To determine the feasibility of conducting a randomized controlled trial (RCT) of low radiation dose helical computed tomography (LDCT) for the detection of lung neoplasms in asymptomatic individuals at high risk for lung cancer.
Six centers from the on-going Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial recruited heavy or long-term smokers who were not in the PLCO trial and randomized them to receive either a screening LDCT or screening postero-anterior view chest x-ray (CXR).
1660 participants were randomized to receive a screening LDCT and 1658 participants were randomized to receive a screening CXR. Screens were completed on 96% of the LDCT arm and 93% of the CXR participants. 19.4% of participants in the LDCT and 9.4% of participants in the CXR arm had screens that were suspicious for lung cancer. A total of 25 lung cancers in the LDCT arm and 7 in the CXR arm were diagnosed following a positive screen. Additional data from the LSS indicate that, among persons at elevated risk of lung cancer, CT use is not pervasive, interest in participating in an RCT of LDCT is strong, and few randomized to CXR either refuse their exam or seek a CT after their study CXR.CONCLUSIONS: The results of the LSS demonstrate the feasibility of an RCT of LDCT in the United States.
The larger National Lung Screening Trial (NLST) can be done to determine whether LDCT or CXR lead to significant reduction in lung cancer mortality.
P.A. Kvale, None.