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National Lung Screening Trial (NLST) Screening (NLST)

This study has been completed.
Sponsor:
Collaborator:
American College of Radiology Imaging Network
Information provided by (Responsible Party):
National Cancer Institute (NCI)
ClinicalTrials.gov Identifier:
NCT00047385
First received: October 3, 2002
Last updated: May 2, 2014
Last verified: October 2012
Results First Received: May 30, 2012  
Study Type: Interventional
Study Design: Allocation: Randomized;   Intervention Model: Parallel Assignment;   Masking: Open Label;   Primary Purpose: Screening
Condition: Lung Cancer
Interventions: Device: low-dose helical computed tomography
Device: chest radiography

  Participant Flow
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Recruitment Details
Key information relevant to the recruitment process for the overall study, such as dates of the recruitment period and locations
Recruitment was from August 2002 through April 2004 at 33 NLST sites.

Pre-Assignment Details
Significant events and approaches for the overall study following participant enrollment, but prior to group assignment
Participants signed a study informed consent prior to being randomized to a study arm.

Reporting Groups
  Description
Low-Dose CT Participants undergo low-dose helical CT examination.
Chest X-ray Participants undergo chest x-ray examination.

Participant Flow:   Overall Study
    Low-Dose CT   Chest X-ray
STARTED   26722   26732 
COMPLETED   26455 [1]   26232 
NOT COMPLETED   267   500 
Death before any screening                2                5 
Lung Cancer diagnosed before screening                5                3 
Eligible for screening but had no screen                260                492 
[1] Had at least one screening exam.



  Baseline Characteristics
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Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
No text entered.

Reporting Groups
  Description
Low-Dose CT Participants undergo low-dose helical CT examination.
Chest X-ray Participants undergo chest x-ray examination.
Total Total of all reporting groups

Baseline Measures
   Low-Dose CT   Chest X-ray   Total 
Overall Participants Analyzed 
[Units: Participants]
 26722   26732   53454 
Age 
[Units: Participants]
     
<=18 years   0   0   0 
Between 18 and 65 years   19612   19622   39234 
>=65 years   7110   7110   14220 
Age 
[Units: Years]
Mean (Standard Deviation)
 61.4  (5.0)   61.4  (5.0)   61.4  (5.0) 
Gender 
[Units: Participants]
     
Female   10952   10970   21922 
Male   15770   15762   31532 
Region of Enrollment 
[Units: Participants]
     
United States   26,722   26,732   53454 


  Outcome Measures
  Show All Outcome Measures

1.  Primary:   Lung Cancer Deaths   [ Time Frame: All events through December 31, 2009; median follow-up 6.5 years. ]

2.  Secondary:   Deaths From All Causes in All Randomized Participants.   [ Time Frame: All events through December 31, 2009; median follow-up 6.5 years. ]

3.  Secondary:   Lung Cancer Diagnoses   [ Time Frame: All events through December 31, 2009; median follow-up 6.5 years ]

4.  Secondary:   Complications of Diagnostic Evaluation Following a Positive Screening Test.   [ Time Frame: One year from screening examination ]

5.  Secondary:   T0 (Baseline) Screening Results   [ Time Frame: T0 (at study entry) ]
  Hide Outcome Measure 5

Measure Type Secondary
Measure Title T0 (Baseline) Screening Results
Measure Description Results of radiologist's interpretation of images from LDCT or CXR screening exam at T0.
Time Frame T0 (at study entry)  
Safety Issue No  

Population Description
Explanation of how the number of participants for analysis was determined. Includes whether analysis was per protocol, intention to treat, or another method. Also provides relevant details such as imputation technique, as appropriate.
All participants randomized were analyzed.

Reporting Groups
  Description
LDCT Screening Participants randomized to receive three annual low-dose helical CT exams of the chest.
CXR Screening Participants randomized to receive three annual chest radiographs.

Measured Values
   LDCT Screening   CXR Screening 
Participants Analyzed 
[Units: Participants]
 26722   26732 
T0 (Baseline) Screening Results 
[Units: Participants]
   
Positive   7191   2387 
Significant abnor. not suspicious for lung cancer   2695   785 
No, or minor abnormality   16423   22863 
Eligible but not screened   406   689 
Not eligible for screen   7   8 

No statistical analysis provided for T0 (Baseline) Screening Results



6.  Secondary:   T1 Screening Results   [ Time Frame: T1 (one year after entry) ]

7.  Secondary:   T2 Screening Results   [ Time Frame: T2 (two years after entry) ]


  Serious Adverse Events


  Other Adverse Events


  Limitations and Caveats
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Limitations of the study, such as early termination leading to small numbers of participants analyzed and technical problems with measurement leading to unreliable or uninterpretable data
NLST utilized institutions with special expertise. The "healthy volunteer" effect may apply. Scanners are now more technologically advanced. Ongoing LDCT screening may reduce the rate of lung cancer deaths more than three rounds done in NLST.


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