Evidence map›Paper›PMID 34806061›Full record

ArticleThe Lancet regional health. Europe2021

Lung cancer mortality reduction by LDCT screening: UKLS randomised trial results and international meta-analysis.

John K Field, Daniel Vulkan, Michael P A Davies, David R Baldwin, Kate E Brain, Anand Devaraj, Tim Eisen, John Gosney, Beverley A Green, John A Holemans and 18 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Europe, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 159 papers, 13 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
159citing papers in PubMed, 13 pooled it
22.2field-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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

159 citing papers in PubMed, 13 syntheses or guidelines pooled it, 214 citations in OpenAlex.

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  10. Lung Cancer Screening With Low-Dose Computed Tomography.Deutsches Arzteblatt international · 2023
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99 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 13 institutions in 1 country.

John K FieldDepartment of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, 6 West Derby Street, Liverpool L7 8TX, UK.
Daniel VulkanCentre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Michael P A DaviesDepartment of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, 6 West Derby Street, Liverpool L7 8TX, UK.
David R BaldwinRespiratory Medicine Unit, David Evans Research Centre, Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK.
Kate E BrainDivision of Population Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Anand DevarajDepartment of Radiology, Royal Brompton Hospital, London, and National Heart and Lung Institute, Imperial College, London, UK.
Tim EisenDepartment of Oncology, University of Cambridge, Cambridge, UK.
John GosneyDepartment of Pathology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK.
Beverley A GreenDepartment of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, 6 West Derby Street, Liverpool L7 8TX, UK.
John A HolemansDepartment of Radiology, Liverpool Heart and Chest Hospital, Liverpool, UK.
Terry KavanaghLung Cancer Patient Advocate, Liverpool, UK.
Keith M KerrDepartment of Pathology, Aberdeen Royal Infirmary, Aberdeen, UK.
Martin LedsonDepartment of Respiratory Medicine, Liverpool Heart and Chest Hospital, Liverpool, UK.
Kate J LiffordDivision of Population Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK.
Fiona E McRonaldDepartment of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, 6 West Derby Street, Liverpool L7 8TX, UK.
Arjun NairDepartment of Radiology, University College, London Hospital, London, UK.
Richard D PageDepartment of Thoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, UK.
Mahesh K B ParmarMRC Clinical Trials Unit, University College London, London, UK.
Doris M RasslDepartment of Pathology, Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Robert C RintoulDepartment of Thoracic Oncology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Nicholas J ScreatonDepartment of Thoracic Oncology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK.
Nicholas J WaldFaculty of Population Health Sciences, University College London, London, UK.
David WellerSchool of Clinical Sciences and Community Health, University of Edinburgh, Edinburgh, UK.
David K WhynesSchool of Economics, University of Nottingham, Nottingham, UK.
Paula R WilliamsonDepartment of Biostatistics, University of Liverpool, Liverpool, UK.
Gasham YadegarfarDepartment of Molecular and Clinical Cancer Medicine, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, 6 West Derby Street, Liverpool L7 8TX, UK.
Rhian GabeCenter for Evaluation and Methods, Wolfson Institute of Population Health. Queen Mary University of London, London, UK.
Stephen W DuffyCentre for Prevention, Detection and Diagnosis, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
University of Liverpool · GBPapworth Hospital NHS Foundation Trust · GBQueen Mary University of London · GBCardiff University · GBAberdeen Royal Infirmary · GBMRC Clinical Trials Unit at UCL · GBNottingham University Hospitals NHS Trust · GBRoyal Brompton Hospital · GBUniversity College Hospital · GBUniversity College London · GBUniversity of Cambridge · GBUniversity of Edinburgh · GBUniversity of Nottingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe NLST reported a significant 20% reduction in lung cancer mortality with three annual low-dose CT (LDCT) screens and the Dutch-Belgian NELSON trial indicates a similar reduction. We present the results of the UKLS trial.

methodsFrom October 2011 to February 2013, we randomly allocated 4 055 participants to either a single invitation to screening with LDCT or to no screening (usual care). Eligible participants (aged 50-75) had a risk score (LLPv2) ≥ 4.5% of developing lung cancer over five years. Data were collected on lung cancer cases to 31 December 2019 and deaths to 29 February 2020 through linkage to national registries. The primary outcome was mortality due to lung cancer. We included our results in a random-effects meta-analysis to provide a synthesis of the latest randomised trial evidence.

findings1 987 participants in the intervention and 1 981 in the usual care arms were followed for a median of 7.3 years (IQR 7.1-7.6), 86 cancers were diagnosed in the LDCT arm and 75 in the control arm. 30 lung cancer deaths were reported in the screening arm, 46 in the control arm, (relative rate 0.65 [95% CI 0.41-1.02]; p=0.062). The meta-analysis indicated a significant reduction in lung cancer mortality with a pooled overall relative rate of 0.84 (95% CI 0.76-0.92) from nine eligible trials.

interpretationThe UKLS trial of single LDCT indicates a reduction of lung cancer death of similar magnitude to the NELSON and NLST trials and was included in a meta-analysis of nine randomised trials which provides unequivocal support for lung cancer screening in identified risk groups.

fundingNIHR Health Technology Assessment programme; NIHR Policy Research programme; Roy Castle Lung Cancer Foundation.

Indexed as

CT ScreeningLung CancerLung Cancer MortalityMeta-analysis

Identifiers

PMID34806061
PMCPMC8589726
OpenAlexW3199475400

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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.