UNC Lineberger’s Jennifer Lund, PhD, MSPH, and Louise Henderson, PhD, have been awarded a five-year, $1.76 million National Cancer Institute grant to study the real-world benefits and harms of lung cancer screening with low-dose computed tomography that can ultimately inform screening recommendations and refine shared decision-making tools for lung cancer screening in clinical practice settings.
Randomized controlled trials, with the largest being the National Lung Screening Trial, have shown that annual lung cancer screening with low dose computed tomography can reduce lung cancer deaths by 15-20%. Based on these findings, the United States Preventive Services Task Force recommends lung cancer screening for current or former smokers, aged 50-80 years, with 20 or more pack-years of smoking history.
However, compared to those eligible for lung cancer screening in the United States, participants in the National Lung Screening Trial were generally younger, less racially diverse, less likely to be current smokers, had a higher educational level, and had fewer comorbidities. Lund said these systematic differences call into question whether the findings from the National Lung Screening Trial can be directly extended to clinical practice populations.
“Our study is designed to generate new evidence on the benefits and harms of lung cancer screening with low-dose computed tomography that explicitly considers how the National Lung Screening Trial population differs from populations of individuals who are eligible for or actually receive lung cancer screening in clinical practice,” said Lund, associate professor of epidemiology at UNC Gillings School of Global Public Health.
Henderson, professor of radiology and cancer epidemiology program leader at UNC Lineberger, said addressing the knowledge gaps in lung cancer screening will generate contemporary data that can inform clinical practice and policy decisions. “Our ultimate goal is to help support more effective delivery of lung cancer screening in the community and ultimately improve patient and population-level outcomes.”
In addition to Henderson and Lund, the other co-investigators include Michael Hudgens, PhD, professor and associate chair of biostatistics, UNC Gillings, Til Stürmer, MD, PhD, MPH, Nancy A. Dreyer Distinguished Professor and chair of epidemiology, UNC Gillings, and Dan Reuland, MD, MPH, professor of medicine and co-director of the Carolina Cancer Screening Initiative.