Evidence map›Paper›PMID 23863051›Full record

Trial reportThe New England journal of medicine2013

Targeting of low-dose CT screening according to the risk of lung-cancer death.

Stephanie A Kovalchik, Martin Tammemagi, Christine D Berg, Neil E Caporaso, Tom L Riley, Mary Korch, Gerard A Silvestri, Anil K Chaturvedi, Hormuzd A Katki

3 registry-linked trialsOpen access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 291 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
291citing papers in PubMed, 8 pooled it
48.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03077230 nacompletednot on this mapstarted 2015, after this paper: background citation

Pre-Post Study for Supporting Appropriate Implementation of Lung Cancer Screening

TypeinterventionalSponsorUNC Lineberger Comprehensive Cancer CenterRan2015 to 2017Enrolled62ConditionsLung Neoplasms, Early Detection of Cancer, Decision Support Techniques, Primary Health CareArmsPre/Post Test of a Lung Cancer Screening Decision Aid
NCT04083859 nacompletednot on this mapstarted 2022, after this paper: background citation

A Pragmatic Randomized-Controlled Trial of a Digital Outreach Intervention for Lung Cancer Screening: mPATH-Lung (Mobile Patient Technology for Health-Lung)

TypeinterventionalSponsorWake Forest University Health SciencesRan2022 to 2024Enrolled26,998ConditionsLung CancerArmsmPATH-Lung, Lung health video
NCT07073898 nacompletednot on this mapstarted 2025, after this paper: background citation

Population Health Management Approaches to Increase Lung Cancer Screening in Community Health Centers - UG3 Pilot Clinical Trial

TypeinterventionalSponsorUniversity of UtahRan2025 to 2026Enrolled65ConditionsLung CancerArmsRepeated Text Messages (TM+), Conversational Agent (CA), Educational Video, Proactive Patient Navigation (PPN), Reactive Patient Navigation (RPN)
3 · Its place in the literature

Who cites it

291 citing papers in PubMed, 8 syntheses or guidelines pooled it, 565 citations in OpenAlex.

  1. Pooled it
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  3. Guideline
  4. Guideline
  5. Pooled it
  6. Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2018
    Guideline
  7. Pooled it
  8. Guideline
  9. Trial
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  13. Lung cancer screening primer: Key information for primary care providers.Canadian family physician Medecin de famille canadien · 2021
    Trial
  14. Aiding shared decision making in lung cancer screening: two decision tools.Journal of public health (Oxford, England) · 2021
    Trial
  15. Trial
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  17. Insights for Management of Ground-Glass Opacities From the National Lung Screening Trial.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2019
    Trial
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231 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 2 countries.

Stephanie A KovalchikDivisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Martin TammemagiDivisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Christine D BergDivisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Neil E CaporasoDivisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Tom L RileyDivisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Mary KorchDivisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Gerard A SilvestriDivisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Anil K Chaturvedi *Divisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Hormuzd A Katki *Divisions of Cancer Epidemiology and Genetics (S.A.K., N.E.C., A.K.C., H.A.K.) and Cancer Prevention (C.D.B.), National Cancer Institute, National Institutes of Health, and Information Management Services (T.L.R., M.K.) - all in Rockville, MD; the Department of Community Health Sciences, Brock University, St. Catharines, ON, Canada (M.T.); and the Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston (G.A.S.).
Cancer Genetics (United States) · USBrock University · CADivision of Cancer Epidemiology and GeneticsInformation Management Services · USMedical University of South Carolina · USNational Institutes of Health · US

Funding

ARRA - ADOPT New Technologies for RDC/CDMSU01CA080098 · NCI · AMERICAN COLLEGE OF RADIOLOGY · PI SCHNALL, MITCHELL D. · 1999 to 2011
$182.7M
BIOSTATISTICS DATA MANAGEMENT CENTER FOR ACROINU01CA079778 · NCI · BROWN UNIVERSITY · PI GATSONIS, CONSTANTINE A. · 1999 to 2011
$48.6M
Methods for Epidemiology StudiesZIACP010181 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI ALBERT, PAUL · 2009 to 2025
$34.8M
PROSTATE, LUNG, COLORECTAL, &OVARIAN CANCER SCREENINGN01CN025476 · CN · WESTAT, INC. · PI O'BRIEN, BARBARA B · 1992 to 2000
$7.9M
PROSTATE, LUNG, COLORECTAL AND OVARIAN (PLCO) CANCERN01CN025512 · CN · HENRY FORD HEALTH SYSTEM · PI DEMERS, RAYMOND Y · 1992 to 2001
$2.0M
PROSTATE, LUNG, COLORECTAL AND OVARIAN (PLCO) CANCERN01CN075022 · CN · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI FOUAD, MONA N. · 1997 to 2001
$1.6M
PROSTATE, LUNG, COLORECTAL &OVARIAN (PLCO) CANCERN01CN025516 · CN · WASHINGTON UNIVERSITY · PI ANDRIOLE, GERALD LOUIS · 1992 to 2001
$1.5M
PROSTATE, LUNG, COLORECTAL AND OVARIAN (PLCO) CANCERN01CN025524 · CN · UNIVERSITY OF UTAH · PI BUYS, SAUNDRA S · 1992 to 2000
$1.5M
PROSTATE, LUNG, COLORECTAL AND OVARIAN (PLCO) CANCERN01CN025514 · CN · UNIVERSITY OF COLORADO DENVER · PI CRAWFORD, E DAVID · 1992 to 2000
$1.3M
PROSTATE, LUNG, COLORECTAL AND OVARIAN (PLCO) CANCERN01CN025515 · CN · PACIFIC HEALTH RESEARCH INSTITUTE · PI YOKOCHI, LANCE L · 1992 to 2000
$1.2M
PROSTATE, LUNG, COLORECTAL AND OVARIAN (PLCO) CANCERN01CN025511 · CN · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI WEISSFELD, JOEL L · 1992 to 2000
$1.2M
PROSTATE, LUNG, COLORECTAL &OVARIAN CANCERN01CN025522 · CN · GEORGETOWN UNIVERSITY · PI GELMANN, EDWARD P · 1992 to 2000
$817k
Intramural NIH HHS Z99 CA999999NCI NIH HHS N01 CN025476NCI NIH HHS N01 CN025511NCI NIH HHS N01 CN025512NCI NIH HHS N01 CN025513NCI NIH HHS N01 CN025514NCI NIH HHS N01 CN025515NCI NIH HHS N01 CN025516NCI NIH HHS N01 CN025518NCI NIH HHS N01 CN025522NCI NIH HHS N01 CN025524NCI NIH HHS N01 CN075022NCI NIH HHS N02 CN063300NCI NIH HHS U01 CA079778NCI NIH HHS U01 CA080098NCI NIH HHS Y99 CA999999
6 · The paper itself

Abstract

backgroundIn the National Lung Screening Trial (NLST), screening with low-dose computed tomography (CT) resulted in a 20% reduction in lung-cancer mortality among participants between the ages of 55 and 74 years with a minimum of 30 pack-years of smoking and no more than 15 years since quitting. It is not known whether the benefits and potential harms of such screening vary according to lung-cancer risk.

methodsWe assessed the variation in efficacy, the number of false positive results, and the number of lung-cancer deaths prevented among 26,604 participants in the NLST who underwent low-dose CT screening, as compared with the 26,554 participants who underwent chest radiography, according to the quintile of 5-year risk of lung-cancer death (ranging from 0.15 to 0.55% in the lowest-risk group [quintile 1] to more than 2.00% in the highest-risk group [quintile 5]).

resultsThe number of lung-cancer deaths per 10,000 person-years that were prevented in the CT-screening group, as compared with the radiography group, increased according to risk quintile (0.2 in quintile 1, 3.5 in quintile 2, 5.1 in quintile 3, 11.0 in quintile 4, and 12.0 in quintile 5; P=0.01 for trend). Across risk quintiles, there were significant decreasing trends in the number of participants with false positive results per screening-prevented lung-cancer death (1648 in quintile 1, 181 in quintile 2, 147 in quintile 3, 64 in quintile 4, and 65 in quintile 5). The 60% of participants at highest risk for lung-cancer death (quintiles 3 through 5) accounted for 88% of the screening-prevented lung-cancer deaths and for 64% of participants with false positive results. The 20% of participants at lowest risk (quintile 1) accounted for only 1% of prevented lung-cancer deaths.

conclusionsScreening with low-dose CT prevented the greatest number of deaths from lung cancer among participants who were at highest risk and prevented very few deaths among those at lowest risk. These findings provide empirical support for risk-based targeting of smokers for such screening. (Funded by the National Cancer Institute.).

Indexed as

Tomography, X-Ray ComputedAgedFalse Positive ReactionsFemaleHumansLungLung NeoplasmsMaleMass ScreeningMiddle AgedRadiation DosageRiskSmoking

Identifiers

PMID23863051
PMCPMC3783654
OpenAlexW2156275503

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.