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In the U.S. National Lung Screening Trial (NLST), screening with low-dose computed tomography (CT) lowered lung-cancer mortality compared with a control group (1.33% vs. 1.66%) during about 6 years of follow-up (NEJM JW Gen Med Aug 1 2011 and N Engl J Med 2011; 365:395). Now we have results from the NELSON study, a randomized trial from the Netherlands and Belgium: Nearly 16,000 heavy current smokers or ex-smokers (84% men) were randomized to low-dose CT screening — with four scans distributed over a 6-year period — or to a no-screening control group.
In men, 10-year lung cancer–specific mortality was significantly lower with screening than with no screening (2.4% vs. 3.1%), indicating 7 fewer deaths per 1000 men screened. However, all-cause…