National Lung Screening Trial (NLST) Screening
RATIONALE: Effective screening tests should help doctors detect lung cancer early and plan curative treatment. It is not yet known whether low-dose helical computed tomography (LDCT) screening is more effective than chest radiography (CXR) screening in reducing death from lung cancer.
PURPOSE: Randomized clinical trial to compare the effectiveness of LDCT scan with that of CXR in screening individuals who are at high risk for developing lung cancer.
Device: low-dose helical computed tomography
Device: chest radiography
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Screening
|Official Title:||National Lung Screening Trial A Randomized Trial Comparing Low-dose Helical CT With Chest Xray for Lung Cancer|
- Lung Cancer Deaths [ Time Frame: All events through December 31, 2009; median follow-up 6.5 years. ] [ Designated as safety issue: No ]Lung cancer deaths confirmed in participants by Endpoint Verification if available, otherwise by death certificate.
- Deaths From All Causes in All Randomized Participants. [ Time Frame: All events through December 31, 2009; median follow-up 6.5 years. ] [ Designated as safety issue: No ]Deaths from all causes were compared between the low-dose CT group and the chest radiography group among all randomized participants.
- Lung Cancer Diagnoses [ Time Frame: All events through December 31, 2009; median follow-up 6.5 years ] [ Designated as safety issue: No ]Lung cancer diagnoses confirmed by medical record abstraction.
- Complications of Diagnostic Evaluation Following a Positive Screening Test. [ Time Frame: One year from screening examination ] [ Designated as safety issue: Yes ]Number of participants who experienced complications during diagnostic work-up of a screening CT or CXR that was suspicious for lung cancer.
- T0 (Baseline) Screening Results [ Time Frame: T0 (at study entry) ] [ Designated as safety issue: No ]Results of radiologist's interpretation of images from LDCT or CXR screening exam at T0.
- T1 Screening Results [ Time Frame: T1 (one year after entry) ] [ Designated as safety issue: No ]Results of radiologist's interpretation of images from LDCT or CXR screening exam at T1. Includes a comparison with images from T0 screen.
- T2 Screening Results [ Time Frame: T2 (two years after entry) ] [ Designated as safety issue: No ]Results of radiologist's interpretation of images from LDCT or CXR screening exam at T2. Includes a comparison with images from T0 and T1 screens.
|Study Start Date:||August 2002|
|Study Completion Date:||October 2010|
|Primary Completion Date:||October 2010 (Final data collection date for primary outcome measure)|
|Experimental: Low-Dose CT||
Device: low-dose helical computed tomography
A LDCT is a computerized tomography image with low-dose technique without contrast. The scan is done from the neck to the diaphragm in one breath-hold.
Other Name: LDCT
|Experimental: Chest X-ray||
Device: chest radiography
The chest x-ray in this study was a single posterior-anterior film done with the participant upright.
Other Name: CXR
- Compare whether screening with low-dose helical CT scan vs chest x-ray reduces lung cancer-specific mortality in participants who are at high risk for developing lung cancer.
NLST participants were randomized to either low-dose helical CT or chest x-ray in equal proportions. A total of 53,454 participants were enrolled (26,722 in low-dose CT and 26,732 in chest radiography) at 33 screening centers across the United States. Screening was offered three times (at baseline and two annual follow-up examinations). The primary endpoint of the study was lung cancer mortality. The study arms were compared with regard to overall mortality, lung cancer incidence, and screening-related complications.
All low-dose scanners and chest x-ray machines were certified for use and met NLST protocol requirements and American College of Radiology guidelines. Low-dose CT acquisitions and chest radiographs were interpreted by trained radiologists. Participants and their health care provider were informed of study examination results. Participants with abnormalities suspicious for lung cancer were contacted for information regarding diagnostic evaluation. Medical records were collected on diagnostic evaluation, medical complications, and initial treatment.
Participants were then contacted at least annually by mail or telephone.
The National Lung Screening Trial (NLST) represents the union of two NCI-sponsored efforts, the NCI Lung Screening Study and the American College of Radiology Imaging Network (ACRIN).
Hide Study Locations
|United States, Alabama|
|University of Alabama at Birmingham|
|Birmingham, Alabama, United States, 35233|
|United States, California|
|Univeristy of California, San Diego|
|La Jolla, California, United States, 92093-0658|
|Jonsson Comprehensive Cancer Center, UCLA|
|Los Angeles, California, United States, 90095-1781|
|United States, Colorado|
|University of Colorado Denver|
|Denver, Colorado, United States, 80262|
|United States, District of Columbia|
|Georgetown University Medical Center|
|Washington, District of Columbia, United States, 20007|
|United States, Florida|
|Jacksonville, Florida, United States, 32224|
|H. Lee Moffitt Cancer Center and Research Institute|
|Tampa, Florida, United States, 33612-9497|
|United States, Georgia|
|Emory University School of Medicine|
|Atlanta, Georgia, United States, 30322|
|United States, Hawaii|
|Pacific Health Research & Education Institute|
|Honolulu, Hawaii, United States, 96813|
|United States, Illinois|
|Chicago, Illinois, United States, 60611|
|United States, Iowa|
|University of Iowa|
|Iowa City, Iowa, United States, 52242-1011|
|United States, Kentucky|
|Jewish Hopsital Heart and Lung Institute|
|Louisville, Kentucky, United States, 40202|
|United States, Louisiana|
|Ochsner Medical Foundation Hospital|
|New Orleans, Louisiana, United States, 70121|
|United States, Maryland|
|Johns Hopkins University|
|Baltimore, Maryland, United States, 21231|
|United States, Massachusetts|
|Beth Israel Deaconess Medical Center|
|Boston, Massachusetts, United States, 02215|
|Brigham and Women's Hospital|
|Boston, Massachusetts, United States, 02115|
|United States, Michigan|
|University of Michigan Comprehensive Cancer Center|
|Ann Arbor, Michigan, United States, 48109-0942|
|Henry Ford Health System|
|Detroit, Michigan, United States, 48202|
|United States, Minnesota|
|University of Minnesota School of Public Health|
|Minneapolis, Minnesota, United States, 55455|
|Mayo Clinic Cancer Center|
|Rochester, Minnesota, United States, 55905|
|United States, Missouri|
|Washington University School of Medicine|
|St. Louis, Missouri, United States, 63108|
|United States, New Hampshire|
|Dartmouth-Hitchcock Medical Center|
|Lebanon, New Hampshire, United States, 03756-0002|
|United States, New Jersey|
|Cancer Institute of New Jersey at Hamilton|
|Hamilton, New Jersey, United States, 08690|
|United States, North Carolina|
|Wake Forest University|
|Winston-Salem, North Carolina, United States, 27106|
|United States, Ohio|
|St Elizabeth Health Center|
|Youngstown, Ohio, United States, 44504|
|United States, Pennsylvania|
|University of Pennsylvania Medical Center|
|Philadelphia, Pennsylvania, United States, 19104|
|University of Pittsburgh Medical Center|
|Pittsburgh, Pennsylvania, United States, 15236|
|United States, Rhode Island|
|Brown University, Rhode Island Hospital|
|Providence, Rhode Island, United States, 02908-4735|
|United States, South Carolina|
|Medical University of South Carolina|
|Charleston, South Carolina, United States, 29425|
|United States, Tennessee|
|Nashville, Tennessee, United States, 37232-6838|
|United States, Texas|
|University of Texas - MD Anderson Cancer Center|
|Houston, Texas, United States, 77030-4009|
|United States, Utah|
|University of Utah Health Sciences Center|
|Salt Lake City, Utah, United States, 84112|
|United States, Wisconsin|
|Marshfield Clinic Research Foundation|
|Marshfield, Wisconsin, United States, 54449|
|Study Director:||Christine D. Berg, MD||NCI - Early Detection Research Group|
|Principal Investigator:||Denise R. Aberle, MD||Jonsson Comprehensive Cancer Center|