Lung Cancer Mortality Decreased by Early Screenings

What if one simple thing could decrease your mortality risk from lung cancer by 26%? Or by 61%? Amazingly, a screening chest CT scan can lower mortality by 26% for men and by 61% for women, according to a large randomized European study called NELSON.

Harry J. de Koning, MD, Ph.D., of Erasmus Medical Center in Rotterdam, The Netherlands, reported the results of the study at the World Conference on Lung Cancer.

In the study, investigators in The Netherlands and Belgium recruited participants from population registries, submitting questionnaires to those who fell into the high-risk category for developing lung cancer. These were individuals between 50 and 74 years of age who had smoked 10 or more cigarettes a day for 30 years or at least 15 cigarettes daily for 25 years, and had ceased smoking within the past 10 years. A total of 15,792 participants who met the criteria were studied.

The group was divided into two groups that were balanced with respect to age, sex, smoking history, and smoking cessation. One group had chest CT imaging in the first and second years of the trial and again at 4 and 6.5 years, with follow-up to year 10. The second group did not have chest CT imaging.

During the term of the study, about 400 lung cancers were diagnosed in the screened group versus 350 in the group that had no screenings. About 50% of the cancers in the screened group were at stage Ia at diagnosis; almost 70% were between stages 1a and II.  These are stages where most cancers can be cured. By contrast, in the group that had no screenings, about 70% of the cancers had reached stage III/IV at diagnosis, stages at which cure is much less likely.

The unscreened group of participants had a significantly higher mortality rate than the screened group; 214 patients died, as opposed to 147 patients who were screened.

The NELSON study was preceded by a similar study, the landmark National Lung Screening Trial (NLST), which also showed reductions in lung cancer mortality among the trial group that had screenings.

Said John Fields, Ph.D., of the University of Liverpool in England, “There is now conclusive evidence for implementation of lung cancer screening based on two large randomized controlled trials.”

Information for this article was obtained from MedPage Today.

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