November 24, 2010

National Lung Screening Trial (NLST) Initial Results

What is the NLST?
  • A multicenter, randomized controlled trial (RCT) comparing low-dose helical CT with standard chest radiography in the screening of men and women at risk for lung cancer
  • Sponsored by the National Cancer Institute
  • Starting in August 2002, the trial enrolled more than 53,000 participants, current or former heavy smokers, ages 55 to 74, at 33 sites over a 20 month period
  • Participants were randomly assigned to received 3 annual screens with either low-dose helical CT or standard chest radiograph. Endpoint = death from lung cancer
  • "Heavy smoker" = at least 30 pack-years and were either current or former smokers without signs, symptoms or history of lung cancer
  • "Low-dose CT" = helical CT with 120-140 kVp, 40-80 mAs, detector collimation equal to or less than 2.5 mm
Findings To Date
  • 354 deaths from lung cancer among participants in the CT arm of the study, v.s. 442 lung cancer deaths in the chest radiograph arm. 20% reduction in lung cancer mortality among participants screened with low-dose helical CT.
  • All-cause mortality (deaths due to any factor) was 7% lower in those screened with low-dose CT than in those with chest radiograph

Reference:
National Lung Screening Trial Research Team. The National Lung Screening Trial: overview and study design. Radiology 2010, published online before print on November 2, 2010.

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