In early 2011 NIOSH posted a blog entry commenting on the preliminary results from the National Lung Screening Trial (NLST), funded by the National Cancer Institute, that found a 20.3% reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray (CXR). On June 29, 2011, the peer-reviewed primary results from the NLST were published online in the New England Journal of Medicine. This is an update to the previous blog.¹

The National Lung Screening Trial

The National Lung Screening Trial (NLST)² was a national randomized controlled trial launched by the National Cancer Institute (NCI) in 2002 to determine whether annual screening with low-dose helical CT would lead to earlier detection and reduced mortality from lung cancer relative to screening with CXR.

Lung cancer is the foremost cause of death from cancer in the United States, leading to nearly 160,000 deaths in 2006 (USCS). Annually, nearly 200,000 people have a new diagnosis of lung cancer (See related blog on new Surgeon General Report).

Efforts to develop methods to detect the cancer early enough to improve survival of the diagnosed persons have been largely unsuccessful. A recent study of a relatively new form of screening using helical computerized tomography (CT) demonstrated fewer lung cancer deaths among individuals at high risk of lung cancer who received this screening than among a similar group screened with chest radiography (chest x-rays or CXRs). There is great interest in this finding, and there is hope that this might provide new approaches to cancer screening among workers with increased risk for lung cancer because of past occupational exposures.