title: Lung Cancer Screening Using Low Dose CT Scanning in Germany. Extrapolation of results from the National Lung Screening Trial.
abstract: BACKGROUND
  It is now debated whether the screening of heavy smokers for lung cancer with low dose computed tomography (low dose CT) might lower their mortality due to lung cancer. We use data from the National Lung Screening Trial (NLST) in the USA to predict the likely effects of such screening in Germany.
  
  
  METHODS
  The number of heavy smokers aged 55-74 in Germany was extrapolated from survey data obtained by the Robert Koch Institute. Published data from the NLST were then used to estimate the likely effects of low dose CT screening of heavy smokers in Germany.
  
  
  RESULTS
  If low dose CT screening were performed on 50% of the heavy smokers in Germany aged 55-74, an estimated 1 329 506 persons would undergo such screening. If the screening were repeated annually, then, over three years, 916 918 screening CTs would reveal suspect lesions, and the diagnosis of lung cancer would be confirmed thereafter in 32 826 persons. At least one positive test result in three years would be obtained in 39.1% of the participants (519 837 persons). 4155 deaths from lung cancer would be prevented over 6.5 years, and the number of persons aged 55-74 who die of lung cancer in Germany would fall by 2.6%. 12 449 persons would have at least one complication, and 1074 persons would die in the 60 days following screening.
  
  
  CONCLUSIONS
  The screening of heavy smokers for lung cancer can lower their risk of dying of lung cancer by 20% in relative terms, corresponding to an absolute risk reduction of 0.3 percentage points. These figures can provide the background for a critical discussion of the putative utility of this type of screening in Germany.
authors.affiliation: Center for Clinical Epidemiology; Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, School of Public Health, Department of Epidemiology, Boston University, USA, German Cancer Consortium (DKTK), Heidelberg, West German Cancer Center, Clinic for Internal Medicine (Tumor Research), University Hospital Essen, Department of Thoracic Oncology, Ruhrlandklinik, University Hospital Essen, Department of Interventional Pneumology, Ruhrlandklinik, University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stang
authors.forename: Martin
authors.initials: M
authors.lastname: Schuler
authors.forename: Bernd
authors.initials: B
authors.lastname: Kowall
authors.forename: Kaid
authors.initials: K
authors.lastname: Darwiche
authors.forename: Hilmar
authors.initials: H
authors.lastname: Kühl
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
mesh_terms: D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000706:statistics & numerical data*; D011835:Radiation Protection / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D012907:Smoking / Q000401:mortality*; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*