Characteristics of lung cancers detected by computer tomography screening in the randomized NELSON trial
- PMID: 23348977
- DOI: 10.1164/rccm.201209-1651OC
Characteristics of lung cancers detected by computer tomography screening in the randomized NELSON trial
Abstract
Rationale: The NELSON (Nederlands Leuvens Longkanker Screenings Onderzoek) trial is, with 15,822 participants, the largest European lung cancer computer tomography screening trial. A volumetry-based screening strategy, stringent criteria for a positive screening, and an increasing length of screening interval are particular features of the NELSON trial.
Objectives: To determine the effect of stringent referral criteria and increasing screening interval on the characteristics of screen-detected lung cancers, and to compare this across screening rounds, between sexes, and with other screening trials.
Methods: All NELSON participants with screen-detected lung cancer in the first three rounds were included. Lung cancer stage at diagnosis, histological subtype, and tumor localization were compared between the screening rounds, the sexes, and with other screening trials.
Measurements and main results: In the first three screening rounds, 200 participants were diagnosed with 209 lung cancers. Of these lung cancers, 70.8% were diagnosed at stage I and 8.1% at stage IIIB-IV, and 51.2% were adenocarcinomas. There was no significant difference in cancer stage, histology, or tumor localization across the screening rounds. Women were diagnosed at a significantly more favorable cancer stage than men. Compared with other trials, the screen-detected lung cancers of the NELSON trial were relatively more often diagnosed at stage I and less often at stage IIIB-IV.
Conclusions: Despite stringent criteria for a positive screening, an increasing length of screening interval, and few female participants, the screening strategy of the NELSON trial resulted in a favorable cancer stage distribution at diagnosis, which is essential for the effectiveness of our screening strategy. Clinical trial registered with www.trialregister.nl (ISRCTN63545820).
Comment in
-
Favorable stage distribution in the NELSON trial: promise or hype?Am J Respir Crit Care Med. 2013 Apr 15;187(8):792-3. doi: 10.1164/rccm.201302-0314ED. Am J Respir Crit Care Med. 2013. PMID: 23586379 No abstract available.
-
Stage shift in computed tomography screening: possible role of indolent cancers, "histology shift," and overdiagnosis.Am J Respir Crit Care Med. 2013 Oct 15;188(8):1034-5. doi: 10.1164/rccm.201305-0832LE. Am J Respir Crit Care Med. 2013. PMID: 24127805 No abstract available.
-
Reply: stage distribution of lung cancers detected by computed tomography screening in the NELSON Trial.Am J Respir Crit Care Med. 2013 Oct 15;188(8):1035-6. doi: 10.1164/rccm.201305-0935LE. Am J Respir Crit Care Med. 2013. PMID: 24127806 No abstract available.
Similar articles
-
Can CT Screening Give Rise to a Beneficial Stage Shift in Lung Cancer Patients? Systematic Review and Meta-Analysis.PLoS One. 2016 Oct 13;11(10):e0164416. doi: 10.1371/journal.pone.0164416. eCollection 2016. PLoS One. 2016. PMID: 27736916 Free PMC article. Review.
-
Final screening round of the NELSON lung cancer screening trial: the effect of a 2.5-year screening interval.Thorax. 2017 Jan;72(1):48-56. doi: 10.1136/thoraxjnl-2016-208655. Epub 2016 Jun 30. Thorax. 2017. PMID: 27364640 Clinical Trial.
-
Occurrence and lung cancer probability of new solid nodules at incidence screening with low-dose CT: analysis of data from the randomised, controlled NELSON trial.Lancet Oncol. 2016 Jul;17(7):907-916. doi: 10.1016/S1470-2045(16)30069-9. Epub 2016 Jun 6. Lancet Oncol. 2016. PMID: 27283862 Clinical Trial.
-
Detection of lung cancer through low-dose CT screening (NELSON): a prespecified analysis of screening test performance and interval cancers.Lancet Oncol. 2014 Nov;15(12):1342-50. doi: 10.1016/S1470-2045(14)70387-0. Epub 2014 Oct 1. Lancet Oncol. 2014. PMID: 25282284 Clinical Trial.
-
Issues with implementing a high-quality lung cancer screening program.CA Cancer J Clin. 2014 Sep-Oct;64(5):352-63. doi: 10.3322/caac.21239. Epub 2014 Jun 27. CA Cancer J Clin. 2014. PMID: 24976072 Review.
Cited by
-
Association of Lung Cancer Risk With the Presence of Both Lung Nodules and Emphysema in a Lung Cancer Screening Trial.World J Oncol. 2024 Apr;15(2):246-256. doi: 10.14740/wjon1782. Epub 2024 Mar 21. World J Oncol. 2024. PMID: 38545483 Free PMC article.
-
Histopathologic fate of resected pulmonary pure ground glass nodule: a systematic review and meta-analysis.J Thorac Dis. 2024 Feb 29;16(2):924-934. doi: 10.21037/jtd-23-1089. Epub 2024 Feb 1. J Thorac Dis. 2024. PMID: 38505083 Free PMC article.
-
Robotic navigational bronchoscopy in a thoracic surgery practice: Leveraging technology in the management of pulmonary nodules.JTCVS Open. 2023 Jul 17;16:1-6. doi: 10.1016/j.xjon.2023.07.004. eCollection 2023 Dec. JTCVS Open. 2023. PMID: 38204680 Free PMC article.
-
An artificial intelligence-assisted diagnostic system for the prediction of benignity and malignancy of pulmonary nodules and its practical value for patients with different clinical characteristics.Front Med (Lausanne). 2023 Dec 22;10:1286433. doi: 10.3389/fmed.2023.1286433. eCollection 2023. Front Med (Lausanne). 2023. PMID: 38196835 Free PMC article.
-
Segmentectomy quality remains important in ground-glass-dominant stage I lung cancer.Thorac Cancer. 2024 Jan;15(1):57-65. doi: 10.1111/1759-7714.15162. Epub 2023 Nov 27. Thorac Cancer. 2024. PMID: 38013619 Free PMC article.
Publication types
MeSH terms
Associated data
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical