Grail, Inc. · NASDAQ:GRAL
Grail — BTS Winter Meeting 2023
17 slides from Grail's conference presentation, November 2023
Slide 1: The SUMMIT Study: Four-week quit rates amongst individuals referred to Stop Smoking Services
The SUMMIT Study: Four-week quit rates amongst individuals referred to Stop Smoking Services following attendance at a Lung Health Check A Bhamani1, E Katsampouris2, F Bojang3, JL Dickson1, C Horst1, S Tisi1, H Hall1, P Verghese1, A Creamer1, R Prendecki1, CR Khaw1, K Gyertson3, A Hacker4, L Farrell
Slide 2: Content
Content • Background to Lung Cancer Screening (LCS) and delivery of smoking cessation interventions in a LCS setting • The SUMMIT Study • Stop Smoking Service (SSS) referral pathway • Outcomes of referrals made to local SSS from the study • Discussion and conclusion
Slide 3: Introduction – Lung Cancer Screening
Introduction – Lung Cancer Screening • Lung cancer is the leading cause of cancer related mortality in the UK • Low-Dose Computed Tomography (LDCT) screening reduces lung cancer related mortality • NLST – 20% relative reduction • NELSON – 24% relative reduction (33% in female sub-group analysis) • 1
Slide 4: Tobacco smoking
Tobacco smoking • Estimated 86% of lung cancer deaths in the UK are caused by tobacco smoking (Cancer Research UK) • Additional association with vascular and respiratory disease • Estimated 4-5 million deaths a year worldwide* • Prevalence of cigarette smoking in the UK has fallen consistently since
Slide 5: Tobacco smoking in context of LCS
Tobacco smoking in context of LCS • Up to 55% of participants in LCS studies are reported to be people who currently smoke • Evidence from screening studies suggests increased motivation to stop smoking in such individuals • LCS visits provide a valuable opportunity for smoking cessation interventio
Slide 6: But…
But… • Unclear how such interventions are best provided in this setting • ATS multistakeholder committee (2017) recommendation: ‘a national research agenda should include strategies for implementing tobacco dependence treatment within the lung cancer screening setting’ • Action on Smoking and Health
Slide 7: Methods – the SUMMIT Study
Methods – the SUMMIT Study • Prospective observational cohort study which aims to assess the implementation of Low Dose Computed Tomography (LDCT) screening for lung cancer in a high- risk population in North Central and East London and validate a multi-cancer early detection blood test (NCT03934866
Slide 8: Methods
Methods • Eligibility for LCS via study participation assessed at baseline Lung Health Check (LHC) • Assessment of smoking history, including duration and average consumption, and current smoking status was included in the baseline LHC appointment • Questions explored both the use of cigarettes and
Slide 9: Smoking cessation referrals
Smoking cessation referrals • Current tobacco smokers = individuals smoking cigarettes on most days of the week, or smoking cigars, cigarillos, and pipes at least once per week at the time of the LHC • Very Brief Advice provided by the research nurse or clinical trials practitioner conducting the ap
Slide 10: Outcomes
Outcomes • Individual SSS contacted for aggregate outcomes for study referrals • Number of referrals received • Number of individuals who accepted the service, defined as those who agreed to be booked into a clinic appointment after being contacted • Number who declined support when contacted and th
Slide 11: Why four-week quit rate?
Why four-week quit rate? • Most people who smoke relapse within the first couple of days of a serious quit attempt • Prognosis for permanent cessation improves five-fold after the first four weeks • Four-week time frame therefore provides a reliable indicator of long-term abstinence • Current standa
Slide 12: Results – acceptance of appointment
Results – acceptance of appointment Total (n) Total (% of • Outcomes available for 742 referrals referrals across five SSS Total number of referrals 742 received) - with available outcome data • 47.3% (n=351/742) of individuals Number of individuals 351 47.3 accepted an appointment with the contacte
Slide 13: Results – outcomes after acceptance of appointment
Results – outcomes after acceptance of appointment • 65.5% (n=230/351) of those who accepted the service set a quit date • Four-week quit rate amongst these individuals was 57.4% (n=132/230) • 40.0% (n=92/230) did not quit • 2.6% (n=6/230) lost to follow-up • Four-week quit rate amongst all individu
Slide 14: Results
Results Total (n) Total (% of Total (% of Total (% of individuals who set individuals who referrals) a quit date) accepted the service) Total number of quit 230 - 65.5% 31.0% dates set Total number of four 132 57.4% 37.6% 17.8% weeks quits - overall Total number of four week 64 27.8% 18.2% 8.6% quit
Slide 15: Discussion
Discussion • 47% acceptance of appointment with SSS following referral • Two-thirds of individuals who accepted SSS appointment seriously attempted to quit by setting a quit date • Four-week quit rate amongst these individuals was 57% • Four-week quit rate amongst all individuals referred was 18% •
Slide 16: Conclusion
Conclusion • Longer term abstinence rates in SUMMIT being assessed • Our data suggests that ‘opt-out’ policies which proactively refer individuals who smoke tobacco to SSS following interaction with a LCS programme may be beneficial
Slide 17: Acknowledgements
Acknowledgements • Professor Sam Janes • Dr Neal Navani • Dr Samantha Quaife • SUMMIT Study team • Summit Study participants • GRAIL, LLC • University College London Hospitals NHS Foundation Trust • UCL Cancer Trials Centre