| Design | Randomised controlled trial |
|---|---|
| Treatment | Volume CT screening at intervals |
| Control | No screening |
| Population | High-risk men and women in the Netherlands and Belgium |
| Follow-up | 10 years |
| Primary endpoint | Lung cancer mortality |
| Result | At 10 years, lung cancer incidence was 5.58 per 1000 person-years in the screening group versus 4.91 in controls, and lung cancer mortality was significantly lower with screening. Average adherence among men was 90.0%. Only 9.2% underwent an additional indeterminate-result CT, and the referral rate for suspicious nodules was 2.1%. |
| Secondary endpoints | Referral rate, stage distribution, all-cause mortality |
In this trial involving high-risk persons, lung-cancer mortality was significantly lower among those who underwent volume CT screening than among those who underwent no screening. There were low rates of follow-up procedures for results suggestive of lung cancer.
The trial authors, in the published abstract
The trial that made lung cancer screening deliverable. Comparing against no screening rather than radiography, and using volumetric nodule growth rather than diameter, it cut the referral rate from NLST's 24% of positives to 2.1% — the difference between a programme that overwhelms services and one that does not.
de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial. N Engl J Med 2020 Feb 6;382(6):503-513.