HJAR Sep/Oct 2024

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2024 47 SamMakhoul, MD Medical Director, Clinical Research CARTI Healthcare providers must ensure that individuals under our care are well informed about the facts regarding tobacco use and disease occurrence, particularly the direct link between usage and increased can- cer risk. While it may sound like common sense, it is crucial to remind our patients that smoking is the leading cause of preventable disease, disability, and death worldwide, in- cluding lung cancer. Recently, the American Cancer Society identified cigarette smoking as the leading risk factor for cancer. The habit contributes to more than half of all potentially prevent- able cancers in men and 40% in women. In addition to significantly increasing cancer incidence and mortality rates, U.S. Centers for Disease Control and Prevention (CDC) states that smoking “causes diminished overall health, increased absenteeism from work and increased health care utilization and cost.” Despite marketing claims that e-ciga- rettes can serve as so-called “safe” cessa- tion aids, these products also have adverse health effects, including an association with higher lung cancer rates. This sum- mer, JAMANetwork Open, a journal of the AmericanMedical Association, reported that e-cigarettes are the “second most common- ly used tobacco product among US adults.” Yet two-thirds of users consider them “less harmful than combustible cigarettes.” Pa- tient education about the risks of these products is imperative. Now for the positives — tobacco cessa- tion can make a difference for our patients. CDC associates it with substantial gains in and lung cancer rates in Arkansas are de- creasing. However, there remains signifi- cant potential to save even more lives in our state. The data from organizations such as theAmerican Cancer Society, AMA, CDC, National Cancer Institute, and theAmerican Lung Association underscore the effective- ness of tobacco cessation and low-dose CT scans. At Carti, we are witnessing firsthand how focusing on patient empowerment can im- prove screening rates. Beyond providing educational resources and comprehensive support, we are dedicated to ensuring that eligible individuals have convenient access to low-dose CT scans. We now offer week- day appointments year-round and special weekend screening events each November for Lung Cancer Awareness Month. We aim to expand these opportunities to more com- munities as the need and patient demand grow. Take the time to discuss with your pa- tients whether they should undergo lung cancer screening. n Sam Makhoul, MD, is a hematologist/oncologist withmore than 20 years of experience and currently serves as themedical director of clinical research at CARTI, Arkansas’s largest community-based can- cer care provider. Under his direction, the clinical research teamseeks to build a network spanning the entire state and offers the newest life-saving treat- ment options available to all Arkansans. Before join- ing the CARTI team, he served at UAMS as the chief of hematology/oncology and the Laura Hutchins hematology/oncology chair. In addition, he helped develop the clinical research programat theWinthrop P.Rockefeller Cancer Institute and was the principal investigator of clinical trials. life expectancy and, if diagnosed with lung cancer, an improved prognosis and a lower recurrence rate. Regardless of the duration of smoking and the patient’s age, the Na- tional Cancer Institute found that cessa- tion substantially reduces an individual’s cancer risk. We can partly credit tobacco cessation for our nation’s steady decrease in lung cancer incidence and mortality rates. However, the American Lung Association also attributes this improvement to a greater use of low- dose CT scans. The organization states that “screening with annual low-dose CT scans can reduce the lung cancer death rate by up to 20%” through improved early detection and treatment. Yet, latent lifesaving opportunities re- main untapped. Despite the U.S. Preven- tive Services Task Force revising its 2021 recommendations for lung cancer screen- ing to include a broader age range, addi- tional smokers, and more women and Black women, fewer than 5% of those eligible are receiving low-dose CT scans in our state. That must change. We can and should do more to encour- age eligible Arkansans to get screened. As a part of our effort, we must ensure that all tobacco users understand the benefits of low-dose CT scans. The JAMA Network study mentioned earlier emphasizes the “importance of raising awareness and cor- recting misconceptions about e-cigarette use.” Former smokers who use e-cigarettes are at increased risk and should be screened when eligible. Through persistent effort, both smoking