6/28/23, 11:22 PM NLST Pathway Feedback Search Clinical Topics Home Studies NLST NLST Disease Disease Non-small cell lung cancer Small cell lung cancer Trial question What is the role of low-dose computed tomographic screening in patients who are at high risk for lung cancer? Study design Multi-center Open label RCT Population Characteristics of study participants 41.0% female N = 53454 59.0% male 53454 patients (21922 female, 31532 male) Inclusion criteria: patients who are at high risk for lung cancer Key exclusion criteria: previous diagnosis of lung cancer, chest CT within 18 months before enrollment, hemoptysis, or unexplained weight loss > 6.8 kg in the preceding year Interventions N=26722 screening using low-dose CT (use of multidetector scanners with a minimum of four channels, at an average effective dose of 1.5 mSv) N=26732 screening using CXRs (single-view posteroanterior chest radiography at an average effective dose of 8 mSv) https://web.pathway.md/studies/recmpSAUOL19xwZrN 1/2 6/28/23, 11:22 PM NLST Pathway Primary outcome Death from any cause 0.1 % 0.08 0.07 0.1 % 0.0 % Significant decrease 0.0 % NNT = 10000 0.0 % Screening using low-dose CT Screening using chest X-rays Significant decrease in death from any cause (0.07% vs. 0.08%; RR 0.93, 95% CI 0.86 to 0.99) Secondary outcomes Significant decrease in the incidence of lung cancer-specific death (247 per 100,000 person-year vs. 309 per 100,000 person-year; RR 0.8, 95% CI 0.73 to 0.93) Borderline significant increase in the incidence of lung cancer (645 /100K py vs. 572 /100K py; RR 1.13, 95% CI 1.03 to 1.23) Conclusion In patients who are at high risk for lung cancer, screening using low-dose CT was superior to screening using CXRs with respect to death from any cause. Reference National Lung Screening Trial Research Team, Aberle DR, Adams AM et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011 Aug 4;365(5):395- 409. Open reference URL https://web.pathway.md/studies/recmpSAUOL19xwZrN 2/2