By ecancer Science Editor, Linda Cairns

Screening former and current smokers with a type of scan called a Spiral CT appears to cut deaths from lung cancer significantly. The results of a long-awaited study, the National Lung Screening Trial (NLST) carried out by the NCI in the USA indicate a 20% reduction in mortality.

These early results are the first to demonstrate a benefit for lung cancer screening in a randomised, controlled study; several previous observational studies produced promising preliminary results on the benefit of the screening, but now there is strong evidence for a reduction in mortality.

The findings were so striking that the NCI announced yesterday that the trial would be halted.

The trial, which started in 2002, has enrolled more than 53,000 current and former heavy smokers. All participants, who were without signs, symptoms or a history of lung cancer, were assigned to receive either low-dose spiral CT or standard chest x-ray.

As of Oct. 20, 2010, the researchers saw a total of 354 deaths from lung cancer in the CT group, compared with 442 in the chest x-ray group.

"We are extremely excited about these results," said Dr. Giulia Veronesi, Director of the Unit of lung cancer early detection in the Division of Thoracic Surgery at the European Institute of Oncology and coordinator of a similar screening trial, the COSMOS study, in Italy.

"We hope that this technology may lead to early treatment of lung cancer, the most common cause of cancer death globally, as mammography has done for breast cancer"

Dr Veronesi went on to explain that "a responsible implementation of screening programs is now required". She further outlined the following issues which now need to be established:

- risk models able to select the best candidates for screening;

- identification of the best surveillance strategy for each individual to reduce radiation exposure and costs;

- guidelines for a non invasive diagnostic protocol for indeterminate lung nodules;

- new surgical strategies to reduce trauma and aggressiveness of treatment of very small lung tumours."

"The Cosmos study has prepared the field for the large-scale application of CT screening for Lung cancer in Italy: we hope our work will be of help in a judicious clinical application of this test".