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Fernández-Blanco R, Rincón-García D, Valero-Alcaide R, Atín-Arratibel MA, De Miguel-Diez J, Corrochano-Cardona R, Torres-Castro R, Moro-Tejedor MN. Preoperative respiratory therapy in patients undergoing surgery for lung cancer: A randomized controlled trial. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2023; 28:e1973. [PMID: 36099408 DOI: 10.1002/pri.1973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 06/22/2022] [Accepted: 08/28/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND A preoperative respiratory therapy treatment was performed to analyze the effectiveness, with respect to postoperative air leak and pain, in patients undergoing surgery for lung cancer. OBJECTIVES To analyze air leakage and postoperative pain. MATERIAL AND METHODS Seventy one patients were studied, with a mean age of 62.58 years. Descriptive variables of gender, carcinogenic pathology, type of surgical incision and lung resection, use of glue and endostapler, and presence of adhesions were analyzed. Likewise, analysis of the quantitative variables of age, body mass index and forced expiratory volume in 1 s Two homogeneous groups resulted. Differentiated, experimental group (EG) that performed preoperative respiratory therapy and control group (CG). RESULTS There were statistically significant differences in favor of the EG with respect to postoperative air leak on days 1-2 during the performance of physiotherapy techniques, the food and during the performance of the exercises autonomously. Furthermore, differences in air leakage were observed on days 2-4 during gait. The number of patients decreased to a greater extent in the EG. Regarding pain, there were statistically significant differences in the sample on days 1-4, with greater intensity of pain in the CG and after doing physiotherapy every day except the second. CONCLUSIONS Preoperative respiratory therapy in patients undergoing surgery for lung cancer was effective in reducing the number of patients who presented postoperative air leak and reducing pain in the EG.
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Affiliation(s)
- Raquel Fernández-Blanco
- Department of Physical Therapy, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
| | - David Rincón-García
- Department of Thoracic Surgery, Hospital Universitario Jimenez Díaz, Madrid, Spain
| | - Raquel Valero-Alcaide
- Departamento de Medicina Física y Rehabilitación-Hidrología Médica, Universidad Complutense de Madrid, Madrid, Spain
| | - María Angeles Atín-Arratibel
- Department of Radiology, Rehabilitation, and Physical Therapy, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier De Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, Madrid, Spain
| | | | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, Spain
| | - Maria Nieves Moro-Tejedor
- Nursing Research Support Unit, Hospital General Universitario Gregorio Marañon, Madrid, Spain.,Red Cross University College of Nursing, Spanish Red Cross, Autonomous University of Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
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Implementing lung cancer screening in Europe: taking a systems approach. JTO Clin Res Rep 2022; 3:100329. [PMID: 35601926 PMCID: PMC9121320 DOI: 10.1016/j.jtocrr.2022.100329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 12/05/2022] Open
Abstract
Lung cancer is the leading cause of cancer death in Europe. Screening by means of low-dose computed tomography (LDCT) can shift detection to an earlier stage and reduce lung cancer mortality in high-risk individuals. However, to date, Poland, Croatia, Italy, and Romania are the only European countries to commit to large-scale implementation of targeted LDCT screening. Using a health systems approach, this article evaluates key factors needed to enable the successful implementation of screening programs across Europe. Recent literature on LDCT screening was reviewed for 10 countries (Belgium, Croatia, France, Germany, Italy, the Netherlands, Poland, Spain, Sweden, and United Kingdom) and complemented by 17 semistructured interviews with local experts. Research findings were mapped against a health systems framework adapted for lung cancer screening. The European policy landscape is highly variable, but potential barriers to implementation are similar across countries and consistent with those reported for other cancer screening programs. While consistent quality and safety of screening must be ensured across all screening centers, system factors are also important. These include appropriate data infrastructure, targeted recruitment methods that ensure equity in participation, sufficient capacity and workforce training, full integration of screening with multidisciplinary care pathways, and smoking cessation programs. Stigma and underlying perceptions of lung cancer as a self-inflicted condition are also important considerations. Building on decades of implementation research, governments now have a unique opportunity to establish effective, efficient, and equitable lung cancer screening programs adapted to their health systems, curbing the impact of lung cancer on their populations.
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Travier N, Fu M, Romaguera A, Martín-Cantera C, Fernández E, Vidal C, Garcia M. 6-Year Risk of Developing Lung Cancer in Spain: Analysis by Autonomous Communities. Arch Bronconeumol 2021; 57:521-527. [PMID: 35699029 DOI: 10.1016/j.arbr.2020.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/26/2020] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Lung cancer screening with low-dose computed tomography (LDCT) has been proposed as a strategy to reduce lung cancer mortality. Since LDCT has side effects there is a need to carefully select the target population for screening programmes. Because in Spain health competences are transferred to the seventeen Autonomous Communities (ACs), the present paper aims to identify individuals at high risk of developing lung cancer in the different ACs. METHODS We used the 2011-2012 data of the Spanish National Interview Health Survey (n=21,006) to estimate the proportion of individuals at high risk of developing lung cancer using a 6-year prediction model (PLCOm2012). This proportion was then extrapolated into absolute figures for the Spanish population, using the population census data of 2018 from the National Institute of Statistics. RESULTS The proportion of individuals aged 50-74 with a risk of lung cancer ≥2% was 9.5% (15.9% in men, 3.5% in women). This proportion ranged from 6.6% in Región de Murcia to 12.7% in Andalucía and 13.0% in Extremadura. When extrapolated to the Spanish population, it was estimated that a total of 1,341,483 individuals may have a 6-year risk of lung cancer ≥2%. CONCLUSIONS The present study is the first one that evaluated the number of individuals at high risk of developing lung cancer in the different Spanish ACs using a prediction model and selecting people with a 6-year risk ≥2%. Further studies should assess the cost and effectiveness associated to the implementation of a lung cancer screening programme to such population.
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Affiliation(s)
- Noemie Travier
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marcela Fu
- Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Amparo Romaguera
- Costa de Ponent Primary Care Directorate, Catalan Institute of Health, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Esteve Fernández
- Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Carmen Vidal
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Madrid, Spain.
| | - Montse Garcia
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Madrid, Spain.
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Travier N, Fu M, Romaguera A, Martín-Cantera C, Fernández E, Vidal C, Garcia M. 6-Year Risk of Developing Lung Cancer in Spain: Analysis by Autonomous Communities. Arch Bronconeumol 2020; 57:S0300-2896(20)30103-4. [PMID: 32402549 DOI: 10.1016/j.arbres.2020.03.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/18/2020] [Accepted: 03/26/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Lung cancer screening with low-dose computed tomography (LDCT) has been proposed as a strategy to reduce lung cancer mortality. Since LDCT has side effects there is a need to carefully select the target population for screening programmes. Because in Spain health competences are transferred to the seventeen Autonomous Communities (ACs), the present paper aims to identify individuals at high risk of developing lung cancer in the different ACs. METHODS We used the 2011-2012 data of the Spanish National Interview Health Survey (n=21,006) to estimate the proportion of individuals at high risk of developing lung cancer using a 6-year prediction model (PLCOm2012). This proportion was then extrapolated into absolute figures for the Spanish population, using the population census data of 2018 from the National Institute of Statistics. RESULTS The proportion of individuals aged 50-74 with a risk of lung cancer ≥2% was 9.5% (15.9% in men, 3.5% in women). This proportion ranged from 6.6% in Región de Murcia to 12.7% in Andalucía and 13.0% in Extremadura. When extrapolated to the Spanish population, it was estimated that a total of 1,341,483 individuals may have a 6-year risk of lung cancer ≥2%. CONCLUSIONS The present study is the first one that evaluated the number of individuals at high risk of developing lung cancer in the different Spanish ACs using a prediction model and selecting people with a 6-year risk ≥2%. Further studies should assess the cost and effectiveness associated to the implementation of a lung cancer screening programme to such population.
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Affiliation(s)
- Noemie Travier
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Marcela Fu
- Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Amparo Romaguera
- Costa de Ponent Primary Care Directorate, Catalan Institute of Health, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | - Esteve Fernández
- Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain
| | - Carmen Vidal
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Madrid, Spain.
| | - Montse Garcia
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Barcelona, Spain; Cancer Prevention and Control Group, Bellvitge Biomedical Research Institute - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBEResp), Madrid, Spain.
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Outcomes and cost of lung cancer patients treated surgically or medically in Catalunya: cost-benefit implications for lung cancer screening programs. Eur J Cancer Prev 2020; 29:486-492. [PMID: 32039928 DOI: 10.1097/cej.0000000000000566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Lung cancer screening programs with computed tomography of the chest reduce mortality by more than 20%. Yet, they have not been implemented widely because of logistic and cost implications. Here, we sought to: (1) use real-life data to compare the outcomes and cost of lung cancer patients with treated medically or surgically in our region and (2) from this data, estimate the cost-benefit ratio of a lung cancer screening program (CRIBAR) soon to be deployed in our region (Catalunya, Spain). We accessed the Catalan Health Surveillance System (CHSS) and analysed data of all patients with a first diagnosis of lung cancer between 1 January 2014 and 31 December 2016. Analysis was carried forward until 30 months (t = 30) after lung cancer diagnosis. Main results showed that: (1) surgically treated lung cancer patients have better survival and return earlier to regular home activities, use less healthcare related resources and cost less tax-payer money and (2) depending on incidence of lung cancer identified and treated in the program (1-2%), the return on investment for CRIBAR is expected to break even at 3-6 years, respectively, after its launch. Surgical treatment of lung cancer is cheaper and offers better outcomes. CRIBAR is estimated to be cost-effective soon after launch.
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Garrido López P, Gorospe Sarasúa L. A call for hope. RADIOLOGIA 2019. [DOI: 10.1016/j.rxeng.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Seijo LM, Trujillo JC, Zulueta JJ. Screening in Lung Cancer: The Latest Evidence. Arch Bronconeumol 2019; 56:7-8. [PMID: 31204006 DOI: 10.1016/j.arbres.2019.04.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/17/2019] [Accepted: 04/25/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Luis M Seijo
- Clínica Universidad de Navarra, Madrid, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, CIBERES, Instituto de Salud Carlos III, España.
| | - Juan Carlos Trujillo
- Hospital de la Santa Creu i Sant Pau, Barcelona, España; Coordinador Área de Oncología Torácica, SEPAR, España
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Martínez Pérez E, de Aguiar Quevedo K, Arrarás Martínez M, Cruz Mojarrieta J, Arana Fernández de Moya E, Barrios Benito M, Hinarejos Parga S, Cervera Deval J, Peñalver Cuesta JC. Lung Cancer Screening: Use of Low-Dose Computed Tomography. Arch Bronconeumol 2019; 55:526-531. [PMID: 31036378 DOI: 10.1016/j.arbres.2019.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 03/06/2019] [Accepted: 03/12/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The prognosis of lung cancer (LC) correlates directly with the stage of the disease at the time of diagnosis. MATERIAL AND METHODS We performed low-dose CT (LDCT) in asymptomatic individuals ≥50years old, smokers or former smokers of ≥10 pack-years, with no history of cancer. We followed an evaluation algorithm, according to the size and morphology of the nodules. The appropriate treatment for the LC diagnosis was given and patients were followed up for 5years. RESULTS We studied 4,951 individuals (65.4% males) with an average age of 56.89±5.26years; 550 presented nodules. Of the 3,891 nodules detected, 692 (19.57%) were considered positive, and 38 tumors (36LC) were identified. In the annual follow-up, nodules were found in 224 subjects, 288 (7.91%) of which were positive (13LC). In 80%, the study was performed with LDCT, and biopsy was indicated in 5.8% (baseline) and in 7.6% (annual) of the positive nodules. Prevalence was 0.89 and incidence was 0.1%. The sensitivity, specificity, PPV and NPV in the baseline study were 92.31, 89.54, 6.55 and 99.93%, respectively, and in the annual study, they were 76.92, 95.7, 4.52 and 99.94%, respectively. A total of 52 tumors were detected (49LC), 25 (52.08%) in stageI. The 5-year overall survival rate for LC was 58.5% and cancer-specific survival was 67.1% (75.8% in surgical patients). CONCLUSION LDCT integrated into an elaborate nodule detection and evaluation program is a useful tool for diagnosing early-stage LC.
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Affiliation(s)
- Encarnación Martínez Pérez
- Unidad de Neumología, Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, España.
| | | | | | - Julia Cruz Mojarrieta
- Servicio de Anatomía Patológica, Fundación Instituto Valenciano de Oncología, Valencia, España
| | | | - María Barrios Benito
- Servicio de Radiodiagnóstico, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - Susana Hinarejos Parga
- Unidad de Diagnóstico Precoz de Cáncer de Pulmón, Fundación Instituto Valenciano de Oncología, Valencia, España
| | - José Cervera Deval
- Servicio de Radiodiagnóstico, Fundación Instituto Valenciano de Oncología, Valencia, España
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Fu M, Travier N, Martín-Sánchez JC, Martínez-Sánchez JM, Vidal C, Garcia M. Identifying high-risk individuals for lung cancer screening: Going beyond NLST criteria. PLoS One 2018; 13:e0195441. [PMID: 29621354 PMCID: PMC5886563 DOI: 10.1371/journal.pone.0195441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 03/22/2018] [Indexed: 12/18/2022] Open
Abstract
Background There are two main types of strategies to identify target population for lung cancer screening: 1) strategies based on age and cumulative smoking criteria, 2) risk prediction models allowing the calculation of an individual risk. The objective of this study was to compare different strategies to identify the proportion of the Spanish population at high risk of developing lung cancer, susceptible to be included in a lung cancer screening programme. Methods Cross-sectional study. We used the data of the Spanish National Interview Health Survey (ENSE) of 2011–2012 (21,006 individuals) to estimate the proportion of participants at high risk of developing lung cancer. This estimation was performed using the U.S. national lung screening trial (NLST) criteria and a 6-year prediction model (PLCOm2012), both independently and in combination. Results The prevalence of individuals at high risk of developing lung cancer according to the NLST criteria was 4.9% (7.9% for men, 2.4% for women). Among the 1,034 subjects who met the NLST criteria, 533 (427 men and 106 women) had a 6-year lung cancer risk ≥2.0%. The combination of these two selection strategies showed that 2.5% of the Spanish population had a high risk of developing lung cancer. However, this selection process did not take into account different groups of subjects <75 years old having an individual risk of lung cancer ≥2%, such as heavy smokers <55 years old who were long-time former smokers, and ever-smokers having smoked <30 pack-years with other risk factors. Conclusions Further research is needed to determine which selection strategy achieves a higher benefit/harm ratio and to assess other prevention strategies for individuals with elevated risk for lung cancer but who do not meet the screening eligibility criteria.
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Affiliation(s)
- Marcela Fu
- Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Llobregat, Spain
| | - Noémie Travier
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Llobregat, Spain
| | - Juan Carlos Martín-Sánchez
- Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Jose M. Martínez-Sánchez
- Tobacco Control Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Llobregat, Spain
- Group of Evaluation of Health Determinants and Health Policies, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Carmen Vidal
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Llobregat, Spain
- * E-mail: (CV); (MG)
| | - Montse Garcia
- Cancer Screening Unit, Cancer Prevention and Control Programme, Catalan Institute of Oncology-IDIBELL, L’Hospitalet de Llobregat, Llobregat, Spain
- * E-mail: (CV); (MG)
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