Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial

Koning, Harry J. de; Aalst, Carlijn M. van der; Jong, Pim A. de; Scholten, Ernst Th.; Nackaerts, Kristiaan; Heuvelmans, Marjolein A; Lammers, Jan‐Willem J.; Weenink, Carla; Yousaf-Khan, Uraujh; Horeweg, Nanda; Westeinde, Susan van ’t; Prokop, Mathias; Mali, Willem P.Th.M.; Hoesein, Firdaus A. A. Mohamed; Ooijen, Peter M. A. van; Aerts, Joachim; Bakker, Michael A. den; Thunnissen, Erik; Verschakelen, Johny; Vliegenthart, Rozemarijn; Walter, Joan; Haaf, Kevin ten; Groen, Harry J.M.; Oudkerk, Matthijs

doi:10.1056/nejmoa1911793

Cited by 1,953 publications

(1,583 citation statements)

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“…The NLST also supports evidence implied by the European screening trials that there is a sex difference in the benefit of LC screening in favour of females, which the NELSON trial could not fully address given most participants were male [7]. In addition, the German LUSI trial found that LDCT screening led to a statistically significant reduction in LC mortality among women (hazard ratio (HR) 0.31, p=0.04), but not among men (HR 0.94, p=0.81) [8].…”

Section: Commentarysupporting

confidence: 53%

“…This study represents a timely and important update to the NLST data, alongside full results of the NELSON [7] and the LUSI trials [8], as Europe begins to set out a vision for LC screening. Although 10 years have passed since the publication of the first results of this landmark study, the USA still encounters the difficulties of implementation and the challenges of screening uptake by highrisk populations.…”

Section: Commentarymentioning

confidence: 99%

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Lung cancer incidence and mortality with extended follow-up in the National Lung Screening Trial

Frille

Hardavella²,

Lee

2020

Breathe

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Section: Commentarysupporting

confidence: 53%

Section: Commentarymentioning

confidence: 99%

Lung cancer incidence and mortality with extended follow-up in the National Lung Screening Trial

Frille

Hardavella²,

Lee

2020

Breathe

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“…For example, in more than 20% of smokers suspicious lesions can be found by low-dose computed tomographic screening. Nevertheless, lung cancer was detected only in ~0.6% of screened smokers within a 10-year follow-up (The National Lung Screening Trial Research Team 2011; de Koning et al 2020). Similarly, around 33% of humans harbor precursor lesions in their pancreas but the life-time risk of developing pancreatic cancer is 1.6% (NCI Seer 2018; Makohon-Moore and Iacobuzio-Donahue 2016).…”

Section: Discussionmentioning

confidence: 99%

A mathematical model of ctDNA shedding predicts tumor detection size

Avanzini

Kurtz

Chabon

et al. 2020

Preprint

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Early cancer detection aims to find tumors before they progress to an uncurable stage. Prospective studies with tens of thousands of healthy participants are ongoing to determine whether asymptomatic cancers can be accurately detected by analyzing circulating tumor DNA (ctDNA) from blood samples. We developed a stochastic mathematical model of tumor evolution and ctDNA shedding to investigate the potential and the limitations of ctDNA-based cancer early detection tests. We inferred ctDNA shedding rates of early stage lung cancers and calculated that a 15 mL blood sample contains on average only 1.5 genome equivalents of ctDNA for lung tumors with 1 billion cells (size of ~1 cm 3 ). We considered two clinically different scenarios: cancer screening and cancer relapse detection. For monthly relapse testing with a sequencing panel covering 20 tumor-specific mutations, we found a median detection size of 0.24 cm 3 corresponding to a lead time of 160 days compared to imaging-based relapse detection. For annual screening, we found a median detection size of 2.8-4.8 cm 3 depending on the sequencing panel size and on the mutation frequency. The expected detection sizes correspond to lead times of 390-520 days compared to current median lung tumor sizes at diagnosis. This quantitative framework provides a mechanistic interpretation of ctDNA-based cancer detection approaches and helps to optimize cancer early detection strategies.

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“…6 The results of a recent NELSON, large Dutch-Belgium lung cancer screening trial have shown the efficacy of low-dose CT screening for lung cancer. 7 The challenge now is to identify the target population in which screening will be acceptable and cost-effective. 8 Drugs to treat more advanced lung cancer, based on immunotherapy, are being trialled and yielding some promising results, in respect of increasing survival time.…”

mentioning

confidence: 99%

Lung cancer: a potential role for dentists

Field¹,

Field

2020

Br Dent J

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Dentists and their teams could potentially play a role in the public perception, prevention and detection of lung cancer. AbstractLung cancer is the leading cause of death from cancer worldwide and causes more deaths than breast, colorectal and cervical cancers combined. The five-year survival rate for lung cancer in the UK is approximately 15%. Over many years, lung cancer has failed to attract the attention and resources given to other cancers; it has also been stigmatised by a culture of blame, attributable to the sufferer because of smoking. Anyone can develop lung cancer, and between 15% and 20% of people with this diagnosis have never smoked. Many patients with lung cancer are diagnosed at late stages; therefore, early detection is pivotal to improving their survival. Dentists and their teams could potentially play a role in the public perception, prevention and detection of lung cancer.

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Reduced Lung-Cancer Mortality with Volume CT Screening in a Randomized Trial

Cited by 1,953 publications

References 34 publications

Lung cancer incidence and mortality with extended follow-up in the National Lung Screening Trial

Lung cancer incidence and mortality with extended follow-up in the National Lung Screening Trial

A mathematical model of ctDNA shedding predicts tumor detection size

Lung cancer: a potential role for dentists

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