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Low-dose CT screening (LCS) for lung cancer reduces 10-year lung cancer mortality
The outcome of the Dutch-Belgian Nederlands-Leuvens Longkanker Screenings Onderzoek (NELSON) trial has been much anticipated. Powered to detect a mortality benefit of LCS in patients at high risk of lung cancer, De Koning et al (N Engl J Med 2020; 382:503) report the lung cancer mortality results after 10-year follow-up of participants enrolled to NELSON, a population-based, LCS randomised controlled trial. The primary analysis included 13 195 men, with a subgroup analysis in 2594 women, aged 50–74 years who were current or former smokers. Patients were randomised 1:1 to receive four CT screening rounds (at baseline, 1, 3 and 5.5 years) or no screening. Data on lung cancer diagnosis and death were collected through National Registries. Lung cancer mortality was significantly lower in those who underwent CT screening compared with no screening, with benefits higher than previously demonstrated. In men, a 24% reduction in lung cancer mortality at 10 years was seen in the screened group compared with the control (rate ratio (RR) 0.76, 95% CI 0.61 to 0.94, p=0.01). The subgroup analysis in women suggests an even greater benefit of up to 33% (RR 0.67, 95% CI 0.38 to 1.14). The …
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Commissioned; internally peer reviewed.
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