Screening with low-dose CT (LDCT) in a high-risk population, as defined by age and smoking behavior, reduces lung cancer-related mortality. However, LDCT screening presents a major challenge. Numerous, mostly benign, nodules are seen in the lungs during screening. The question is how to distinguish the malignant from the benign nodules. Various studies use different protocols for nodule management. The Dutch-Belgian NELSON (Nederlands-Leuvens Longkanker Screenings Onderzoek) trial, the largest European lung cancer screening trial, used distinctions based on nodule volumetric assessment and growth rate. This review discusses key findings from the NELSON study regarding the characteristics of screening-detected nodules, including nodule size and its volumetric assessment, growth rate, subtype, and their associated malignancy risk. These results are compared with findings from other screening studies and current recommendations for lung nodule management. By examining differences in nodule management strategies and providing a comprehensive overview of outcomes specific to lung cancer screening, this review aims to contribute to the broader discussion on optimizing lung nodule management in screening programs.

中文翻译：

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肺癌低剂量 CT 筛查中的肺结节管理：NELSON 试验的经验教训。


对高危人群（根据年龄和吸烟行为定义）进行低剂量 CT （LDCT） 筛查可降低肺癌相关死亡率。然而，LDCT 筛查是一项重大挑战。在筛查过程中，肺部会出现许多结节，主要是良性的。问题是如何区分恶性结节和良性结节。各种研究使用不同的结节管理方案。荷兰-比利时 NELSON （Nederlands-Leuvens Longkanker Screenings Onderzoek） 试验是欧洲最大的肺癌筛查试验，根据结节体积评估和生长速率进行区分。本综述讨论了 NELSON 研究中关于筛查检测到的结节特征的主要发现，包括结节大小及其体积评估、生长速度、亚型及其相关的恶性肿瘤风险。将这些结果与其他筛查研究的结果和当前肺结节管理的建议进行比较。通过检查结节管理策略的差异并全面概述肺癌筛查的特定结局，本综述旨在为在筛查计划中优化肺结节管理的更广泛讨论做出贡献。