The document reviews two recent studies on the efficacy of lung cancer screening and smoking cessation interventions. The first study evaluates the cost-effectiveness of lung cancer screening combined with cessation support, finding it enhances screening program effectiveness. The second study compares a quitline strategy to provide information about lung cancer screening against traditional methods, concluding that the educational brochure approach is effective and affordable.

1. NOTES FOR TWO MORE RESEARCH ARTICLES1
The Effects of Smoking on Lung Cancer Rates among Adults in
New York
Pulla Rao Uppatala
MSc in Computer Science, King Graduate School
KG 604: Graduate Research & Critical Analysis
Dr. Aditi Puri
14 Nov 2022
New Research Article 1

2. Who: The assessment of cost-utility analysis of lung cancer
screening and the paybacks on integrating smoking cessation
interventions was performed by Villanti et al.
Why: This study aimed to assess whether LDCT screening for
lung cancer among commercially insured individuals between
50 and 64 years at high risk for this disorder is turning out to be
cost-effective. The authors also strived to quantify the extra
payback of integrating smoking cessation solutions within lung
cancer screening programs.
When: The authors analyzed their study in 2012 assuming that
all existing smokers and half of the prior smoker population
aged between 50 and 64 years were eligible for screening, with
the minimum being set at least thirty packs –years of smoking.
Where: The researchers used data from National Health
Interview Survey on cigarette smoking conditions for
individuals between 45 and 64 years who were making 30% of
active smokers across the United States at the time. The cancer
treatment costs were acquired from New York's taxpayer
database, which provided information including physician,
hospital, drug and ancillary costs eligible for insurer
reimbursement.
How: The authors used qualitative research methods to build up
on the prior simulation model to determine the utility cost of
yearly, recurring LDCT screenings for the last 15 years within
an assumed high-risk population of 18 million adults aged
between 50 and 64 years. It specifically involved those who
have consumed over 30 packs within their smoking history. The
authors' findings indicate that the recurring yearly lung cancer
screening within the high-risk population has been effective.
Providing smoking cessation strategies within the yearly
screening program has increased the cost-effectiveness of the
disorder by between 40 and 45%.

3. New Research Article 2
Who: The study on Using a smoking cessation quitline to
promote lung cancer screening was performed by Sharma et al.
Why: The goal of their study was to compare two alternatives to
dispense information concerning lung cancer screening. This
included a quitline, a mailed brochure pinned with in-depth
messaging facilitated by a quitline coach. Therefore, the authors
focused on assessing the strategy that will be effective and have
a significant impact on the participants searching for
information about lung cancer screening. The authors thus
hypothesized that the individuals who received the brochure
would report having spoken to their insurance company or
physician and compare it to those who only received the
brochure and made no contact.
When: The authors recruited their research participants in 2018
Where: The target population came from residents residing in
New York State but outside Niagara and Erie counties.
How: The authors performed a randomized trial involving New
York State Smokers Quitline respondents to determine the
impact of disseminating a brochure comprising information on
benefits, risks and costs related to lung cancer screening
compared to a brochure supplemented with phone-based and in-
depth messaging. The research findings identified that the
educational brochure was an effective and affordable strategy
for dispensing information regarding lung cancer screening.
References
Sharma, A., Bansal-Travers, M., Celestino, P., Fine, J., Reid,
M. E., Hyland, A., & O’Connor, R. (2018). Using a smoking

4. cessation quitline to promote lung cancer screening.
American journal of health behavior,
42(6), 85-100.
Villanti, A. C., Jiang, Y., Abrams, D. B., & Pyenson, B. S.
(2013). A cost-utility analysis of lung cancer screening and the
additional benefits of incorporating smoking cessation
interventions.
PloS one,
8(8), e71379.
Find a current event (e.g., story from a television show, news
report, or social media, etc.) related to one of the topics below.
· Mental health disorder (e.g., Autism, ADD/ADHD,
Depression, Bipolar, Anxiety, PTSD, Schizophrenia, etc.).
· Substance use disorder (e.g., alcohol, prescription
medications, street drugs, etc.).
In your discussion post,
300 words
· Share the link to the current event at the top of your post
(Note: it MUST be a link your classmates can open and view).
· Summarize the current event; include the wording used by the
author to describe the mental or substance use disorder.
· Discuss the back story of the person(s) involved in the event
(e.g., medical history, life-altering event, trauma, etc.) as
described by the source.
· Discuss any social, physical, and/or psychological behaviors
that are normally associated with the disorder described;
include any unique life stressors (e.g., relationships,
employment, housing, life event, etc.) that may have
contributed to the event.

5. · Prepare an APA-formatted reference at the end of your initial
discussion post for the source.
1
Discussion
Globally, lung cancer is the most common type of cancer that
contributes to most deaths. Sharma et al. (2018) reported that
the disease led death of more than 1.7 million in 2015,
particularly due to cigarette smoking. According to Villanti et
al. (2013), use of tobacco leads in terms of contribution to lung
cancer, with more than 70 percent of men and about 55 percent
of women dying of lung cancer as a result of smoking. A news
article by Grady (2015), points out that more than 42 million
Americans smoke, which includes 21% of men and 15% of
women. The article reveals that the rate of death among smokers
is two or three times higher than non-smokers, and they are
highly likely to die more than ten years before those who have
never smoked. These statistics clearly indicate that smoking
behavior significantly differs based on sex. In particular, men
smoke more pipes and cigars compared to women, which
explains why men are potentially predisposed to a greater risk
of developing cancer due to smoking. Substantial physiological
differences based on gender also lead to sex differences when it
comes to the impact of smoking, especially for women. In
particular, women have a different airway behavior and smaller
lung size compared to men, which increases their vulnerability
to lung cancer even when they smoke less than men do. Sharma
et al. (2018) also noted that the rate of lung cancer mortality
due to smoking is higher among men than women. Therefore, it
is inevitable that cigarette-smoking related lung cancer is
extremely common and a serious killer to the victims. The
population that is most vulnerable includes men and women
who smoke, including those exposed to second-hand smoking.

6. Mitigation
Medical research has been unable to establish a sure way
that may be utilized in preventing and mitigating lung cancer.
However, there are numerous ways that each individual may
need to practice as a way of lowering the risk of developing
lung cancer. For individuals who have never smoked, there is a
need to ensure that they avoid starting, which helps in ensuring
that they keep their lungs healthy, which lowers the risk of
developing lung cancer (Villanti et al., 2013). For smokers, it is
important to stop smoking. Smokers may need to consult a
healthcare professional for stop-smoking aids and strategies that
they leverage to quit smoking. Secondhand smoking is also a
major cause of lung cancer. Therefore, individuals who work or
live with a smoker should urge him/her to smoke outside or
quit. It is essential to avoid areas where people usually smoke
such as restaurants and bars. More importantly, non-smokers
should avoid carcinogens at their places of work, which
includes avoidance of exposure to toxic chemicals. Above all,
people who seek to keep lung cancer at bay should ensure that
they exercise regularly and eat a diet full of vegetables and
fruits.
Recommendation
Lack of exercise, being overweight, and smoking are
critical risk factors that increases the susceptibility of an
individual to lung cancer. For those who have already developed
smoking-related lung cancer, it is recommended that they quit
smoking the soonest possible (Villanti et al., 2013). A study
conducted by Sharma et al. (2018) revealed if a patient with
lung cancer continues to smoke during radiotherapy or
chemotherapy, their rate of survival is severely compromised
compared to those who quit smoking. This is because continued
smoking after an individual is diagnosed with lung cancer is
associated with such effects as reduced cancer treatment
efficacy, impaired healing, increased risk for cancer recurrence,
diminished general quality of life, impaired healing, and
decreased survival. According to O’Keeffe et al. (2018), after

7. lung cancer is diagnosed early, quitting smoking can go a long
way in helping victims survive longer as it serves to prevent the
disease becoming worse or delays return of the cancer. In
addition to quit smoking, smoking-related cancer patients
should consider such treatment alternatives as targeted therapy,
radiation therapy, chemotherapy, surgery, or a combination of
the alternatives. Surgery helps in the removal of the cancer
tissue while chemotherapy leverages specific medicines aimed
at killing or shrinking the cancer. Radiation therapy utilizes
high-energy rays in killing the cancer, with targeted therapy
involving use of drugs to hamper the spread or growth of cancer
cells.
References
Grady, D. (2015). Smoking’s toll on health is even worse than
previously thought, a study finds.
The New York Times.
https://www.nytimes.com/2015/02/12/health/smokings-
health-toll-worse-than-previously-thought-study-says.html

8. O’Keeffe, L. M., Taylor, G., Huxley, R. R., Mitchell, P.,
Woodward, M., & Peters, S. A. (2018). Smoking as a risk factor
for lung cancer in women and men: a systematic review and
meta-analysis.
BMJ open,
8(10), e021611.
http://dx.doi.org/10.1136/bmjopen-2018-021611
Sharma, A., Bansal-Travers, M., Celestino, P., Fine, J., Reid,
M. E., Hyland, A., & O’Connor, R. (2018). Using a smoking
cessation quitline to promote lung cancer screening.
American journal of health behavior,
42(6), 85-100.
https://doi.org/10.5993/AJHB.42.6.9
Villanti, A. C., Jiang, Y., Abrams, D. B., & Pyenson, B. S.
(2013). A cost-utility analysis of lung cancer screening and the
additional benefits of incorporating smoking cessation
interventions.
PloS one,
8(8), e71379.
https://doi.org/10.1371/journal.pone.0071379
The Effects of Anti-Cancer Drugs on Cancer Outcomes
Introduction
Cancer is a major cause of morbidity and mortality globally,
accounting for 9.5 million deaths as of 2018. Thyroid Cancer is
one of the most frequent endocrine malignancies, contributing
to 3.4 percent of all cancers in the United States each year
Indini et al.(2022). While there has been significant progress in
the development of new cancer treatments and the increase in
the use of anticancer drugs over the past few years, the side
effects of these drugs can be severe and sometimes life-
threatening. However, there is still a lack of evidence regarding
their efficacy and safety. As a result, it is critical to assess the
benefits and risks of these medications before hospitals use
them to treat cancer patients. This literature review aims to

9. assess the benefits and risks of anticancer medicines in patients
with advanced cancer. This literature study will aid in a deeper
understanding of these medications and their prospective usage
in cancer care.
Compare and Contrast
1. What articles have similarities in each section below?
a. Methodology
Silaghi et al. (2022) and Bachelard et al. (2021) conducted
systematic reviews and meta-analyses to investigate the risks
and advantages of anticancer medications in patients with
advanced cancer, as well as potential causes of resistance to
such treatments. Both investigations looked for clinical trials in
English written between the years 2000 through 2021 and
followed the PRISMA criteria. Indini et al. (2022) employed a
different technique conducting a systematic review of the
function of the mTOR and NAD pathways in malignancy
treatment, progression, and resistance. This study searched
Google Scholar, Scopus, PubMed, and Embase for English
language papers published between 2000 through 2021.
b. Findings
Anticancer medication usage was related to a considerable risk
of death in advanced cancer patients, according to Silaghi et al.
(2022) and Bachelard et al. (2021). However, the authors
discovered that these medications were linked to a considerable
increase in the likelihood of surviving for at least a year.
Furthermore, the researchers discovered that using these
medications was related to a considerable increase in the
likelihood of living for more than five years. Their findings
differed significantly from those of Indini et al. (2022), who
discovered that the mTOR and NAD paths are responsible for
drug resistance in malignant cells. Furthermore, the authors
discovered that these pathways might be possible targets for
future treatment methods.

10. c. Recommendations
Targeted therapy is recommended by Bachelard et al. (2021),
Indini et al. (2022), and Silaghi et al. (2022) as potential
therapeutic choices for individuals with advanced cancer who
have completed standard-of-care treatment. They also
emphasize the necessity of knowing medication resistance
mechanisms to design more effective targeted therapeutics.
Furthermore, they underline the need for trustworthy biomarkers
in guiding treatment decisions. Finally, they examine the
prospects of immunotherapeutic and combinatorial treatment as
resistance-busting techniques for targeted therapeutics.
2. What articles have differences in each section below?
a. Methodology
There are major discrepancies in technique between studies by
Bachelard et al.(2021) and Indini et al. (2022). Bachelard et
al.(2021) assessed the benefits and dangers of anticancer
medicines in advanced cancer patients using a meta-analysis and
systematic review. Indini et al.(2022) conducted a literature
review to find the most recent guidelines, clinical and
preclinical research, and novel perspectives in treating
advanced, malignant RAIR-DTC. Both Bachelard (2021) and
Indini et al. (2022) employed various databases and search
phrases. Such databases included PubMed, Google Scholar, and
Embase. Bachelard et al. (2021) explored clinical trials testing
Anti-cancer medications in adult patients with metastatic
tumors, whereas Indini et al. (2022) looked for publications
about DTC therapy and innovative therapeutic approaches. It is
also worth mentioning that Bachelard et al. (2021) included a
data meta-analysis, but Indini et al. (2022) did not; this is the
most likely because Bachelard (2021) was concerned with
assessing the effectiveness of anticancer medications. In
contrast, Indini et al. (2022) were concerned with locating the

11. most recent recommendations and research on the therapy of
DTC.
b. Findings
Indini et al. (2022) had different results than Silaghi et al.
(2022). While Indini et al. (2022) discovered that the mTOR and
NAD paths play a role in drug resistance development in
malignant cells, Silaghi et al. (2022) discovered that targeted
therapy is a viable therapeutic option for thyroid cancer.
c. Recommendations
When discussing therapy choices with advanced cancer patients,
Bachelard et al. (2021) propose that adverse effects documented
in clinical trials should be considered.
As prospective options for overcoming resistance, Indini et al.
(2022) propose combinatorial treatment, redifferentiation
therapy, targeting alternative pathways and immunotherapy.
Silaghi et al. (2022) propose targeted therapy for patients with
distinguishable thyroid carcinoma who have developed
resistanceto radioiodine treatment. They advocate salvage
treatment for patients who fail to respond to first-line Tyrosine
kinase inhibitors therapy.
References:
Indini, A., Fiorilla, I., Ponzone, L., Calautti, E., & Audrito, V.
(2022). NAD/NAMPT and mTOR pathways in melanoma:
Drivers of drug resistance and prospective therapeutic targets.
International Journal of Molecular Sciences, 23(17), 9985.
https://doi.org/10.3390/ijms23179985
Moreau Bachelard, C., Coquan, E., du Rusquec, P., Paoletti, X.,
& Le Tourneau, C. (2021). Risks and benefits of anticancer
drugs in advanced cancer patients: A systematic review and
meta-analysis. EClinicalMedicine, 40, 101130.
https://doi.org/10.1016/j.eclinm.2021.101130
Silaghi, H., Lozovanu, V., Georgescu, C. E., Pop, C., Nasui, B.
A., Cătoi, A. F., & Silaghi, C. A. (2022). State of the art in the

12. current management and future directions of targeted therapy
for differentiated thyroid cancer. International Journal of
Molecular Sciences, 23(7), 3470.
https://doi.org/10.3390/ijms23073470