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Lung cancer screening trial shows screening with CT scans reduces lung cancer deaths
Date:6/29/2011

imately found to be cancer. The authors report, "During the screening phase of the trial, 39.1 percent of participants in the low-dose helical CT arm and 16.0 percent of those in the chest X-ray arm had a positive screening result. Across all three screening examination rounds, when a positive result was found, 96.4 percent of the low-dose helical CT and 94.5 percent of the chest X-ray examinations were false-positive." William C. Black, MD, chair of the ACRIN Outcomes and Economics Committee and NLST site principal investigator at Dartmouth-Hitchcock Medical Center comments, "The follow-up for positive screening examinations most frequently involved further imaging tests and the data show that follow-up with invasive procedures was uncommon. We also found that lower rates of follow-up resulting from a positive scan occurred at later screening rounds." The vast majority of false-positive results were probably due to the detection of normal lymph nodes or inflamed tissues.

Adverse events (harms resulting from the actual screening examinations) were few and relatively minor in the NLST. The rate of complications among participants who underwent a diagnostic evaluation prompted by a positive screening was under 2 percent for either type of screening.

"Although the NLST provides definitive evidence about the effectiveness of low-dose helical CT screening for lung cancer, significant further work is required to answer questions critical for the development of public policy recommendations," says Constantine Gatsonis, Ph.D., the director of the ACRIN Biostatistics and Data Management Center, and chair of biostatistics in the public health program of the Warren Alpert Medical School of Brown University. Additional studies based on NLST datato include the use of statistical modelingwill determine important information about which patient risk profiles, screening regimens and positive screen criteria result in the greatest screening benefit. As Gatsonis emp
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Contact: Shawn Farley
PR@acr.org
703-648-8936
American College of Radiology
Source:Eurekalert

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