Q125) A 55 Year old man comes to your office with complaints of progressively shortness of breath on exertion for the past 3 months. Physical examination reveals scattered wheezes . Pulmonary function tests reveal irreversible obstructive pattern. The patient is started on tiotropium inhaler. His other medications include enalapril for hypertension and over-the-counter vitamin supplements that he routinely uses on a daily basis which include Vitamin A, Vitamin B-complex, Beta-carotene , Selenium and Vitamin E. Chest X-ray is consistent with chronic obstructive airway disease but did not reveal any lung nodules or masses. The patient is counselled about lung cancer risk and strongly counselled on cessation of smoking. In addition to counselling regarding smoking cessation, which of the following is the most important measure to reduce his lung cancer risk?

A) CT scan of the chest every year

B) Discontinue Vitamin E

C) Discontinue Selenium

D) Discontinue Beta Carotene

E) Start Vitamin D supplements for chemoprevention

Related Links : http://www.cancer.gov/cancertopics/pdq/prevention/lung/HealthProfessional#Section_113