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Low-dose computed tomography screening for lung cancer: results of the first screening round Evaluation of: National Lung Screening Trial Research Team, Church TR, Black WC, Aberle DR et al. Results of initial low-dose computed tomographic screening for lung cancer. N. Engl. J. Med. 368, 1980–1991 (2013). In 2011, the US NLST trial demonstrated that mortality from lung cancer can be reduced by using low-dose computed tomography (LDCT) screening rather than chest x-ray (CXR) screening. This paper from the US NLST research team focuses on the results of the initial round of LDCT for lung cancer. A total of 53,439 participants were included and randomly assigned to LDCT screening (n = 26,715) or CXR screening (n = 26,724). In total, 27.3% of the participants in the LDCT group and 9.2% in the CXR group had a positive screening result. As a result, 3.8% (LDCT group) and 5.7% (CXR group) of these subjects were diagnosed with lung cancer. The sensitivity (93.8%) and specificity (73.4%) for lung cancer were higher for LDCT compared with CXR screening; 73.5 and 91.3%, respectively. KEYWORDS: early detection of cancer n histology n lung neoplasms n neoplasm staging n predictive value of tests n tomography n x-ray computed tomography
In 2013, lung cancer is estimated to become the second most frequently diagnosed cancer and the most lethal cancer in both males and females [1]. Typically, lung cancer patients are diagnosed at an advanced disease stage and their survival remains poor [1]. Several lung cancer screening trials have been conducted to investigate whether early detection can reduce lung cancer-specific mortality [2–6]. In 2011, the US NLST trial demonstrated a 20% mortality reduction using low-dose computed tomography (LDCT) screening compared with chest x-ray (CXR) screening [7]. Nowadays, several prominent medical associations have recommended implementation of LDCT screening for high-risk subjects [8,9,101,102].
Nanda Horeweg*1,2, Kristiaan Nackaerts3, Matthijs Oudkerk4,5 & Harry J de Koning1 Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands 2 Department of Pulmonology, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands 3 Department of Pulmonary Medicine, University Hospital Gasthuisberg, Herestaat 49, 3000 Leuven, Belgium 4 Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands 5 Center for Medical Imaging – North East Netherlands, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands *Author for correspondence: Tel.: +31 107 038 468 Fax: +31 107 038 475 [email protected] 1
Methods & results
In the current paper, the NLST research team presents results of the initial screening round: screening test characteristics, diagnostic evaluation and treatment of all lung cancers diagnosed by screening or during the 1-year interval to the next screening round [10]. Asymptomatic 55–74-year-old men and women, who smoked ≥30 pack-years and were still smoking or had quit 500 mm³ or volume 50–500 mm³ and VDT
Low-dose computed tomography screening for lung cancer: results of the first screening round Evaluation of: National Lung Screening Trial Research Team, Church TR, Black WC, Aberle DR et al. Results of initial low-dose computed tomographic screening for lung cancer. N. Engl. J. Med. 368, 1980–1991 (2013). In 2011, the US NLST trial demonstrated that mortality from lung cancer can be reduced by using low-dose computed tomography (LDCT) screening rather than chest x-ray (CXR) screening. This paper from the US NLST research team focuses on the results of the initial round of LDCT for lung cancer. A total of 53,439 participants were included and randomly assigned to LDCT screening (n = 26,715) or CXR screening (n = 26,724). In total, 27.3% of the participants in the LDCT group and 9.2% in the CXR group had a positive screening result. As a result, 3.8% (LDCT group) and 5.7% (CXR group) of these subjects were diagnosed with lung cancer. The sensitivity (93.8%) and specificity (73.4%) for lung cancer were higher for LDCT compared with CXR screening; 73.5 and 91.3%, respectively. KEYWORDS: early detection of cancer n histology n lung neoplasms n neoplasm staging n predictive value of tests n tomography n x-ray computed tomography
In 2013, lung cancer is estimated to become the second most frequently diagnosed cancer and the most lethal cancer in both males and females [1]. Typically, lung cancer patients are diagnosed at an advanced disease stage and their survival remains poor [1]. Several lung cancer screening trials have been conducted to investigate whether early detection can reduce lung cancer-specific mortality [2–6]. In 2011, the US NLST trial demonstrated a 20% mortality reduction using low-dose computed tomography (LDCT) screening compared with chest x-ray (CXR) screening [7]. Nowadays, several prominent medical associations have recommended implementation of LDCT screening for high-risk subjects [8,9,101,102].
Nanda Horeweg*1,2, Kristiaan Nackaerts3, Matthijs Oudkerk4,5 & Harry J de Koning1 Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands 2 Department of Pulmonology, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands 3 Department of Pulmonary Medicine, University Hospital Gasthuisberg, Herestaat 49, 3000 Leuven, Belgium 4 Department of Radiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands 5 Center for Medical Imaging – North East Netherlands, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands *Author for correspondence: Tel.: +31 107 038 468 Fax: +31 107 038 475 [email protected] 1
Methods & results
In the current paper, the NLST research team presents results of the initial screening round: screening test characteristics, diagnostic evaluation and treatment of all lung cancers diagnosed by screening or during the 1-year interval to the next screening round [10]. Asymptomatic 55–74-year-old men and women, who smoked ≥30 pack-years and were still smoking or had quit 500 mm³ or volume 50–500 mm³ and VDT
