• Nanda Horeweg, Carlijn M van der Aalst, Rozemarijn Vliegenthart, Yingru Zhao, Xueqian Xie, Ernst Th Scholten, Willem Mali, Erik Thunnissen, Carla Weenink, Harry J M Groen, Jan-Willem J Lammers, Kristiaan Nackaerts, Joost van Rosmalen, Matthijs Oudkerk, and Harry J de Koning.
• Erasmus MC, Rotterdam.
• Eur. Respir. J. 2013 Dec 1;42(6):1659-67.

AbstractSeveral medical associations recommended lung cancer screening by low-dose computed tomography scanning for high-risk groups. Counselling of the candidates on the potential harms and benefits and their lung cancer risk is a prerequisite for screening. In the NELSON trial, screenings are considered positive for (part) solid lung nodules with a volume >500 mm3 and for (part) solid or nonsolid nodules with a volume-doubling time <400 days. For this study, the performance of the NELSON strategy in three screening rounds was evaluated and risk calculations were made for a follow-up period of 5.5 years. 458 (6%) of the 7582 participants screened had a positive screen result and 200 (2.6%) were diagnosed with lung cancer. The positive screenings had a predictive value of 40.6% and only 1.2% of all scan results were false-positive. In a period of 5.5 years, the risk of screen-detected lung cancer strongly depends on the result of the first scan: 1.0% after a negative baseline result, 5.7% after an indeterminate baseline and 48.3% after a positive baseline. The screening strategy yielded few positive and false-positive scans with a reasonable positive predictive value. The 5.5-year lung cancer risk calculations aid clinicians in counselling candidates for lung cancer screening with low-dose computed tomography.

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