{"entity":{"id":"nlst-nelson","kind":"trial","name":"NLST & NELSON (low-dose CT screening)","aka":[],"tldr":"The two trials that proved a yearly low-dose CT scan cuts lung cancer deaths in heavy smokers.","summary":"NLST (NEJM 2011) showed a 20% relative reduction in lung cancer mortality with three annual low-dose CTs versus chest radiography. NELSON (NEJM 2020) showed a 24% reduction in men at 10 years with volume-based nodule management and a lower false-positive rate. Together they underpin USPSTF (age 50-80, ≥20 pack-years) and European screening recommendations. Uptake remains low.","status":"positive","asOf":"2026-09-06","links":[{"label":"ClinicalTrials.gov NCT00047385","url":"https://clinicaltrials.gov/study/NCT00047385"},{"label":"NELSON, NEJM 2020","url":"https://www.nejm.org/doi/full/10.1056/NEJMoa1911793"}],"tags":[],"related":[],"cancers":["nsclc"],"sections":[],"technologies":["low-dose-ct-screening","ct"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":["harry-de-koning","denise-aberle"],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"phase":"3","setting":"Annual low-dose CT versus chest X-ray (NLST, 53,454 heavy smokers) or no screening (NELSON, 15,789) in current and former smokers","sponsor":"NCI; Dutch-Belgian consortium","result":"Lung cancer mortality reduced 20% (NLST) and 24% in men (NELSON).","yearReported":2011,"enrolled":53454,"enrolledBasis":"registry","outcomes":[{"endpoint":"NLST: relative reduction in lung cancer mortality","primary":true,"unit":"%","arms":[{"name":"Low-dose CT vs chest X-ray","value":20}],"ci":[6.8,26.7],"source":"https://www.nejm.org/doi/full/10.1056/NEJMoa1102873"},{"endpoint":"NELSON: relative reduction in lung cancer mortality at 10 years (men)","primary":true,"unit":"%","arms":[{"name":"Low-dose CT vs no screening","value":24}],"source":"https://www.nejm.org/doi/full/10.1056/NEJMoa1911793"}],"replication":"Two independent randomised trials on two continents agree; MILD and LUSI are consistent."},"route":"/trials/nlst-nelson/","neighbours":{"cancer":[{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"resectable-nsclc","kind":"cancer","name":"Resectable stage I to III non-small-cell lung cancer","route":"/cancers/resectable-nsclc/"}],"technology":[{"id":"ct","kind":"technology","name":"CT (computed tomography)","route":"/technologies/ct/"},{"id":"low-dose-ct-screening","kind":"technology","name":"Low-dose CT lung screening","route":"/technologies/low-dose-ct-screening/"},{"id":"nhs-targeted-lung-health-check","kind":"technology","name":"NHS Targeted Lung Health Check (lung cancer screening programme)","route":"/technologies/nhs-targeted-lung-health-check/"},{"id":"tumour-doubling-time","kind":"technology","name":"Tumour volume doubling time","route":"/technologies/tumour-doubling-time/"}],"person":[{"id":"denise-aberle","kind":"person","name":"Denise R. Aberle","route":"/people/denise-aberle/"},{"id":"harry-de-koning","kind":"person","name":"Harry J. de Koning","route":"/people/harry-de-koning/"}],"trial":[{"id":"ukls","kind":"trial","name":"UKLS","route":"/trials/ukls/"}],"institution":[{"id":"nci","kind":"institution","name":"National Cancer Institute (NIH)","route":"/institutions/nci/"}],"bottleneck":[{"id":"b-overdiagnosis","kind":"bottleneck","name":"Overdiagnosis and false alarms","route":"/bottlenecks/b-overdiagnosis/"},{"id":"b-early-detection","kind":"bottleneck","name":"The hardest cancers are found late","route":"/bottlenecks/b-early-detection/"}],"paper":[{"id":"paper-nelson-nejm-2020","kind":"paper","name":"NELSON: volume-based CT screening reduces lung cancer deaths with fewer false alarms","route":"/key-papers/paper-nelson-nejm-2020/"},{"id":"paper-nlst-nejm-2011","kind":"paper","name":"NLST: yearly low-dose CT scans cut lung cancer deaths in heavy smokers","route":"/key-papers/paper-nlst-nejm-2011/"}],"roadmap":[{"id":"prevention-roadmap","kind":"roadmap","name":"Cancer prevention roadmap: tobacco control and vaccines → biomarker-guided chemoprevention → interception in carriers","route":"/roadmaps/prevention-roadmap/"}]}}