for 30 years. Based on this information, I was wondering if you have ever had a lung cancer screening or heard of the screening? Would you be interested in hearing more about lung cancer screening?”
As a Source of Motivation
As a TTS, you will hear about health and/or lung cancer as a common patient motivator. When the topic of lung cancer/health comes up, you can use this moment to review the patient’s motivations and share information surrounding lung cancer screening.
Example: “It sounds like creating a healthier lifestyle and reducing your risk of lung cancer is important to you. It is great that you are taking the first step in that process by showing interest in quitting smoking. I am curious, have you heard of lung cancer screening? If you are interested, I would be happy to discuss lung cancer screening in more detail.”
Summarizing the Session
At the end of the session, you will take time to review the session, the patient’s motivations, treatment goals, and next steps. This is a great opportunity to plant a seed about lung cancer screening.
Example: “It was great to talk with you today about your goals surrounding tobacco use, and I am excited to work with you to accomplish your goals. I know improving your health is important to you, and I was wondering if you’ve heard of lung cancer screening? Would you be interested in hearing a bit more about the screening?”
Key Takeaways for TTS
Remember, as a TTS it is not your role to go through the shared decision-making model or convince a patient to schedule a lung cancer screening. However, you can discuss the process and share that they may be eligible. You should educate patients about the screening guidelines, provide a brief overview of the benefits and risks, and encourage the patient to discuss screening options with their Primary Care Provider. In honor of the Great American Smokeout and Lung Cancer Awareness Month, take time this month to discuss how you can better provide education surrounding lung cancer screening to your patients.
Additional Resources About Lung Screening
For more information regarding lung cancer screening, please visit the links below.
To learn more about how to help your patients quit, check out one of our upcoming Duke-UNC TTS trainings:
Comprehensive Tobacco Treatment Specialist Training Program (offered three times per year)
Tobacco Treatment in Adolescent and Young Adult Populations CE Short Course (January 14, 2025)
Tobacco Dependence Pharmacotherapy CE Short Course (April 9, 2025)
Mindfulness Training for Smokers Facilitator Training CE Short Course (May 6, 2025)
Visit www.dukeunctts.com for more information or to register.
About the Author
Schuyler Griffin received her Masters of Science in Social Work from University of Tennessee Knoxville in 2022. While in graduate school, Schuyler received a certificate in gerontology studies and participated in a hospital program for interprofessional learning. Schuyler is a Licensed Clinical Social Worker Associate and an active member of the Association of Oncology Social Workers.
Schuyler provides evidenced-based tobacco cessation interventions to patients at the North Carolina Cancer Hospital. Schuyler previously worked as an oncology social worker, offering therapy and supportive counseling to patients and family members. Schuyler’s interests include research, motivational interviewing, mindfulness, strength-based approaches, and partnering with interdisciplinary teams.