Does Early CT Screening for Lung Cancer Reduce Mortality?
Posted: Wednesday, October 31, 2018
Computed tomography (CT) screening for asymptomatic men at a high risk for lung cancer led to a 26% reduction in lung cancer deaths at 10 years of study follow-up, according to findings from the NELSON study. Harry J. De Koning, MD, PhD, of Erasmus MC, the Netherlands, presented these results during the plenary session at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) in Toronto (Abstract PL02.05) and published in the Journal of Thoracic Oncology. The investigators believe their study results “should be used to inform and direct future CT screening in the world.”
“These findings show that CT screenings are an effective way to assess lung nodules in people at high risk for lung cancer, often leading to detection of suspicious nodules and subsequent surgical intervention at relatively low rates and with few false-positives,” said Dr. De Koning in a press release.
The population-based, controlled study included 15,792 people who were randomly assigned 1:1 for the study and control arms. The study arm was offered CT screenings at 1, 3, and 5.5 years, and no screenings were offered to the control group.
The study found an average 94% CT screening compliance rate, amounting to 29,736 scans. Within 2 months for 9.3% of the participants, additional CT scans were used to determine nodule volume doubling time, which led to an overall referral rate of 2.3% for suspicious nodules. Detection rates varied between 0.8% and 1.1%, and 69% of screen-detected lung cancers were detected at stage IA or IB. Records detected 261 lung cancers before the fourth round of follow-ups. Surgical treatment was three times more prevalent in study patients than in control patients (67.7% vs. 24.5%, P < .001), in a subset of analyzed patients.