NELSON Is Effective in Predicting Lung Cancer Population-Based Screening

NELSON Is Effective in Predicting Lung Cancer Population-Based Screening

Non-Small Cell Lung CancerAccording to a recent study published in the Journal of Thoracic Oncology, results from the NELSON lung cancer screening trial using low dose computed tomography (LDCT) revealed the method to be effective in predicting the effect of population-based screening in the Dutch population.

In the United States, results from a large National Lung Screening Trial (NLST) revealed that lung cancer screening using low dose computed tomography can decrease lung cancer mortality by 20% compared to a chest x-ray for a high-risk population of current or former smokers with history of at least 30 pack-year, aged 55 to 74 years.

In Europe, the NELSON trial, an ongoing Dutch-Belgian lung cancer screening trial, evaluated if screening with LDCT could reduce lung cancer mortality by at least 25% compared to no screening at 10 years of follow-up for individuals aged 50 to 75 years with smoking history of 15 cigarettes per day for 25 years or 10 cigarettes for 30 years who were still smoking or had quit 10 years ago.

In their study, entitled “Baseline characteristics and mortality outcomes of NELSON control group participants and eligible non-responders,” a total of 30,051 people were considered eligible to participate. From these, 15,822 subjects took part in the research and were randomized in two study arms, LDCT arm (n=7,915) or control arm (n=7,907). The remaining were considered eligible non-participants (13,670), and the researchers compared baseline characteristics and mortality profiles between participants in the control group and eligible non-responders.

Results revealed that compared to eligible non-participants, the control participants were younger, more physically active, higher educated and more often former smokers. Mortality due to all causes and mortality classification was lower in the participants’ group. However, the proportion of death due to cancer was higher among participants — 62.4% versus 54.9% for eligible non-participants.

The authors noted in a recent news release “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.”

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