Thread by @lung_ca_screen

11 year follow-up of NLST #lungcancerscreening trial published online in @JTOonline
doi.org/10.1016/j.jtho…

Main findings as follows:

Overall increase in number of lung cancers between CXR (red) arm and LDCT (black) goes away, suggesting catch-up occurring in CXR arm. Still see an excess of "BAC" type cancers.

Relative risk of lung cancer deaths decreases as move away from last screen, but Number-Needed-to-Screen still ~300, suggesting as per authors "that LDCT screening did not just delay lung cancer death by a few years, but prevented it, or at least delayed it for > than a decade"

Overall mortality difference no longer statistically significant although point estimate of difference similar (4.6/1000 vs. 4.2/1000).

Stage 4 lung cancer cases separate in first 6 years (red is CXR) then increase in parallel afterwards since no more screening is happening.

My take: impressed that can still see lung cancer mortality difference 9 years after a 24 month screening intervention. Nice to see reduction in excess lung cancer cases. Ongoing screening likely require to further initial benefits of 24 months screening window!

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