NELSON lung cancer screening study

Abstract

The Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON study) was designed to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk subjects will lead to a decrease in 10-year lung cancer mortality of at least 25% compared with a control group without screening. Since the start of the NELSON study in 2003, 7557 participants underwent CT screening, with scan rounds in years 1, 2, 4 and 6. In the current review, the design of the NELSON study including participant selection and the lung nodule management protocol, as well as results on validation of CT screening and first results on lung cancer screening are described.

Figure 1

Baseline and 3-month follow-up CT images in a 68-year-old participant of the NELSON study. Transverse thin-section CT (a,c) and volume-rendered reconstruction (b,d) images show a lobulated pulmonary nodule with vessel attachment (boxed on a,c and green area in b,d). On the baseline scan (a,b) the volume was 303 mm³. On the 3-month follow-up CT (c,d), the volume was 576 mm³. This is consistent with a percentage volume growth of 90% and a volume-doubling time of 98 days. Histopathology of the resected nodule: squamous cell carcinoma.