According to study findings, rates of death from lung cancer were significantly lower in high-risk individuals who underwent volume computed tomographic (CT) screening versus no screening (N Engl J Med. 2020;382[6]:503-513).

“There are limited data from randomized trials regarding whether volume-based, low-dose…CT…screening can reduce lung-cancer mortality among male former and current smokers,” explained Harry J. de Koning, MD, PhD, Department of Public Health, Erasmus MC–University Medical Center Rotterdam, the Netherlands, and colleagues, who conducted a trial of national registry data for 13,195 men (primary analysis) and 2594 women (subgroup analyses).

Patients in the study were aged 50 years to 74 years and were randomized to undergo CT screening at baseline, year 1, year 3, and year 5.5 or no screening at all. Follow-up lasted for at least 10 years for all patients and ended on December 31, 2015.

On average, 90.0% of men adhered to CT screening, and 9.2% of the screened participants had at least 1 more CT scan (initially indeterminate).

“The overall referral rate for suspicious nodules was 2.1%. At 10 years of follow-up, the incidence of lung cancer was 5.58 cases per 1000 person-years in the screening group and 4.91 cases per 1000 person-years in the control group; lung-cancer mortality was 2.50 deaths per 1000 person-years and 3.30 deaths per 1000 person-years, respectively,” Dr de Koning et al reported.

At 10 years, the cumulative rate ratio for lung cancer mortality was 0.76 (95% CI, 0.61-0.94; P = .01) in the screened cohort versus the control group, which did not differ greatly from values observed at years 8 and 9. Of note, women had a rate ratio of 0.67 (95% CI, 0.38-1.14) at 10 years of follow-up, with values of 0.41 to 0.52 during years 7 to 9.

“In this trial involving high-risk persons, lung-cancer mortality was significantly lower among those who underwent volume CT screening than among those who underwent no screening,” Dr de Koning and colleagues concluded.

There were low rates of follow-up procedures for results suggestive of lung cancer,” they added.—Hina Porcelli