Negative Low-dose Lung CT May Warrant Less Frequent Screening

Patients with a high risk for developing lung cancer and a negative low-dose computed tomography prevalence screen had a lower incidence.
Patients with a high risk for developing lung cancer and a negative low-dose computed tomography prevalence screen had a lower incidence.

Patients with a high risk for developing lung cancer and a negative low-dose computed tomography (LDCT) prevalence screen had a lower incidence of lung cancer and lung cancer-specific mortality than did all persons who underwent a prevalence screen, a study published in The Lancet Oncology has shown.1

Persons at high risk for lung cancer are recommended to undergo annual LDCT screening for lung cancer; however, whether this is necessary for all eligible persons to receive yearly screening is unclear. Therefore, researchers examined rates of lung cancer among those who had a negative initial LDCT screen to determine if less frequent screening could be justified in certain populations.

For the retrospective study, researchers analyzed data from 26 231 participants of the National Lung Screening Trial (NLST), a multicenter, randomized screening trial comparing 3 annual LDCT assessments with 3 annual chest radiographs for the early detection of lung cancer in high-risk persons.

Of those, 19 066 participants had a negative initial LDCT screen. Researchers found that those participants had a lower incidence of lung cancer than did all 26 231 participants who underwent an initial screening. Patients with negative screening results also had lower lung cancer-related mortality.

In addition, results showed 0.34% of participants who had a negative initial screen had lung cancer at the first annual screen as compared with 1.0% of participants who had a positive initial CT screen.

Researchers estimated that if the first annual screen had not been performed in patients with a negative initial screen, an additional 28 participants at most would have died from lung cancer over the course of the trial.

The findings ultimately suggest that increasing the interval between LDCT screens in participants with a negative initial LDCT screen might be warranted.

REFERENCE

1. Patz EF, Greco E, Gastsonis C, et al. Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial [published online ahead of print March 18, 2016]. Lancet Oncol. doi:10.1016/S1470-2045(15)00621-X.
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