- Persistent lung cancer risk: Lung cancer incidence and mortality remain elevated in former smokers even after long-term cessation, independent of quit duration.
- Competing mortality remains elevated: Former smokers who previously met screening criteria continue to have higher other-cause mortality than never smokers, though lower than current smokers.
- Age at quitting matters: Quitting before age 30 (men) or 40 (women) eliminates excess other-cause mortality, whereas later cessation is associated with progressively higher risk.
- Past-eligible smokers resemble younger eligible smokers: Older former smokers who are no longer eligible based on quit time have mortality profiles similar to younger current-eligible smokers, challenging fixed cessation cutoffs.
- Implications for screening policy: Findings suggest that stopping screening based solely on years since quitting may be insufficient, but the study does not evaluate screening benefits, harms, or cost-effectiveness.
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