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The National Lung Screening Trial Research Team of the National Cancer Research Institute has recently reported a large-scale trial showing that screening with low-dose computed tomography (CT) is associated with a significant reduction in lung cancer mortality compared with chest radiography in persons at high risk for lung cancer.^1,2

From August 2002 through April 2004, 53,454 persons at high risk for lung cancer were enrolled at 33 US medical centers and randomized to three annual screenings with either low-dose CT (n = 26,722) or singleview posteroanterior chest radiography (n = 26,732). Data on lung cancer cases and deaths were collected through the end of December 2009. Eligible participants were aged between 55 and 74 years, had a history of smoking of at least 30 pack-years and, if former smokers, had quit within the past 15 years. Persons with a previous diagnosis of lung cancer, a chest CT within the preceding 18 months, hemoptysis, or unexplained weight loss of more than 15 lb in the preceding year were excluded from the study. Participants in the two groups were well matched for age at randomization, gender distribution (59% men in each group), and proportion of current smokers (48% in each group). The participants in the trial were younger, had a higher level of education, and were more likely to be former smokers than were respondents to a 2002– 2004 US Census survey of tobacco use who matched the age and smoking history criteria of the trial. ...

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