Since the release of the NLST
results, guidelines and best practices for responsible lung cancer screening were conceived by a team of health professionals at the Lung Cancer Alliance, which evolved into the National Framework for Excellence in Lung Cancer Screening and Continuum of Care.
The investigators promoted the screening program through flyers, radio programs, face-to-face information sessions, and a multidisciplinary lung symposium; prospectively collected data over a 12-month period; and decided patient eligibility based on NLST
Of note, however, was the large number of false-positive screening results in the NLST
For every six lives saved in the NLST
, one person died from complications following subsequent procedures or surgery'-and 80 percent of lung cancer deaths still occurred.
Across the quintiles of lung cancer risk studied in the NLST
, those considered to have experienced a probable benefit from screening varied from 5,276 in the lowest-risk group to 161 in the highest-risk group.
As already noted, those enrolled in the NLST
were relatively young and had large pack-year smoking histories.
On the benefit side, the NLST
found that the number of high-risk smokers who had to be screened with CT to save one person from dying of lung cancer was 320.
The NCI has developed its own one-page, online NLST
study guide for patients and physicians that provides specific data on low-dose CT vs.
Lung cancer kills more people than cancers of the breast, prostate, colon, and pancreas combined and will kill more than 155,000 people this year," says the NLST
project officer, Dr.
While we were working on our first guidelines, the results of the NLST
became available, which makes this update very timely.
Even incredibly curated and purpose-built datasets, such as the NLST
, have surprisingly minimal annotation of the pixel data, and the data that are annotated, such as the LIDC from the NCI, consist of about 1,000 cases, with only lung nodules annotated.
subset study included 47,902 participants who self-identified as non-Hispanic white and 2,361 who self-identified as non-Hispanic black; 24,190 were current smokers and 26,073 were former smokers who had quit within the 15 years prior to entering the study.