Study | Patients n | Inclusion criteria | Screening modalities | Main results |
National Lung Screening Trial [7] | 53 454 | Age: 55–74 years Sex: male and female Smoking status: history of cigarette smoking of at least 30 pack-years, and, if former smokers, had quit within the previous 15 years Country: USA | Three annual screenings with LDCT OR three annual screenings with single view postero-anterior chest radiography | Relative reduction in mortality from lung cancer with LDCT screening of 20.0% (95% CI 6.8–26.7; p=0.004) Reduction of death from any cause in the LDCT group, as compared with the radiography group, by 6.7% (95% CI 1.2–13.6; p=0.02) |
UK Lung Cancer Screening [8] | 4055 | Age: 50–75 years Sex: male and female Smoking status: 5-year lung cancer risk ≥5%, based on the LLPv2 risk prediction model# Country: UK | Single thoracic LDCT scan OR usual care | Pilot study concluding that lung cancer screening is feasible in the UK in the target population |
Lung Cancer Screening Intervention [9] | 4052 | Age: 50–69 years Sex: male and female Smoking status: at least 25 years smoking of at least 15 cigarettes per day, or at least 30 years smoking of at least 10 cigarettes per day, including ex-smokers who had stopped smoking ≤10 years Country: Germany | Five annual screenings with LDCT OR no screening | HR for lung cancer mortality 0.74 (95% CI 0.46–1.19; p=0.21) among men and women combined Modelling by sex: statistically significant reduction in lung cancer mortality among women (HR 0.31 (95% CI 0.10–0.96); p=0.04), but not among men (HR 0.94 (95% CI 0.54–1.61); p=0.81) |
NELSON [10] | 13 195 | Age: 50–74 years Sex: male Smoking status: current or former smokers (those who had quit ≤10 years ago) who had smoked >15 cigarettes a day for >25 years or >10 cigarettes a day for >30 years Countries: Netherlands, Belgium | Four screens with LDCT at baseline, year 1, year 3 and year 5.5 OR no screening | Cumulative rate ratio for death from lung cancer at 10 years 0.76 (95% CI 0.61–0.94; p=0.01) in the screening group as compared with the control group |
LDCT: low-dose computed tomography. #: LLPv2 risk model includes age, sex, smoking duration (cigarettes, pipe and cigars), previous history of respiratory diseases (COPD, emphysema, bronchitis, pneumonia, tuberculosis), history of previous cancer, family history (early/late onset) and exposure to asbestos.