News | February 17, 2015

European Lung Cancer Screening Trial Results Can Infer Effects of Population-Based Screening

Study compares baseline characteristics of participants, eligible non-participants for low dose computed tomography screening

CT systems, computed tomography, lung cancer, study, screening, Europe

February 17, 2015 — Results of the NELSON lung cancer screening trial using low dose computed tomography (LDCT) can be used to predict the effect of population-based screening on the Dutch population. Researchers say the study results — which were published in the Journal of Thoracic Oncology — can be used even though there were slight differences in baseline characteristics of participants in the control arm versus eligible non-participants.

In the United States, the National Lung Screening Trial (NLST) showed that lung cancer screening with LDCT can reduce lung cancer mortality by 20 percent compared to chest X-ray for a high-risk population defined as current or former smokers with at least a 30 pack-year history and an age of 55-74 years. In Europe, the ongoing Dutch-Belgian lung cancer screening trial (NELSON) investigated whether screening with LDCT can reduce lung cancer mortality by at least 25 percent compared to no screening at 10 years of follow-up for individuals aged 50-75 years with a smoking history of 15 cigarettes per day for 25 years or 10 cigarettes for 30 years, and were still smoking or had quit 10 years ago. It is important when interpreting the results of screening studies to know whether study participants are representative of the target population, since there may be selection bias in the volunteers who are willing to participate in screening programs.

In the NELSON trial individuals at high risk for lung cancer were identified by sending a health questionnaire to 606,409 persons aged 50-74. Of those that responded, 30,051 eligible subjects received an invitation to participate with 15,822 accepting and randomized to either LDCT (N=7,915) or control (N=7,907). The remaining individuals were defined as eligible non-responders (non-participants), and in this sub-study of the NELSON trial the baseline characteristics and mortality profiles of eligible non-participants (N=13,670) were compared to the control arm (N=7,453).

The results show that the control participants of the NELSON trial were statistically younger, had better self-reported health, were more physically active, higher educated, and more often former smokers compared to eligible non-participants, although the actual numerical differences were minimal. Eligible non-participants had a higher all-cause mortality rate and mortality due to cardiovascular, respiratory, and non-cancerous diseases. However, the relative proportion of subjects that died due to all types of cancer was higher among participants.

The authors noted that "so far no large lung screening trial using LDCT has studied the differences in baseline characteristics and potential effect on mortality profiles between participants and eligible non-participants. While the distribution of participant characteristics in the NELSON study suggest that the study population is somewhat younger, healthier (e.g. more physically active, less current smokers), higher educated and has a slightly different mortality rate profiles, these differences are modest and therefore it seems unlikely that these differences will influence the generalizability of the main results of the NELSON trial to the target population."

For more information: www.iaslc.org

Related Content

Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Smartphone Addiction Creates Imbalance in Brain
News | Mobile Devices | January 11, 2018
Researchers have found an imbalance in the brain chemistry of young people addicted to smartphones and the internet,...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Minimally Invasive Treatment Provides Relief from Back Pain

Lumbar spine MRI showing disc herniation and nerve root at baseline and one month after treatment

News | Interventional Radiology | January 11, 2018
The majority of patients were pain free after receiving a new image-guided pulsed radiofrequency treatment for low back...
Emergency Radiologists See Inner Toll of Opioid Use Disorders

Rates of Imaging Positivity for IV-SUDs Complications. Image courtesy of Efren J. Flores, M.D.

News | Clinical Study | January 11, 2018
January 11, 2018 – Emergency radiologists are seeing a high prevalence of patients with complications related to opio
CT Shows Enlarged Aortas in Former Pro Football Players

3-D rendering from a cardiac CT dataset demonstrating mild dilation of the ascending aorta.

News | Computed Tomography (CT) | January 11, 2018
Former National Football League (NFL) players are more likely to have enlarged aortas, a condition that may put them at...
Study Finds No Evidence that Gadolinium Causes Neurologic Harm

MR images through, A, C, E, basal ganglia and, B, D, F, posterior fossa at level of dentate nucleus. Images are shown for, A, B, control group patient 4, and the, C, D, first and, E, F, last examinations performed in contrast group patient 13. Regions of interest used in quantification of signal intensity are shown as dashed lines for globus pallidus (green), thalamus (blue), dentate nucleus (yellow), and pons (red).

News | Contrast Media | January 11, 2018
January 11, 2018 — There is no evidence that accumulation in the brain of the element gadolinium speeds cognitive dec

Size comparison between 3-D printed prosthesis implant and a penny.

News | 3-D Printing | January 11, 2018
January 11, 2018 — Researchers using...
RSNA 2017 technical exhibits, expo floor, showing new radiology technology advances.
Feature | RSNA 2017 | January 11, 2018
January 11, 2018 — Here is a list of some of the key clinical study presentations, articles on trends and videos from
Hip Steroid Injections Associated with Bone Changes

58-year-old woman with left hip pain. X-ray from one month prior to the steroid/anesthetic injection demonstrates moderate joint space narrowing (arrows) and bony proliferation (arrowheads).

News | Orthopedic Imaging | January 11, 2018
January 11, 2018 – Osteoarthritis patients who received a steroid injection in the hip had a significantly greater in
Overlay Init