Document Detail

Characteristics of lung cancers detected by computer tomography screening in the randomized NELSON trial.
MedLine Citation:
PMID:  23348977     Owner:  NLM     Status:  MEDLINE    
RATIONALE: The NELSON (Nederlands Leuvens Longkanker Screenings Onderzoek) trial is, with 15,822 participants, the largest European lung cancer computer tomography screening trial. A volumetry-based screening strategy, stringent criteria for a positive screening, and an increasing length of screening interval are particular features of the NELSON trial.
OBJECTIVES: To determine the effect of stringent referral criteria and increasing screening interval on the characteristics of screen-detected lung cancers, and to compare this across screening rounds, between sexes, and with other screening trials.
METHODS: All NELSON participants with screen-detected lung cancer in the first three rounds were included. Lung cancer stage at diagnosis, histological subtype, and tumor localization were compared between the screening rounds, the sexes, and with other screening trials.
MEASUREMENTS AND MAIN RESULTS: In the first three screening rounds, 200 participants were diagnosed with 209 lung cancers. Of these lung cancers, 70.8% were diagnosed at stage I and 8.1% at stage IIIB-IV, and 51.2% were adenocarcinomas. There was no significant difference in cancer stage, histology, or tumor localization across the screening rounds. Women were diagnosed at a significantly more favorable cancer stage than men. Compared with other trials, the screen-detected lung cancers of the NELSON trial were relatively more often diagnosed at stage I and less often at stage IIIB-IV.
CONCLUSIONS: Despite stringent criteria for a positive screening, an increasing length of screening interval, and few female participants, the screening strategy of the NELSON trial resulted in a favorable cancer stage distribution at diagnosis, which is essential for the effectiveness of our screening strategy. Clinical trial registered with (ISRCTN63545820).
Nanda Horeweg; Carlijn M van der Aalst; Erik Thunnissen; Kristiaan Nackaerts; Carla Weenink; Harry J M Groen; Jan-Willem J Lammers; Joachim G Aerts; Ernst T Scholten; Joost van Rosmalen; Willem Mali; Matthijs Oudkerk; Harry J de Koning
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  187     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-04-16     Completed Date:  2013-06-11     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  848-54     Citation Subset:  AIM; IM    
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MeSH Terms
Adenocarcinoma / diagnosis*,  epidemiology,  pathology,  radiography
Age Distribution
Early Detection of Cancer / methods*,  standards
Longitudinal Studies
Lung Neoplasms / diagnosis*,  epidemiology,  pathology,  radiography
Mass Screening / methods,  standards
Middle Aged
Neoplasm Staging
Netherlands / epidemiology
Sex Distribution
Smoking / adverse effects*,  epidemiology
Tomography, X-Ray Computed
Comment In:
Am J Respir Crit Care Med. 2013 Oct 15;188(8):1035-6   [PMID:  24127806 ]
Am J Respir Crit Care Med. 2013 Apr 15;187(8):792-3   [PMID:  23586379 ]
Am J Respir Crit Care Med. 2013 Oct 15;188(8):1034-5   [PMID:  24127805 ]

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