***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: STUDY OBJECTIVE To evaluate the feasibility of lung cancer screening using low-dose spiral CT as a part of annual health examinations . DESIGN Nonr and omized , screening practice . METHODS From April 1998 to August 2000 , CT screening was performed as a part of annual health examinations on a total of 7,956 individuals who belonged to the Hitachi Employee 's Health Insurance Group . Of those participants , 5,568 were rescreened 1 year later . When a noncalcified solitary pulmonary nodule ( SPN ) > or= 8 mm was detected on CT screening , a detailed CT scan was carried out approximately 1 month later . RESULTS During the baseline screening , a total of 2,865 noncalcified SPNs were detected among the 7,956 participants . Primary lung cancer was histologically confirmed in 40 patients ( 41 lesions ) . The prevalence was 0.44 % of all participants from the baseline , and 0.07 % from the repeated screening . Thirty-five of 41 tumors were stage I. Current or former smokers represented only 17 of 40 cases . The detection rate was rather high in female participants . CONCLUSION Low-dose spiral CT seems to be a promising method for screening early lung cancer as a part of annual health examinations . Female and nonsmoking subjects should be included in the baseline screening . However , for yearly repeat screening , the participants may be selected on the basis of gender , smoking history , and results at the baseline screening BACKGROUND Results of r and omized clinical trials ( RCTs ) are needed to assess the efficacy of lung cancer screening with low-dose chest computed tomography ( CT ) in reducing lung cancer mortality . We report design and results of enrolment and baseline screening test in the ITALUNG trial , a RCT . METHODS Invitation letters were sent to subjects of 55 - 69 years of age clients of 269 general practitioners . Smokers or former smokers of at least 20 pack/years were eligible and after written consent were r and omized in an active arm undergoing a low-dose CT annually for 4 years and in a control arm receiving no screening . Management of positive screening test was carried out using follow-up low-dose CT , fluorodeoxyglucose positron emission tomography , fine needle aspiration cytology and fiber optic bronchoscopy . RESULTS A sample of 3206 eligible subjects was achieved by sending 71,232 letters ( enrolment efficacy = 4.5 % ) . Subjects in control ( n = 1593 ) and active ( n = 1613 ) arm were balanced for age , gender and smoking history . Two-hundred and seven ( 12.8 % ) subjects did not undergo CT after r and omization . The baseline screening test was positive in 426 ( 30.3 % ) of 1406 subjects . Twenty-one lung cancers ( prevalence = 1.5 % ) were found in 20 subjects : 18 non-small cell lung cancer ( NSCLC ) , 2 small cell lung cancer ( SCLC ) and a case of typical carcinoid . Ten NSCLC ( 47.6 % ) were in Stage I. Sixteen fine needle aspirations were performed in 15 lung cancers , with a positive result in 12 ( 75 % ) cases . One biopsy only ( 6.3 % ) was performed on a benign lesion . Seventeen lung cancers ( 81 % ) were treated with surgical resection in 16 subjects . One subject underwent surgery for a benign lesion ( 5.5 % of all surgical resections ) . CONCLUSIONS Recruitment by mail of high risk subjects for a lung cancer screening RCT is feasible but not efficient . Results of the baseline screening test in the active arm of the ITALUNG trial are substantially in line with those of RCT and observational studies Objective The current study aim ed to identify the barriers to participation among high-risk individuals in the UK Lung Cancer Screening ( UKLS ) pilot trial . Setting The UKLS pilot trial is a r and omised controlled trial of low-dose CT ( LDCT ) screening that has recruited high-risk people using a population approach in the Cambridge and Liverpool areas . Participants High-risk individuals aged 50–75 years were invited to participate in UKLS . Individuals were excluded if a LDCT scan was performed within the last year , if they were unable to provide consent , or if LDCT screening was unable to be carried out due to coexisting comorbidities . Outcome measures Statistical associations between individual characteristics and UKLS uptake were examined using multivariable regression modelling . In those who completed a non-participation question naire ( NPQ ) , thematic analysis of free-text data was undertaken to identify reasons for not taking part , with subsequent exploratory linkage of key themes to risk factors for non-uptake . Results Comparative data were available from 4061 high-risk individuals who consented to participate in the trial and 2756 who declined participation . Of those declining participation , 748 ( 27.1 % ) completed a NPQ . Factors associated with non-uptake included : female gender ( OR=0.64 , p<0.001 ) , older age ( OR=0.73 , p<0.001 ) , current smoking ( OR=0.70 , p<0.001 ) , lower socioeconomic group ( OR=0.56 , p<0.001 ) and higher affective risk perception ( OR=0.52 , p<0.001 ) . Among non- participants who provided a reason , two main themes emerged reflecting practical and emotional barriers . Smokers were more likely to report emotional barriers to participation . Conclusions A profile of risk factors for non-participation in lung screening has emerged , with underlying reasons largely relating to practical and emotional barriers . Strategies for engaging high-risk , hard-to-reach groups are critical for the equitable uptake of a potential future lung cancer screening programme . Trial registration number The UKLS trial was registered with the International St and ard R and omised Controlled Trial Register under the reference 78513845 Background : Little is known about the psychological predictors of  colorectal screening  uptake in Engl and and mediators of associations between uptake and socioeconomic status ( SES ) . This study tested the hypotheses that although higher threat and efficacy beliefs , lower cancer fatalism , lower depression , and better self-rated health would predict higher screening uptake , only efficacy beliefs , fatalism , depression , and self-rated health would mediate associations between uptake and SES . Methods : Data from 529 adults aged 60 to 69 who had completed a postal survey in 2005–2006 were linked with data on fecal occult blood test ( FOBt ) uptake recorded at the screening “ hub ” following its introduction in 2007 , result ing in a prospect i ve study . Results :  Screening uptake was 56 % and was higher among people with higher SES , better self-rated health , higher self-efficacy beliefs , and lower cancer fatalism in univariate analyses . Path analysis on participants with complete data ( n = 515 ) showed that both better self-rated health and lower cancer fatalism were directly associated with higher uptake of FOBt screening and significantly mediated pathways from SES to uptake . Lower depression only had an indirect effect on uptake through better self-rated health . Efficacy beliefs did not mediate the relationship between SES and uptake . Conclusion : SES differences in uptake of FOBt in Engl and are partially explained by differences in cancer fatalism , self-rated health , and depression . Impact : This is one of only a few studies to examine mediators of the relationship between SES and screening uptake , and future research could test the effectiveness of interventions to reduce fatalistic beliefs to increase e quality of uptake . Cancer Epidemiol Biomarkers Prev ; 20(10 ) ; 2132–40 . © 2011 AACR BACKGROUND Lung cancer has the highest mortality-rate per cancer , with an overall 5-year survival < 15 % . Several non-r and omized studies pointed out the high sensitivity of low dose computed tomography ( LDCT ) to detect early stage lung cancer . In France , Depiscan , a pilot RCT of LDCT versus chest X-ray ( CXR ) , started on October 2002 to determine the feasibility of enrollment by general practitioners ( GPs ) , investigations and diagnostic procedures by university hospital radiologists and multidisciplinary teams , data management by central ized clinical research assistants , and anticipate the future management of a large national trial . METHODS GPs and occupational physicians ( OPs ) selected and enrolled 1000 subjects in 1 year . Eligible subjects were asymptomatic males or females aged 50 - 75 years with a current or former cigarette smoking history of > /=15 cigarettes per day for at least 20 years ( former smokers having quit < 15 years prior to enrollment ) . Based to r and omization , annual LDCT or CXR screenings were planned at baseline and annually for 2 years . RESULTS Between October 2002 and December 2004 , 765 subjects were enrolled by 89 out of the 232 participating GPs and OPs . Complete clinical and imaging baseline data were available for 621 individuals out of the 765 enrolled , due to 144 noncompliant subjects who withdrew their consent . At least one nodule was detected in 152 out of 336 subjects ( 45.2 % ) in the LDCT screening , versus 21 out of 285 subjects ( 7.4 % ) in the CXR screening arm . Eight lung cancers were detected in the LDCT arm and one in the CXR arm . DISCUSSION This pilot trial allows estimating that non-calcified nodules are 10 [ 6.36 - 17.07 ] times more often detected from LDCT than from CXR . However enrollment by GPs was more difficult than expected with 41 % active investigators and a high rate ( 19 % ) of noncompliant patients . This experience speaks to the need for a high level of GPs formation and a large , coordinated clinical research team in such a trial . TRIAL REGISTRATION NUMBER 02526 Background : Before evidence of efficacy , lung cancer screening was being ordered by many physicians . The National Lung Screening Trial ( NLST ) , which showed a 20 % reduction in lung cancer mortality among those r and omized to receive low-dose computed tomography ( LDCT )  , will likely lead to increased screening use . Methods : We estimated the prevalence of chest X-ray and CT use in the United States using data from the 2010 National Health Interview Survey ( NHIS ) . Subjects included 15,537 NHIS respondents aged ≥40 years without prior diagnosis of lung cancer . Estimates of the size of the U. S. population by age and smoking status were calculated . Multivariate logistic regression examined predictors of test use adjusting for potential confounders . Results : Twenty-three percent of adults reported chest X-ray in the previous year and 2.5 % reported chest X-ray specifically to check for lung cancer ; corresponding numbers for chest CT were 7.5 % and 1.3 % . Older age , black race , male gender , smoking , respiratory disease , personal history of cancer , and having health insurance were associated with test use . Approximately , 8.7 million adults in the United States would be eligible for LDCT screening according to NLST eligibility criteria . Conclusions and Impact : Monitoring of trends in the use of lung screening tests will be vital to assess the impact of NLST and possible changes in lung cancer screening recommendations and insurance coverage in the future . Education of patients by their physicians , and of the general public , may help ensure that screening is used appropriately , in those most likely to benefit . Cancer Epidemiol Biomarkers Prev ; 21(7 ) ; 1049–59 . © 2012 AACR BACKGROUND The aggressive and heterogeneous nature of lung cancer has thwarted efforts to reduce mortality from this cancer through the use of screening . The advent of low-dose helical computed tomography ( CT ) altered the l and scape of lung-cancer screening , with studies indicating that low-dose CT detects many tumors at early stages . The National Lung Screening Trial ( NLST ) was conducted to determine whether screening with low-dose CT could reduce mortality from lung cancer . METHODS From August 2002 through April 2004 , we enrolled 53,454 persons at high risk for lung cancer at 33 U.S. medical centers . Participants were r and omly assigned to undergo three annual screenings with either low-dose CT ( 26,722 participants ) or single-view posteroanterior chest radiography ( 26,732 ) . Data were collected on cases of lung cancer and deaths from lung cancer that occurred through December 31 , 2009 . RESULTS The rate of adherence to screening was more than 90 % . The rate of positive screening tests was 24.2 % with low-dose CT and 6.9 % with radiography over all three rounds . A total of 96.4 % of the positive screening results in the low-dose CT group and 94.5 % in the radiography group were false positive results . The incidence of lung cancer was 645 cases per 100,000 person-years ( 1060 cancers ) in the low-dose CT group , as compared with 572 cases per 100,000 person-years ( 941 cancers ) in the radiography group 
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The results highlight differences in gender and social characteristics of participants across programs , while noting that differences may be partly explained by the various epidemiological context s , program inclusion criteria , and socio-economic status ( SES ) measures collected .
Most importantly , despite a well-recognized predominance of low SES among heavy smokers , people with high SES are seemingly over-represented among participants .
Male participants also seem to be over-represented .