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NLST
About the Trial
The National Lung Screening Trial randomized 53,454 heavy smokers to three annual low dose CT scans or chest X rays. CT screening reduced lung cancer mortality by 20 percent and all cause mortality by 6.7 percent. The number needed to screen to prevent one lung cancer death was around 320, with substantial false positive rates and overdiagnosis concerns. NELSON in Europe confirmed with volume based protocols. NLST prompted US screening recommendations, Medicare coverage, and structured lung screening programs, with eligibility criteria later broadened, for example by the USPSTF in 2021.
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