Lung cancer screening, what has changed after the latest evidence?

Table 1 Quality criteria of a screening program

Quality criteria of a screening program[16]
False-positive	Should be low
Cost	Inexpensive
True negative	Should not be hurt
Screening test should	Improve outcome; Be scientifically validated; Be low risk; Be reproducible; Be accessible; Be cost effective

Table 2 Comparison between nlst and nelson

	NLST	NELSON
Age	55-74	50-74
Smoking habit	≥ 30 pack/year; ≥ 15 years since quitting	≥ 15 pack/year; ≥ 10 years since quitting
CT scan	Diameter-based	Volume-based
Sample size	53454	15822
Number of rounds	3	4
Intervals	1 yr intervals	0, 1, 2 and 2.5 yr
Adherence	95% LDCT group	87.6%
Number of cancers	1060 (645/100000 person/year)	5.58/1000 person/year
% early stage cancers	40% stage IA	50% stage IA
Positive test	24%	2.1%
PPV	3.8%	43.5%
Reduction in lung cancer mortality	20%	Higher than 20%
Population	North America	Europe

NLST: National Lung Screening Trial; NELSON: Nederlands Leuvens Longkanker Screenings Onderzoek; CT: Computed tomography; LDCT: Low-dose computed tomography; PPV: Positive predictive value.