The case for targeted screening programs for lung cancer has been bolstered by results from the European NELSON study, a leading UK clinician argues.
Professor David Baldwin, consultant respiratory physician in Nottingham and a member of NHS England’s advisory group on lung cancer, said the long-awaited results from the NELSON study meant there would likely be full implementation of a UK-wide targeted screening program based on low-dose CT in high risk patient.
The results of the 10-year study published in February showed a substantial reduction in lung cancer mortality in high-risk former and current smokers who had undergone lung cancer screening at year 1, 3 and 5.
Among 13,195 men in the study, 156 men with a lung-cancer diagnosis in the screening group and 206 in the control group had died from lung cancer – a cumulative rate ratio for death from lung cancer of 0.76, the researchers reported in the New England Journal of Medicine.
There appeared to be a greater 33% reduction in lung cancer deaths for women but the numbers were small as only 2494 were screened.
However, as the trial reported no difference in overall mortality rates, the results have caused debate over whether the impact of screening would be great enough to justify potential overdiagnosis and other adverse implications for patients.
In his evidence-based medicine podcast, Plenary Session, US oncologist Dr Vinay Prasad was highly critical of the paper. He said: “You’re subjecting people who are heavy smokers to a battery of invasive tests and being put on the medicalisation pipeline and you don’t know for sure you are improving longevity or quality of life.”