Appendix Table 2.

Risk of Bias Assessments From Systematic Reviews and Meta-Analyses Included in Literature Search

	Publication	Risk of Bias Assessment by 2022 Cochrane Review1	Risk of Bias Assessment by 2021 Review by Field et al.2	Risk of bias and overall quality Rating by USPSTF3
United States National Lung Screening Trial (NLST)	Aberle 20114, NLST 20195	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: Low Incomplete outcome data: Low Selective reporting: Low Other bias: Low	Randomization process: Low Deviations from intended intervention: Low Missing outcome data: Low Measurement of the outcome: Low Selective reporting: Low Overall: Low	Fair
German Lung Cancer Screening Intervention (LUSI)	Becker 20206	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: Unclear Incomplete outcome data: Low Selective reporting: Low Other bias: Low	Randomization process: Low Deviations from intended intervention: Low Missing outcome data: Low Measurement of the outcome: some concerns Selective reporting: Low Overall: some concerns	Fair
Multicentric Italian Lung Detection Trial (MILD)	Pastorino 20197	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: Low Incomplete outcome data: Low Selective reporting: Low Other bias: Low	Randomization process: High Deviations from intended intervention: some concerns Missing outcome data: Low Measurement of the outcome: Low Selective reporting: Low Overall: High	Poor
Dutch-Belgian Nederlands-Leuvens Longkanker Screenings Onderzoek trial (NELSON)	De Koning 20208	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: High Incomplete outcome data: Low Selective reporting: Low Other bias: High	Randomization process: Low Deviations from intended intervention: Low Missing outcome data: Low Measurement of the outcome: Low Selective reporting: Low Overall: Low	Not available
Italian Lung Cancer Screening trial (ITALUNG)	Paci 20179	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: Low Incomplete outcome data: Low Selective reporting: Low Other bias: Low	Randomization process: Low Deviations from intended intervention: Low Missing outcome data: Low Measurement of the outcome: Low Selective reporting: Low Overall: Low	Fair
UK Lung Cancer Screening Trial (UKLS)	Field 20212	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: Low Incomplete outcome data: Low Selective reporting: Low Other bias: High	Randomization process: Low Deviations from intended intervention: Low Missing outcome data: Low Measurement of the outcome: Low Selective reporting: Low Overall: Low	Not available
Italian Detection And screening of early lung cancer by Novel imaging TEchnology trial (DANTE)	Infante 201510	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: High Incomplete outcome data: Low Selective reporting: Low Other bias: High	Randomization process: some concerns Deviations from intended intervention: some concerns Missing outcome data: high Measurement of the outcome: Low Selective reporting: Low Overall: High	Fair
Danish Lung Cancer Screening Trial (DLCST)	Wille 201611	Random sequence generation: Low Allocation concealment: Low Blinding of participants of personnel: High Blinding of outcome assessment: Low Incomplete outcome data: Low Selective reporting: Low Other bias: Low	Randomization process: Low Deviations from intended intervention: some concerns Missing outcome data: Low Measurement of the outcome: Low Selective reporting: Low Overall: some concerns	Good