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.