| Design | Randomised controlled trial |
|---|---|
| Treatment | Three annual rounds of low-dose CT screening |
| Control | Three annual rounds of chest radiography |
| Population | 53454 people at high risk of lung cancer |
| Follow-up | Median 6.5 years |
| Primary endpoint | Lung cancer mortality |
| Result | Screening with low-dose CT reduced lung cancer mortality. Adherence exceeded 90%. Positive screens occurred in 24.2% with low-dose CT versus 6.9% with radiography, and 96.4% of positive low-dose CT results were false positives. Lung cancer incidence was 645 per 100,000 person-years in the CT group. |
| Secondary endpoints | All-cause mortality, false-positive rate, downstream investigation |
Screening with the use of low-dose CT reduces mortality from lung cancer.
The trial authors, in the published abstract
Established CT screening and, in the same breath, its central problem: nearly all positive scans were false. NELSON later showed that volumetric nodule assessment brings the referral rate down to 2.1%, which is what makes population screening tolerable in practice.
Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011 Aug 4;365(5):395-409.