Screening of People at High-Risk for Lung Cancer With Low Dose CT Scans Significantly Reduces Lung Cancer Deaths

American College of Radiology | November 5 – The National Cancer Institute (NCI) released initial results from a large-scale clinical trial evaluating whether lung cancer screening with low-dose helical computed tomography (CT) or standard chest X-rays saves lives.

Lung cancer, most frequently caused by cigarette smoking, is the leading cause of cancer-related deaths in the United States. It is expected to claim 157,300 lives in 2010. There are more than 94 million current and former smokers in the United States, many of whom are at high risk of lung cancer.

The American College of Radiology Imaging Network (ACRIN) and the Lung Screening Study group enrolled more than 53,000 current and former heavy smokers ages 55 to 74 into the National Lung Screening Trial (NLST) at 33 sites across the United States. The NLST, a randomized clinical trial, compared the effects of lung cancer screening with CT and X-ray on lung cancer mortality and found 20 percent fewer lung cancer deaths among trial participants screened with low-dose helical CT.  The NLST was sponsored by NCI, a part of the National Institutes of Health and is the largest randomized study of lung cancer screening in a high-risk population to date.

“Everyone who participated in this trial has played an important role in providing hard evidence of a mortality benefit from CT screening for lung cancer as well as a road map for public policy development in the future,” states Denise R. Aberle, MD, the national principal investigator for NLST ACRIN, site co-principal investigator for the UCLA NLST team and a deputy chair of ACRIN. Aberle, a member of the UCLA Jonsson Comprehensive Cancer Center, professor of Radiology and Bioengineering and vice chair for Research in Radiology at UCLA, also emphasizes “Given the high association between lung cancer and cigarette smoking, the single best way to prevent lung cancer deaths is to never start smoking, and if already smoking, to quit permanently.”

Starting in August 2002, participants were enrolled over a 20-month period and randomly assigned to receive three annual screens with either low-dose helical CT (often referred to as spiral CT) or a standard chest X-ray.  Helical CT uses X-rays to obtain a multiple-image scan of the entire chest compared to a standard chest X-ray that produces a single image of the whole chest in which anatomic structures overlie one another.


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