Low-dose CT for lung cancer screening in a high-risk population (SUMMIT): a prospective, longitudinal cohort study.

Summary

Among 12,773 high-risk participants, low-dose CT screening achieved 97.0% episode sensitivity and 95.2% specificity with a 4.8% false-positive rate at 12 months. Most screen-detected lung cancers were stage I–II (79.3%), with surgery as the primary treatment (77.0%) and low 90-day surgical mortality (0.4%).

Key Findings

• Episode sensitivity 97.0% and specificity 95.2% at 12 months; false-positive rate 4.8%.
• 79.3% of screen-detected lung cancers were stage I–II; surgery was primary treatment in 77.0%.
• Low 90-day postoperative mortality (0.4%) and benign resection rate of 11.6% among resections.

Clinical Implications

Health systems can deploy low-dose CT screening with high sensitivity and manageable false positives, anticipating predominantly early-stage detection and low perioperative mortality when surgical management is pursued.

Limitations

• Baseline round analysis; long-term mortality impact not assessed here.
• Benign resection rate (11.6%) indicates potential for further optimization of nodule management algorithms.

Future Directions

Evaluate longitudinal outcomes (mortality, overdiagnosis), refine risk models and nodule management to reduce benign resections, and assess equity and adherence in program scale-up.