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It summarizes results from the NELSON trial, extended follow-up of other LCS randomized controlled trials (RCTs), and meta-analyses of RCTs, showing a 16% relative reduction in lung cancer mortality with low-dose CT versus non-LDCT controls. It also reviews updates to US clinical guidelines and addresses implementation, including eligibility criteria, program structure, shared decision-making, smoking cessation, uptake, adherence, management of screen-detected and incidental findings, disparities, and emerging personalized approaches such as risk models, biomarkers, and AI.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/updates-in-lung-cancer-screening-a-decade-of-evidence/440142/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/updates-in-lung-cancer-screening-a-decade-of-evidence/440142.png","ImageObject",300,407,{"name":92,"@type":93},"Well Done","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-23","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What mortality benefit does the review report for low-dose CT lung cancer screening?","Question",{"text":112,"@type":113},"Across RCT evidence summarized in the review, low-dose CT screening versus non-LDCT controls produced a 16% relative reduction in lung cancer mortality.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the NLST and NELSON trials differ in their study population and nodule assessment?",{"text":117,"@type":113},"The NLST and NELSON trials differed in participant characteristics and in how nodules were measured: NELSON assessed nodules by volume growth, while NLST used nodule diameter.",{"name":119,"@type":110,"acceptedAnswer":120},"Which implementation components does the review highlight for lung cancer screening programs?",{"text":121,"@type":113},"The review highlights implementation across areas including selection criteria, program structure, shared decision making, smoking cessation, uptake, annual adherence, management of screen-detected and incidental findings, and disparities.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},440142,1790899172,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},5909892210082,"https://ap-avatar.wpscdn.com/avatar/56001069da27c9f41e8?x-image-process=image/resize,m_fixed,w_180,h_180&k=1789614185077863061","Accepted Manuscript online: 2025-09-16 Article published online: 2025-10-16  \n502  \nTHIEME  \nUpdates in Lung Cancer Screening: A Decade of Evidence  \nLori C. Sakoda, PhD, MPH 1,2 Louise M. Henderson, PhD3,4  \n1 Division of Research, Kaiser Permanente Northern California, Pleasanton, California  \n2 Department of Health Systems Science, Kaiser Permanente Bernard  \nJ. Tyson School of Medicine, Pasadena, California  \n3 University of North Carolina at Chapel Hill, Chapel Hill, North Carolina  \n4 Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina  \nSemin Respir Crit Care Med 2025;46:502–519.  \nAddress for correspondence Louise M. Henderson, PhD, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599  \n(e-mail: [louise_henderson@med. unc.edu](louise_henderson@med. unc.edu)).  \nAbstract  \nKeywords  \n► lung cancer screening  \n► review  \n► randomized controlled trials  \nIn this review, we summarize recent evidence from approximately the last 5 years across the lung cancer screening (LCS) care continuum. First, we review the results from the NELSON trial, from the extended follow-up of other LCS randomized controlled trials (RCTs), and from a meta-analysis of RCTs. Together, these RCTs reported a 16% relative reduction in lung cancer mortality for low-dose CT (LDCT) LCS versus non-LDCT controls. Next, we summarize updates to clinical guidelines and recommendations around LCS in the United States, noting the current debate around the use of time since quit as an eligibility criterion. We also discuss the implementation of LCS focusing on the following areas: (1) global landscape, (2) selection criteria and approach, (3) LCS program structure, (4) shared decision making, (5) smoking cessation, (6) LCS uptake, (7) American College of Radiology Lung Reporting and Data System,(8) annual LCS adherence,(9) screen-detected findings and management,(10) incidental findings and management, and (11) disparities. Lastly, we highlight emerging data and considerations for personalized LCS and new technologies, with an emphasis on risk prediction models, biomarkers, and artificial intelligence. This review highlights the latest changes to LCS and the ongoing need to monitor and evaluate LCSas it diffuses into clinical practice across various real-world settings.  \nLung cancer is the leading cause of cancer incidence and mortality worldwide, with an estimated 2.4 million individuals diagnosed with and 1.8 million dying from the disease in 2022.1 Advances in lung cancer screening (LCS) over the last two decades have the potential to alter lung cancer outcomes among populations at high risk. However, there is no universal consensus on how best to define the high-risk population  \nreceived  \nJuly 31, 2025  \naccepted  \nSeptember 15, 2025  \naccepted manuscript online September 16, 2025  \narticle published online October 16, 2025  \nIssue Theme Lung Cancer; Guest Editors: M. Patricia Rivera, MD, and Catherine R. Sears, MD, ATSF  \nDOI [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.1055/a-2701-9312.](10.1055/a-2701-9312.)[ ](10.1055/a-2701-9312.)[ISSN](ISSN 1069-3424.)[ 1069-3424.](ISSN 1069-3424.)  \nthat will experience a net benefit from LCS. As such, variability in clinical guidelines and recommendations for whom to screen for lung cancer exists. In addition, implementation of LCS faces numerous challenges related tothe identification of eligible individuals, the use of shared decision making, and the incorporation of smoking cessation into practice. In this review, we summarize the evidence from approximately the  \n© 2025 . The Author(s) .  \nThis is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited.([https://creativecommons.org/licenses/by/4.0/](https://creativecommons.org/licenses/by/4.0/))  \nThieme Medical Publishers, Inc. , 333 Seventh Avenue, 18th Floor, New Yo","cbCailCqcN7fwgao","https://ap.wps.com/l/cbCailCqcN7fwgao","pdf",327104,18,"English","# Abstract\n# Lung Cancer Screening Trials\n## Evidence from NLST and NELSON\n## Additional RCTs and meta-analysis\n# Clinical Guidelines, Recommendations, and Implementation\n## Eligibility criteria and selection approach\n## LCS program structure and shared decision making\n## Smoking cessation, uptake, and adherence\n## Management of findings and disparities\n# Emerging Data and Personalized Approaches","[{\"question\":\"What mortality benefit does the review report for low-dose CT lung cancer screening?\",\"answer\":\"Across RCT evidence summarized in the review, low-dose CT screening versus non-LDCT controls produced a 16% relative reduction in lung cancer mortality.\"},{\"question\":\"How did the NLST and NELSON trials differ in their study population and nodule assessment?\",\"answer\":\"The NLST and NELSON trials differed in participant characteristics and in how nodules were measured: NELSON assessed nodules by volume growth, while NLST used nodule diameter.\"},{\"question\":\"Which implementation components does the review highlight for lung cancer screening programs?\",\"answer\":\"The review highlights implementation across areas including selection criteria, program structure, shared decision making, smoking cessation, uptake, annual adherence, management of screen-detected and incidental findings, and disparities.\"}]","Updates in Lung Cancer Screening - A Decade of Evidence | PDF",1790691287,45]