Extract

The National Lung Screening Trial (NLST) demonstrated that low-dose computed tomography (LDCT) screening reduced lung cancer mortality by 20% [1]. Lung cancer screening was subsequently recommended by the US Preventive

Services Taskforce (USPSTF) for patients at high risk of lung cancer [2], but European nations have awaited the results of the Dutch–Belgian NELSON trial [3] before committing to national programmes. The initial findings from NELSON, presented recently at the World Conference on Lung Cancer [4], appear to confirm the reduction in lung cancer mortality, and will increase the impetus for implementation in Europe. A European position statement on lung cancer screening identified specific actions required prior to systematic LDCT screening [5]. These include the development of a risk stratification approach to identify the population for lung cancer screening, and recognition that harm-to-benefit considerations make it unethical to screen low risk patients.