Table 1.
Selected lung cancer screening studies
| Study | Interventions | Overall follow-up, years | Participants, n | Inclusion criteria | Primary outcome |
|---|---|---|---|---|---|
| NLST 19,20 | LDCT vs. CXR | 7.4 | 53,454 | Age 55–75 years, ≥30 pack-years, <10 years ex-smoker | LDCT decreased lung cancer-related mortality (HR = 0.80; P < 0.004) |
| NELSON 18,21,22 | LDCT vs. no intervention | 10 | 15,789 | Age 55–75 years, ≥15 pack-years, <10 years ex-smoker | LDCT decreased lung cancer-related mortality (HR = 0.76; 95% CI 0.62-0.94 in men) |
| DANTE 23,24 | LDCT vs. no intervention | 8.35 (median) | 2,811 | Age 60–74 years, ≥20 pack-years, <10 years ex-smoker | A non-significant decrease was observed in lung cancer-related mortality (HR = 0.99) |
| DLCST 22,25,26 | LDCT vs. CXR | 10 | 4,104 | Age 50–70 years, ≥20 pack-years, <10 years ex-smoker | A non-significant decrease was observed in lung cancer-related mortality (HR = 1.03) |
| MILD 27,28 | LDCT vs. no intervention | 10 | 4,099 | Age ≥49 years, ≥20 pack-years, <15 years ex-smoker | LDCT decreased cumulative risk of 10-year lung cancer-related mortality (HR = 0.61; P = 0.02) |
| LUSI 29 | LDCT vs. no intervention | 8.8 (median) | 4,052 | Age 50–69 years, ≥15 pack-years, <10 years ex-smoker | LDCT decreased lung cancer-related mortality only in women (HR = 0.31; P = 0.04) |
| UKLS 59,169 | LDCT vs. no intervention | 10 | 4,055 | Age 50–75 years, LLPv2-defined 5-year lung cancer risk ≥5% | 67% of stage I lung cancers were detected in the screening arm; mortality results to be published |
| ITALUNG 22,165,170,171 | LDCT vs. no intervention | 8.5 (median) | 3,206 | Age 55–69 years, ≥20 pack-years, <10 years ex-smoker | A non-significant decrease was observed in lung cancer-related mortality (HR = 0.7) |
| DEPISCAN 30 | LDCT vs. CXR | 4 | 765 | Age 50–75 years, ≥15 pack-years, <15 years ex-smoker | LDCT enabled the detection of more lung cancers than CXR (8 vs. 1) |
| Beijing I-ELCAP cohort 38 | LDCT | 5 | 4,690 | Age ≥40 years, without cancer history within 5 years | The diagnosis rate of lung cancer by LDCT was 76.0%, and most of the cancers were detected in an early stage |
| Shanghai ChestHosp RCT 41 | LDCT vs. usual care | 2 | 6,717 | Age 45–70 years, ≥20 pack-years, <15 years ex-smoker | LDCT led to a 74.1% increase in detection of early-stage lung cancer |
| Shanghai CancerHosp cohort 172 | LDCT | 1 | 11,332 | Age 50-80 years, ≥20 pack-years, <5 years ex-smoker | LDCT improved the early diagnosis rate of lung cancer in both smokers and nonsmokers |
| Shanghai-ChangzhengHosp cohort 43 | LDCT | 2 | 14,506 | Age >35 years, asymptomatic participants | The incidental detection rate for stage I lung cancer was 0.97% |
| Anti-Lung Cancer Association Project 173 | LDCT vs. CXR vs. sputum cytology | 7 | 1,611 | Age ≥40 years, asymptomatic participants | The proportions of positive tests were 9.1%, 2.6%, and 0.7% with low-dose helical CT, chest X-ray, and sputum cytology |
| Mass screening for lung cancer with mobile spiral computed tomography scanner 15,174 | LDCT | 5 | 5,438 | Age 40–74 years | The lung-cancer detection rate with CT was 0.48%, significantly higher than the 0.03%–0.05% for standard mass assessments previously performed in the same geographic area |
| Hitachi Employee’s Health Insurance Group program 175 | LDCT | 3 | 7,956 | Age 50–69 years | The prevalence was 0.44% among all participants from baseline, and 0.07% from repeated screening |
| Hitachi lung cancer screening program 44 | LDCT vs. CXR | 6 | 17,935 | Aged 50–64 years, <30 pack-years | LDCT decreased lung cancer-related mortality (HR = 0.76; P < 0.001) |
| Samsung Medical Center program 176 | LDCT | 5 | 6,406 | Age ≥45 years, asymptomatic participants | LDCT helped detect early-stage lung cancer in an asymptomatic Korean population, with a detection rate of 0.36% |
| K-LUCAS Project 177 | LDCT | 1 | 256 | Age 55–75 years, ≥30 pack-years, <10 years ex-smoker | 7.4% of participants exhibited positive findings |
CI, confidence interval; CXR, chest X-ray; DANTE, Detection and screening of early lung cancer with novel imaging technology; DEPISCAN, french randomized pilot trial of lung cancer screening comparing low-dose CT scan and chest X-ray; DLCST, Danish lung cancer screening trial; HR, hazard ratio; ITALUNG, italian lung cancer screening trial; LDCT, low-dose computed tomography; LUSI, german lung cancer screening intervention; K-LUCAS, korean lung cancer screening; MILD, multi-centric Italian lung detection; NELSON, Dutch-Belgian randomized lung cancer screening trial; NLST, national lung screening trial; UKLS, UK lung cancer screening trial.