Screening may facilitate minimal invasive treatment and can be performed with a relatively low rate of false-positive screen results compared with previous studies on lung cancer screening.

The use of PET-CT for preoperative staging of NSCLC reduced both the total number of thoracotomies and the number of futile thoracotomies but did not affect overall mortality. (ClinicalTrials.gov number, NCT00867412.)

No statistically significant effects of CT screening on lung cancer mortality were found, but the results of post hoc high-risk subgroup analyses showed nonsignificant trends that seem to be in good agreement with the results of the National Lung Screening Trial. Clinical trial registered with www.clinicaltrials.gov (NCT00496977).

Background The effects of low-dose CT screening on disease stage shift, mortality and overdiagnosis are unclear. Lung cancer findings and mortality rates are reported at the end of screening in the Danish Lung Cancer Screening Trial. Methods 4104 men and women, healthy heavy smokers/former smokers were randomised to five annual low-dose CT screenings or no screening. Two experienced chest radiologists read all CT scans and registered the location, size and morphology of nodules. Nodules between 5 and 15 mm without benign characteristics were rescanned after 3 months. Growing nodules (>25% volume increase and/or volume doubling time<400 days) and nodules >15 mm were referred for diagnostic workup. In the control group, lung cancers were diagnosed and treated outside the study by the usual clinical practice. Results Participation rates were high in both groups (screening: 95.5%; control: 93.0%; p<0.001). Lung cancer detection rate was 0.83% at baseline and mean annual detection rate was 0.67% at incidence rounds (p¼0.535). More lung cancers were diagnosed in the screening group (69 vs 24, p<0.001), and more were low stage (48 vs 21 stage IeIIB non-small cell lung cancer (NSCLC) and limited stage small cell lung cancer (SCLC), p¼0.002), whereas frequencies of high-stage lung cancer were the same (21 vs 16

Fig. 1, • " Fig. 5) is suggested in patients with NSCLC and an abnormal mediastinum by CT or CT-PET (Recommendation grade D).This document was downloaded for personal use only. Unauthorized distribution is strictly prohibited. Definitions! Combined endosonography EBUS-TBNA and EUS-(B)-FNA combined Complete mediastinal nodal staging All nodes evaluated (in contrast to only analysis of suspected nodes based on CT and/or PET imaging) Targeted mediastinal nodal staging Evaluation of the node(s) that is (are) suspicious on CT and/or PET Centrally located lung tumor Lung tumor located within the inner third of the chest Peripherally located lung cancer Lung tumor located within the outer two thirds of the chest Lymph node(s) suspicious for malignancy (abnormal mediastinum) Node with a short axis (> 10 mm) and/or that is FDG-PET-avid