To carry out the trial, NCI is using two research networks funded by the Institute: one network has been conducting the lung screening study called the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, and the other is the American College of Radiology Imaging Network (ACRIN), a network of researchers who conduct imaging studies. In addition, NCI is collaborating with the American Cancer Society to organize grassroots recruitment efforts at NLST sites.
"NLST is important because there an estimated 90 million current and former smokers in the United States at high risk for lung cancer, and death rates for this disease, unlike many other cancers, have not declined," said NLST co-director John Gohagan, Ph.D., of NCI's Division of Cancer Prevention. "Lung cancer kills more people than cancers of the breast, prostate, colon, and pancreas combined and will claim nearly 155,000 lives this year. Our hope is that this study will lead to saving lives."
To help ensure that NLST reaches full enrollment quickly, the American Cancer Society will support NCI with targeted promotional and outreach efforts in communities surrounding the trial sites.
"Reducing lung cancer deaths is a high priority of the American Cancer Society," said Harmon Eyre, M.D., chief medical officer and executive vice president for research and cancer control of the American Cancer Society. "With a recognized commitment to saving lives from cancer, and a trusted local presence near each of the NLST sites, the Society is uniquely positioned to communicate the benefits of the trial, build trust in eligible participants, and help NCI reach full enrollment as soon as possible."
The trial is a randomized, controlled study--the "gold standard" of research studies. Study participants will be randomly assigned--designated by chance--to receive either a chest X-ray or a spiral CT once a year for three years. Researchers will continue to contact participants annually to monitor their health until 2009.
When detected, lung cancer has usually spread outside the lung in 15 percent to 30 percent of cases. Spiral CT can pick up tumors well under 1 centimeter (cm) in size, while chest X-rays detect tumors about 1 to 2 cm in size.
"Conventional wisdom suggests that the smaller the tumor when it is found, the more likely the chance of survival--but that remains to be proven," said ACRIN researcher and NLST co-director Denise Aberle, M.D., from the University of California Los Angeles. "Because of the number of individuals participating and because it is a randomized, controlled trial, NLST will be able to provide the evidence needed to determine whether spiral CT scans are better than chest X-rays at reducing a person's chances of dying from lung cancer."
Spiral CT, a technology introduced in the 1990s, uses X-rays to scan the entire chest in about 15 to 25 seconds, during a single breath hold. A computer creates images from the scan, assembling them into a 3-dimensional model of the lungs. More than half of the hospitals in the United States own a spiral CT machine and routinely use them for staging lung and other cancers--that is, determining how advanced the cancer is after diagnosis. Recently some hospitals have begun performing spiral CT scans as a new way to find early lung cancer in smokers and former smokers. However, no scientific evidence to date has shown that screening or early detection of lung cancer with either spiral CT or chest X-rays actually saves lives.
In addition to the lung cancer screenings, some NLST centers will collect blood, urine, and sputum. These samples will be used for future research to test for biomarkers that may someday help doctors better diagnose lung cancer.
Participants in NLST will receive lung cancer screenings free of charge. Men and women can participate in NLST if they meet the following requirements:
- Are current or former smokers ages 55 to 74
- Have never had lung cancer and have not had any cancer within the last five years (except some skin cancers or in situ cancers)
- Are not currently enrolled in any other cancer screening or cancer prevention trial
- Have not had a CT scan of the chest or lungs within the last 18 months.
Additionally, participants can receive referrals to smoking cessation programs if they are interested in quitting smoking. For more information about NLST and to find the center nearest you:
- Call the National Cancer Institute's Cancer Information Service toll-free, Monday through Friday, 9 a.m. to 4:30 p.m., at 1-800-4-CANCER (1-800-422-6237) for information in English or Spanish. The number for callers with TTY equipment is 1-800-332-8615.
- Log on to cancer.gov/NLST.
Additional materials related to NLST include:
National Lung Screening Trial Questions and Answers at http://newscenter.cancer.gov/pressreleases/NLSTQA.html
An interview with NLST scientists, a video news release on the launch of the trial, photos, stills, audio clips, and other materials related to NLST at http://newscenter.cancer.gov/BenchMarks/
The National Cancer Institute is a component of the National Institutes of Health, U.S. Department of Health and Human Services.
For more information about cancer, visit NCI's Web site at http://cancer.gov