title: Volumetric computed tomography screening for lung cancer: three rounds of the NELSON trial.
abstract: Several medical associations recommended lung cancer screening by low-dose computed tomography scanning for high-risk groups. Counselling of the candidates on the potential harms and benefits and their lung cancer risk is a prerequisite for screening. In the NELSON trial, screenings are considered positive for (part) solid lung nodules with a volume >500 mm3 and for (part) solid or nonsolid nodules with a volume-doubling time <400 days. For this study, the performance of the NELSON strategy in three screening rounds was evaluated and risk calculations were made for a follow-up period of 5.5 years. 458 (6%) of the 7582 participants screened had a positive screen result and 200 (2.6%) were diagnosed with lung cancer. The positive screenings had a predictive value of 40.6% and only 1.2% of all scan results were false-positive. In a period of 5.5 years, the risk of screen-detected lung cancer strongly depends on the result of the first scan: 1.0% after a negative baseline result, 5.7% after an indeterminate baseline and 48.3% after a positive baseline. The screening strategy yielded few positive and false-positive scans with a reasonable positive predictive value. The 5.5-year lung cancer risk calculations aid clinicians in counselling candidates for lung cancer screening with low-dose computed tomography.
authors.affiliation: Erasmus MC, Rotterdam.
authors.forename: Nanda
authors.initials: N
authors.lastname: Horeweg
authors.forename: Carlijn M
authors.initials: CM
authors.lastname: van der Aalst
authors.forename: Rozemarijn
authors.initials: R
authors.lastname: Vliegenthart
authors.forename: Yingru
authors.initials: Y
authors.lastname: Zhao
authors.forename: Xueqian
authors.initials: X
authors.lastname: Xie
authors.forename: Ernst Th
authors.initials: ET
authors.lastname: Scholten
authors.forename: Willem
authors.initials: W
authors.lastname: Mali
authors.forename: Erik
authors.initials: E
authors.lastname: Thunnissen
authors.forename: Carla
authors.initials: C
authors.lastname: Weenink
authors.forename: Harry J M
authors.initials: HJ
authors.lastname: Groen
authors.forename: Jan-Willem J
authors.initials: JW
authors.lastname: Lammers
authors.forename: Kristiaan
authors.initials: K
authors.lastname: Nackaerts
authors.forename: Joost
authors.initials: J
authors.lastname: van Rosmalen
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
mesh_terms: D000368:Aged; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D055088:Early Detection of Cancer; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D055613:Multiple Pulmonary Nodules / Q000175:diagnosis; D011237:Predictive Value of Tests; D012306:Risk; D012907:Smoking