3 ms·

Frequent screening reduces mortality due to lung cancer by 24%: https://www.nejm.org/doi/full/10.1056/NEJMoa1911793 https://www.nejm.org/doi/full/10.1056/NEJMoa

• Engineering-MD 7y ago
  Interesting find! I have had a quick skim. Couple of quick points: a) it was published yesterday, which means there is insufficient time to have a good critical appraisal. b) looking at the confidence intervals, although there is significance in men, there is not one in men, and the confidence interval is quite wide c) all cause mortality is similar in both groups despite screening d) the follow up is only 10 years after first CT. the effect of radiation from these multiple CTs is unlikely to have reached maximum effect in damage to tissues/new neoplasms. This may also explain the increased non lung cancer mortality. e) no mention is made of morbidity (although I might have missed it) which is a huge importance. Overall, it’s unsurprising that in a group screened regularly for lung cancer that lung cancer incidence increases but mortality drops. The problem is the other effects of screening which this paper doesn’t seem to focus on. I don’t think this actually shows screening is particularly worth it especially given it’s caveats.
  • edejong 7y ago
    Thanks! I really like this critical analysis. Tbh, I didn’t read the article but it was on the Dutch news this morning.