Trial reportJAMA internal medicine2014
Overdiagnosis in low-dose computed tomography screening for lung cancer.
Trial report in JAMA internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05557487 (Taiwan Real-world Low-dose Computed Tomography Screening behavIor and Outcome Research for High Risk Subjects Based on Health Promotion Administration-part A), which is not on this map. Cited by 368 papers, 9 of them syntheses that pooled 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.
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.
Taiwan Real-world Low-dose Computed Tomography Screening behavIor and Outcome Research for High Risk Subjects Based on Health Promotion Administration-part A: Questionnaire Survey -Part B: LDCT Screening Outcome and Management
Who cites it
368 citing papers in PubMed, 9 syntheses or guidelines pooled it, 778 citations in OpenAlex.
- Screening for lung cancer: A systematic review of overdiagnosis and its implications.Molecular oncology · 2026Pooled it
- Knowledge mapping analysis of ground glass nodules: a bibliometric analysis from 2013 to 2023.Frontiers in oncology · 2024Pooled it
- Lung Cancer Screening With Low-Dose Computed Tomography.Deutsches Arzteblatt international · 2023Pooled it
- The influence of postscreening follow-up time and participant characteristics on estimates of overdiagnosis from lung cancer screening trials.International journal of cancer · 2022Pooled it
- Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality.The Cochrane database of systematic reviews · 2022Pooled it
- Guideline
- Guideline
- Role of circulating tumor cells in diagnosis of lung cancer: a systematic review and meta-analysis.The Journal of international medical research · 2021Pooled it
- Lung Cancer Screening with Low-Dose CT: a Meta-Analysis.Journal of general internal medicine · 2020Pooled it
- Utility of isocitrate dehydrogenase 1 as a serum protein biomarker for the early detection of non-small-cell lung cancer: A multicenter in vitro diagnostic clinical trial.Cancer science · 2020Trial
- Lung Cancer Incidence and Mortality with Extended Follow-up in the National Lung Screening Trial.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2019Trial
- Geographic disparities and health inequality evolution in the disease burden of tracheal, bronchus, and lung cancer in Asia: a 33-year longitudinal analysis and future projections.Annals of medicine · 2026Article
- Multi-Institutional Integration of Circulating miRNAs and Protein Tumor Markers for Early Lung Cancer Detection.JTO clinical and research reports · 2026Article
- Incidence and mortality trends after introduction of lung cancer screening in a community-based healthcare system.Cancer epidemiology · 2026Article
- Urinary miR-574-5p as a candidate biomarker for early-stage lung adenocarcinoma: an exploratory case-control study.Translational lung cancer research · 2026Article
- A Noninvasive Circulating Tumor DNA Methylation Classifier to Identify Benign Pulmonary Nodules.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Should Multi-Cancer Early Detection Testing Replace Guideline-Recommended Colorectal Cancer Screening? A Comparative Modeling Analysis.medRxiv : the preprint server for health sciences · 2026Article
- Impact of lung cancer discovery mode on cancer outcomes: data from the KBP-2020-CPHG study.ERJ open research · 2026Article
- [Advances in the Growth Risk Assessment and Precision Management of Pulmonary Subsolid Nodules].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Review
- Lung Cancer Screening and Prevention: Beyond Conventional Strategies in a Rapidly Changing Global Milieu.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2026Review
308 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Erratum issued
Authors and funding
10 authors at 8 institutions in 2 countries.
Funding
Abstract
importanceScreening for lung cancer has the potential to reduce mortality, but in addition to detecting aggressive tumors, screening will also detect indolent tumors that otherwise may not cause clinical symptoms. These overdiagnosis cases represent an important potential harm of screening because they incur additional cost, anxiety, and morbidity associated with cancer treatment.
objectiveTo estimate overdiagnosis in the National Lung Screening Trial (NLST). DESIGN, SETTING, AND
participantsWe used data from the NLST, a randomized trial comparing screening using low-dose computed tomography (LDCT) vs chest radiography (CXR) among 53 452 persons at high risk for lung cancer observed for 6.4 years, to estimate the excess number of lung cancers in the LDCT arm of the NLST compared with the CXR arm. MAIN OUTCOMES AND MEASURES: We calculated 2 measures of overdiagnosis: the probability that a lung cancer detected by screening with LDCT is an overdiagnosis (PS), defined as the excess lung cancers detected by LDCT divided by all lung cancers detected by screening in the LDCT arm; and the number of cases that were considered overdiagnosis relative to the number of persons needed to screen to prevent 1 death from lung cancer.
resultsDuring follow-up, 1089 lung cancers were reported in the LDCT arm and 969 in the CXR arm of the NLST. The probability is 18.5% (95% CI, 5.4%-30.6%) that any lung cancer detected by screening with LDCT was an overdiagnosis, 22.5% (95% CI, 9.7%-34.3%) that a non-small cell lung cancer detected by LDCT was an overdiagnosis, and 78.9% (95% CI, 62.2%-93.5%) that a bronchioalveolar lung cancer detected by LDCT was an overdiagnosis. The number of cases of overdiagnosis found among the 320 participants who would need to be screened in the NLST to prevent 1 death from lung cancer was 1.38. CONCLUSIONS AND RELEVANCE: More than 18% of all lung cancers detected by LDCT in the NLST seem to be indolent, and overdiagnosis should be considered when describing the risks of LDCT screening for lung cancer.
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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.