Trial reportAnnals of internal medicine2014
National Lung Screening Trial findings by age: Medicare-eligible versus under-65 population.
Trial report in Annals of internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00047385 (National Lung Screening Trial A Randomized Trial Comparing Low-dose Helical CT With Chest Xray for Lung Cancer), which is not on this map. Cited by 44 papers, 4 of them syntheses that pooled it.
What it found
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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.
National Lung Screening Trial A Randomized Trial Comparing Low-dose Helical CT With Chest Xray for Lung Cancer
Who cites it
44 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Impact of low-dose computed tomography (LDCT) screening on lung cancer-related mortality.The Cochrane database of systematic reviews · 2022Pooled it
- Guideline
- Guideline
- Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2018Guideline
- Utilization of Diagnostic Procedures After Lung Cancer Screening in the National Lung Screening Trial.Journal of the American College of Radiology : JACR · 2023Trial
- Lung Cancer Screening in a Population from Northeast Italy Exposed to Both Asbestos and Smoking: A Cost-Effectiveness Analysis.Journal of clinical medicine · 2026Article
- Monitoring the Harms of Lung Cancer Screening: Why the Nonmalignant Resection Rate Is Our Best Bet.Journal of the American College of Radiology : JACR · 2025Article
- Burden of Comorbid Conditions Among Individuals Screened for Lung Cancer.JAMA health forum · 2025Article
- The pros and cons of lung cancer screening.European radiology · 2025Review
- Article
- Estimating the Effects of Cancer Screening in Clinical Practice Settings: The Role of Selective Uptake and Suboptimal Adherence along the Cancer Screening Continuum.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Article
- Comparing Lung Cancer Screening Strategies in a Nationally Representative US Population Using Transportability Methods for the National Lung Cancer Screening Trial.JAMA network open · 2024Article
- Rates of Downstream Procedures and Complications Associated With Lung Cancer Screening in Routine Clinical Practice : A Retrospective Cohort Study.Annals of internal medicine · 2024Article
- Assessment of the EarlyCDT-Lung test as an early biomarker of lung cancer in ever-smokers: A retrospective nested case-control study in two prospective cohorts.International journal of cancer · 2023Article
- Assessment of Barriers and Challenges to Screening, Diagnosis, and Biomarker Testing in Early-Stage Lung Cancer.Cancers · 2023Review
- Using Cg05575921 methylation to predict lung cancer risk: a potentially bias-free precision epigenetics approach.Epigenetics · 2022Article
- Article
- Chronic Obstructive Pulmonary Disease and Lung Cancer: A Review for Clinicians.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2022Article
- Article
- Polygenic risk scores: the future of cancer risk prediction, screening, and precision prevention.Medical review (2021) · 2021Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe NLST (National Lung Screening Trial) showed reduced lung cancer mortality in high-risk participants (smoking history of ≥30 pack-years) aged 55 to 74 years who were randomly assigned to screening with low-dose computed tomography (LDCT) versus those assigned to chest radiography. An advisory panel recently expressed reservations about Medicare coverage of LDCT screening because of concerns about performance in the Medicare-aged population, which accounted for only 25% of the NLST participants.
objectiveTo examine the results of the NLST LDCT group by age (Medicare-eligible vs. <65 years).
designSecondary analysis of a group from a randomized trial (NCT00047385).
setting33 U.S. screening centers. PATIENTS: 19 612 participants aged 55 to 64 years (under-65 cohort) and 7110 participants aged 65 to 74 years (65+ cohort) at randomization.
intervention3 annual rounds of LDCT screening. MEASUREMENTS: Demographics, smoking and medical history, screening examination adherence and results, diagnostic follow-up procedures and complications, lung cancer diagnoses, treatment, survival, and mortality.
resultsThe aggregate false-positive rate was higher in the 65+ cohort than in the under-65 cohort (27.7% vs. 22.0%; P < 0.001). Invasive diagnostic procedures after false-positive screening results were modestly more frequent in the older cohort (3.3% vs. 2.7%; P = 0.039). Complications from invasive procedures were low in both groups (9.8% in the under-65 cohort vs. 8.5% in the 65+ cohort). Prevalence and positive predictive value (PPV) were higher in the 65+ cohort (PPV, 4.9% vs. 3.0%). Resection rates for screen-detected cancer were similar (75.6% in the under-65 cohort vs. 73.2% in the 65+ cohort). Five-year all-cause survival was lower in the 65+ cohort (55.1% vs. 64.1%; P = 0.018). LIMITATION: The oldest screened patient was aged 76 years.
conclusionNLST participants aged 65 years or older had a higher rate of false-positive screening results than those younger than 65 years but a higher cancer prevalence and PPV. Screen-detected cancer was treated similarly in the groups. PRIMARY FUNDING SOURCE: National Institutes of Health.
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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.