New data show ‘unequivocal support’ for LDCT screening patients at risk of lung cancer

Newly released data on low-dose CT screening shows the practice can significantly reduce lung cancer mortality, researchers underscored recently.

U.K. experts performed a meta-analysis of nine international randomized controlled trials, including the National Lung Screening Trial and the NELSON trial. Both have shown LDCT screening for lung cancer can reduce deaths by 20% and 24%, respectively.

Adding their data from more than 4,000 patients at high risk of developing cancer over the next five years, the team found screening could reduce mortality by up to 16%. And a majority were diagnosed at stage 1, meaning many patients could have undergone potentially successful treatment.

John K. Field, PhD, with the University of Liverpool’s Department of Molecular and Clinical Cancer Medicine, and co-authors shared their findings Sept. 11 in The Lancet Regional Health-Europe.

The added value of this manuscript has been to enhance our knowledge of lung cancer CT screening, including effects on mortality (lung cancer mortality and all-cause mortality), as well as on [the] stage of the disease and on pulmonary nodule classification,” Field et al. noted. “The associated meta-analysis, which includes the UKLS trial, provides the most up to date international view of lung cancer mortality in lung cancer CT screening studies.”

The team enrolled 4,055 patients with a single LDCT screening visit or usual care (no screening) between October 2011 to February 2013. In total, 3,968 participants were eligible, and the primary outcome was cancer mortality.

After a median follow-up of 7.3 years, 30 of 1,987 participants in the LDCT group died of lung cancer compared to 46 of the 1,981 in the non-screened cohort. Additionally, 61% of cases were found at stage 1, and surgery to remove the disease could have been scheduled in 83% of cases.

Fields and co-investigators noted risk model-based screening programs are “well underway” in the U.K., reaching participation levels near 40%-53%. But despite Medicare funding LDCT programs in the U.S., uptake remains low, at around 4%.

“In conclusion, the meta-analysis incorporating the results from nine randomized controlled trials provides further support for lung cancer screening by low-dose chest CT,” the authors concluded.

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