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N Engl J Med. 2013 Sep 5;369(10):920-31. doi: 10.1056/NEJMoa1208962.

Results of the two incidence screenings in the National Lung Screening Trial.

Collaborators (1489)

Aberle DR, Berg CD, Black WC, Brewer B, Church TR, Clingan KL, DeMello S, Duan F, Fagerstrom RM, Gareen IF, Gatsonis CA, Gierada DS, Jain A, Jones GC, Mahon I, Marcus PM, Rathmell JM, Sicks J, Aberle DR, Berg CD, Black WC, Church TR, Fagerstrom RM, Galen B, Gareen IF, Gatsonis C, Goldin JG, Gohagan JK, Hillman B, Jacobs PM, Jaffe C, Kramer BS, Lynch D, Marcus PM, Schnall M, Sullivan DC, Sullivan D, Tatum JL, Zylak CJ, Aberle DR, Fagerstrom RM, Gatsonis C, Gareen IF, Marcus PM, Berg CD, Cagnon C, Cody D, Fletcher G, Flynn MJ, Judy PF, Kruger R, Larke FJ, McNitt-Gray M, Payne T, Seibert J, Wu X, Abbott G, Aberle DR, Amorosa JK, Barr RG, Black WC, Boiselle PM, Chiles C, Clark R, Coppage L, Falk R, Fishman EK, Gemmel D, Goldin JG, Goodman E, Hart EM, Hazelton T, Johnson E, Judy PF, Kazerooni E, McComb BL, McLennan G, Munden RF, Ravenel J, Sullivan MA, Swensen SJ, Thomas K, Torigian DA, Tung G, Vydareny KH, Worrell JA, Balkin P, Church TR, Fouad M, Freedman MT, Garg K, Gelmann EP, Gierada DS, Hocking W, Inampudi S, Isaacs C, Kvale P, Lynch DA, Mann H, Manor W, Nath H, Reding D, Spizarny DL, Strollo DC, Waltz J, Chen MH, Corle D, Duan F, Izmirilian G, Pinsky P, Prorok PC, Sausville EA, Burke W, Colice G, Edwards B, Emerson S, Harris R, Klein JS, Korn EL, Mayer R, Selby JV, Sturges DW, Turnbull BW, Watson TJ, Fletcher J, Green S, Miller AB, Edelman MJ, Evans WK, Fontana RS, Machtay M, Young RC, Alberts D, DeMets D, Greenwald P, Jacobs PM, McLoud TC, Naidich DP, Tatum JL, Aberle DR, Barr R, Black WC, Goldin JG, Torigian D, Vydareny K, Worrell J, Gierada DS, Clark KW, Clingan KL, Fagerstrom RM, Fletcher G, Flynn MJ, Garg K, Larke FJ, Márquez G, Moore SM, Nath H, Ohan P, Payne TJ, Rosenbaum JL, Strollo DC, Wu X, Ford MB, Peace S, Aberle DR, Baylin S, Caporaso N, Dennis P, Duan F, Dubinett S, Franklin W, Gatsonis C, Grizzle W, Hirsch F, Massion P, McKeeta-Probeck K, Minna J, Patz E, Spitz M, Galen B, Jaffe C, Jacobs PM, Aberle DR, Gatsonis C, Gareen I, Schnall M, Apgar C, Mahon I, Brastater H, Iyer V, George J, Gopalakrishnan D, Blair P, Bradley M, Crozier C, Oh M, Spiese N, Steward C, Kelly-Truran M, Thompson T, Cunningham E, Levering A, McMurtrie K, Nahill M, Snowden S, Smith K, Wilton F, Welsh T, Welsh R, Apgar C, Boyle A, Caldwell T, Fredericks N, Harbison D, Hartfeil D, Jones S, King S, Mahon I, Medina R, Masiejczyk C, Sears L, Zamora P, Christie W, Clabo S, Clune R, Cunningham N, Downs J, Dymond L, Falcone J, Harris S, Harvey P, Hill J, Hill L, Letizia D, Looney K, McGinley H, Mean A, Moore M, Norton R, Ortico V, Sabina S, Sole R, Stetz J, Ssali A, Stubblefield J, Taylor T, White S, Gatsonis C, Chen MH, Duan F, Lu B, Duggan M, Souza C, Gareen IF, Adams A, Baum S, Blevins M, Fox P, Girardi V, Gorelick J, Hunt E, McMullen Q, Meganathan K, Rendas-Baum R, Sicks JD, Snyder B, Yeh M, Berg CD, Fagerstrom RM, Prorok PC, Marcus PM, Corle D, Hu P, Izmirlian G, Pinsky P, Marquez G, Sullivan D, Gaegler J, Gohagan JK, Hoffman S, Jackson C, Lange E, Loesch M, Papadopoulos E, Kramer B, Brewer BK, O'Brien B, Cahill J, Ford MB, Rosenbaum JL, Clingan KL, Payte N, Price H, Keating KJ, Galbraith M, Lawler-Heavner J, Devereux G, Peace S, Chanapatna R, Florczyk M, Morgan A, Ohan P, Tiet L, Martinusen L, Lewis T, Roberts LM, DeBaugh R, Narayanaswami V, McSwain J, Rosario R, Singh J, Lake W Jr, Clapp JD, Riley T, Austin J, Goodman AS, Irons B, Wright P, Kibic C, Hawkins LL, Jones GC, Rathmell JM, Xu F, Young M, Sheridan P, Kadish N, Moline D, Phillips R, Adkinson M, Creed D, DeCoste T, Gembala D, Hurst S, King E, Knowles J, McBride P, Pangburn P, Preston J, Stokes K, Tesch P, Wenmoth S, Galocy L, Mandley D, McBride P, Orvis G, Boiselle PM, Schwartzstein R, Lin PJ, Parritt TA, Grady EA, Damon L, Gard S, Griggs R, Potemkin A, Pollock MM, Owens T, Mc Clellan S, Laron M, Costello P, Jacobson FL, Judy PF, Hunsaker AR, Spirn PW, Trotman-Dickenson B, Nawfel RD, Christopoulos VE, Kazda IK, MacDougall RC, Walsh A, Berger R, Chan P, Delano M, Geiger J, Krinopol C, McGinnis AD, McLaughlin AM, Weatherby R, Abbott G, Tung G, Maineiro M, Camara L, Cobb C, Smith W, Foley S, Morrell E, Romano D, Guillette D, Amorosa JK, Furlong M, Hudak C, Hugill A, Konduri S, Weslowsky E, Aisner J, Backer M, Bramwitt M, de Caravalho V, Epstein R, Joyce P, Langenfeld JE, Reinert A, DeMarco K, Lutzker S, Musanti R, Shiff S, Wolfsohn T, Carmen S, Foster DL, Hansen K, Pennetta B, White LV, Tokarz R, Trotta M, Birofka A, Black WC, Kasales CJ, Lewis PJ, Weaver JB, Lenz SB, Barrett AC, Dauphinais RX, Heinz JR, Siemionko MK, Taplin A, Wasson LS, DeAlmeida L, Longacre S, Meagher K, Moser CM, Lawlor JK 3rd, O'Quinn C, Black NE, Bradley HL, Bronson JK, Cosgrove T, Haron MK, King D, Mazuerk PM, O'Donnell NF, Pluta DJ, Sackett TJ, Turgeon GD, Albano H, Bell C, Bergen J, Bizer G, Carmichael NM, Cimis C, Davis S, DeAngelis T, Fellows G, Fenton C, Ferola J, Gankiewicz N, Hastings D, Howell C, Johnson ME, Krisk M, Lancor H, Leary C, LeBlanc M, Leming A, Leming M, Mead D, Milacek M, Mood J, Nordstrom H, Palazzolo C, Pierce J, Remitz RP, Rider J, Robbins KA, Sleasman B, Spaulding J, Vashel C, Welch A, White L, Whitty M, Vydareny KH, Williams AM, Karellas A, Grayson L, McCalister-Cross C, Mesquita S, Nguyen A, Myers LN, Deaton E, Falk R, Maxfield S, Thomas K, Brenzel L, Allen P, Brooks D, Chadwell C, Couch E, DeVore A, Flores R, Francis M, Landes S, Mattingly J, Oechsli M, Pitino B, Sams S, Soukhanova O, Bland P, Bube S, Hoffa T, McElsain B, Johnson D, Francow C, Johnson S, Senn P, Fishman EK, Horton KM, Lawler LP, Mahesh M, Bradford L, Christensen G, Bishop J, Motley L, Robertson D, Stewart R, Yung R, Zeng M, Blake HB, Bradford H, Bradford J, Burner J, Christensen J, Christensen J, Guzman C, Kasecamp J, Kaufmann JB, Kimball D, Lewis Z, Moesinger S, Walsh S, Taylor K, Gambill G, Merrill S, McComb BL, Johnson EA, Jolles HI, Kuzo RS, Morin RL, Abaya R, Chewar D, Shwarts P, Allen S, Manning S, Hildestad J, Adams M, Awan Z, Beagle L, Cape D, Zeiger T, Amendolare L, Bahr N, Belyea M, Berg T, Burkhard M, Cottrell L, DeAngelis K, Dvorak M, Gay L, Hatton K, Jacoby S, Kennedy V, Krach K, Laughren M, Lavergne C, Lawrence M, Lynch J, McDonald A, Mestas F, Moody J, O'Brien C, Pitts J, Polding B, Richardson L, Robinson K, Warren A, Washburn H, Wilson E, Zagarra L, Batton KM, Chellini D, DeWitt K, Fleming DR, Newton-Foster C, Krach K, MacDonald R, O'Brien C, Ott J, Peterson J, Sallas M, Teepe M, Thomas R, Torrence K, Zagarra L, Swensen SJ, Hartman TE, Jett JR, McCollough CH, Midthun DE, Andrist BR, Hanson NE, Sathre CL, Schroeder LD, Sheeran JR, Walters LC, Andrist CL, Bungum AO, Bornhorst CL, Deno DM, Krpata TS, Lambrecht AM, McKey CM, Prudoehl DK, Richter HR, Ravenel J, Costello P, Brisendine A, Adrales-Bentz T, Arnold K, Benjamin B, Dodd A, Keller J, Saunders T, Shannon S, Bailey L, Comer H, Espiritu J, Helwi S, Mack-Pipkin B, Spicker P, Clark R, Coppage L, Hazelton T, Tockman M, Evans B, Wadhwa N, Baptiste N, Eysmans C, Vera-Gonzalez N, Hamm L, Harjani V, Sear A, Blackwell S, Kirchoff L, Fernandez A, Williams E, Coleman KA, Afiat J, Bowman R, Brothers C, Cohen B, Fields N, Guzman R, Monje C, Sterling W, Thorpe L, White K, Williams B, Hart EM, Nekervis E, Berns E, Franco A, Glick I, Grigolo M, Harts Y, Migo A, Rockwell KP, Stein A, Weyls R, Biringer MT, Del Pino A, Dubbs P, Fehrmann GM, Goodwin AL, Granger L, Haglage J, Hirschy J, King M, Kristopher JW, Mac NM, Mahony G, Markarian A, Ramirez M, Taylor M, West KM, Sullivan MA, Matthews CC, Jones J, Cole A, Dow P, Fearon J, Fodera B, Ginther B, McCall RL, Williams S, Young S, Juul C, LaFleur A, Schmidt A, Wright S, Lohmann K, Pineda L, Greenup S, McNulty K, Pawlak S, Porter H, Lanning T, Loria D, Barr RG, Gemmel D, Cook A 2nd, DuChateau A, Engartner C, Evans DM, Love C, Schuler P, Kobistek R, Hallsky JA, Boulos A, Dalal P, Dickstein B, Evans J, Evans K, Gemmel M, Hallsky S, Hoffman P, Hritz C, Kerchum L, Kolich M, Kolich M, Kolich M, Kumar N, Lobaugh J, Love D, Love M, Marchese M, Nelson D, Petkus C, Petruzzi M, Raver C, Schuler E, Schultz D, Jackson J, Ziegler J, Fleischer J, Welch LL, Acerra M, Brittain B, Conklin L, Cyphert C, Delfosse B, Franceshelli L, Fuller J, Garland D, Gocala PJ, Grunenwald M, Kowalik D, Kurjan SL, Lavernick P, Maderitz J, Metz R, Quinn R, Semansky M, Smith S, St Claire A, Taybus P, Wisler D, Zubena K, Goldin JG, Aberle DR, Duda C, Kay P, Trapnell P, Vlachou M, Cagnon C, McNitt-Gray M, Spivak J, Pollard M, Brown E, Campa O, Carter B, Clark S, Flores M, Ho J, Lee T, Lewis B, McMahon J, Momongan L, Ngo J, Perryman A, Rivas N, Romo C, Sookpisal K, Stone L, Voight B, William C, Adams K, Do P, Engber K, Henry L, Khalili M, Morales S, O'Carroll C, Quijano J, Borgheian S, Inatomi R, Lorenzo A, Lorenzo D, Nyborg G, Salazar V, Woo M, Bigby BB, Gallego A, Goodman E, Beck P, Voight K, Beerman P, Jacobsen J, Phillips R, Vranceanu A, Allman E, Chen S, Farkas C, Forter I, Kulkarni G, Low L, Marcus P, Matthews L, Silva-Gietzen J, Sturgeon E, Varner G, McLennan G, Thomas K, Mullen B, Stanford W, Hoffman E, Sprenger K, Chapman A, Crawford K, Marietta J, Kmetty L, Meier J, Pirotte P, Rathmell L, Hudson M, Sieren J, Kazerooni E, Holloway L, Cronin P, Gross B, Kelly A, Patel S, Pernicano P, Chalom G, Harper T, Henricks E, Pool J, Shepherd D, Zapolski D, Goodsitt M, Hooks H, Torigian DA, Gefter W, Werner D, Smith CE, Choi BK, Lee JK, Holland C, Matuza J, Nosker HC, Russell W, Cupp S, O'Shea M, Munden R, Cates M, Sanchez E, Cody D, Geiser WR, Montague JL, Patel M, Robinson T, Aganon-Acheta M, Black M, Blalock D, Brown C, Cromwell H, Dunnington J, Erasmus J, Gladish G, Gupta S, Haynes MW, Hensley T, Iyer RB, Madewell J, Malbari T, Marom EM, Morice R, Rao S, Read C, Sabloff B, Scully NF, Tekchandani S, Truong M, Wicks D, Worrell JA, Donnelly EF, Massion P, Thielke E, Bell AM, Pickens DR, Bowman WA, Herron T, Shone D, Chin B, Chiles C, Chen M, Harmon L, Hinshaw L, Nelson C, Bowman E, Dyer S, Peacock P, Biracree D, Boyles D, Burrough A, Davis A, Drake E, Frost E, Long A, Gelmann EP, Isaacs C, Freedman MT, Dial A, Clark L, Cohen L, Gerber J, Jamis-Dow C, Makariou E, Smith E, Garrett A, McGuire C, Neff S, Riley T, Barriera A, Cantrell S, Marsh G, Wray C, Yondonsambuu B, Giles U, Ford M, Brown V, Evangelista AL, Hammond T, Nickel J, Brangan M, Lee M, Lin C, Adkins EC, Armah G, Blue C, Cooke V, Gray N, Gustitis M, Hawkins L, Isaacs G, Kim M, King M, Kumbalasiri K, Laura R, McDaniel K, Mulugeta A, Riley L, Sorrell S, Thomas W, Woodard L, Kvale P, Johnson CC, Tammemagi M, Spizarny D, Zylak CJ, Flynn M, Griesemer E, Kwit B, Hafeez Y, Maddy N, Fantuz P, McLellan B, Simmons D, Jacobsen G, Sankey S, Schultz L, Davis L, Estell R, Kozakowski S, Rowe J, Stanley M, Zhang X, Albertsen K, Broski K, Kucera G, Poler K, Spoutz-Ryan C, Thomas D, Frebes ME, Paquette M, Tecmire M, Tye C, Young L, Greene D, Hill C, Young K, Bellware K, Bohn K, Caird N, Fink H, Fiarman S, Houston M, Jolly A, Krzeczkowski C, Mack C, Murray L, Nanovski A, Rempinski D, Tumberlinson H, William D, Eldridge-Smith E, Graves V, Szabo N, Reding D, Manor W, Kruger R, Hocking W, Crump J, Greenlee R, Lappe K, Multerer D, Kriescher D, Vieth A, Wein S, Fischer V, Mathiesen-Viergutz K, Kofka K, Fuehrer D, Gjertson C, Krebsbach J, Kuhlka C, Luttrop K, Netzer J, Wegner J, Jablonsky N, Johnson B, Kitchner T, Mueller L, Rueth A, Wachholz S, Bohman K, Bruger M, Kramer KR, Kuenhold K, Mueller C, Mueller C, Multerer L, Zahradka S, Alkilidar J, Bhattacharjee N, Cangelosi C, Carlson R, Coppens A, Cousins M, Edelstein B, Gerndt K, Heffernon J, Hinke T, Hinson M, Hutchins L, Hinson M, Hutchins L, Lieberman K, Manor W, Mulligan G, Omoba E, Risa T, Sheflin J, Swan T, Warner J, Williams A, Yokochi L, Balkin P, Adaniya R, Glanz K, Navin J, Shambaugh V, Tabrah F, Willcox B, Williams P, He Q, Jenkins V, Bow K, Tsukamoto J, Hyun S, Turner L, Hino G, Chung A, Brown E, Morrow H, Stryker K, Shiratori H, Lau P, Au D, Francis W, Dolan L, Brooke J, Calulot M, Chun V, Rabanal K, Tani J, Lewis C, Morfit J, Brunst A, Elbon-Copp C, Huynh W, Johnson M, Nakano E, Villaruz L, Fouad MN, Nath H, Bailey WC, Garver R, Wu X, Brawner D, Malcomb I, Morgan D, Sanders PC, Sandy A, Schwartz M, Singh S, Dransfield M, Higgins D, Moore A, Acemgil A, Blake T, Lee J, Quattlebaum S, Schach J, Martin T, Khatri R, Jordan S, Prayer V, Walker C, Johnson C, Sears J, Gendi W, Powell B, Johnson M, Thompson J, Crawford E, Garg K, Larke FJ, Bunn P Jr, Gamito E, Lynch DA, Ogden S, Pretzel S, Ramsay L, Vaughn C, Sammons D, Springhetti L, Tenorio S, Whiton C, Cadez N, Laster S, O'Donnell C, Hughes J, Livingston JG, Morrison G, Moss W, Mullennix M, Peters M, Sahin H, Slear M, Burck M, Hill C, Jewitt E, Pena R, Ordonez E, Sammons G, Hernandez J, Reyes A, Somoza A, Church TR, Oken M, Inampudi S, Payne TJ, Zirbes A, Day D, Edelman K, Fox T, Gaerte S, Myra-Bloom K, Plunkett M, Olson F, Rust P, Schneider L, Trombley B, Vahey T, Bangerter A, David-Schlegel T, DesMarais D, Frederickson S, Geisser M, Portnov N, Silverman G, Strahan F, Vuong S, Watt G, Woodside J, Zirbes A, Breer S, Haselhuhn C, Longen C, Mueller C, Rice M, Warren D, Collins S, Levi S, Manual J, Matous L, Olsson P, Peterson S, Rogers C, Steele ML, Beckmann P, Jurjans L, Terrian S, Fraki S, Fronheiser M, Heinrichs L, Kirby D, Seivert J, Steinberg C, Watry M, Boyle K, Burnside A, Kiffmeyer R, Mosiman W, Bailey A, Byrnes P, Stark L, Weston M, Whistler D, Cordes J, Engelhard D, Becker J, Bradley P, Fisher J, Lee R, McLaughlin H, Mendez AM, Meyer G, Miller D, Palmquist K, Ronan R, Sigal B, Weissfeld JL, Salerno MD, Schragin J, Strollo DC, Warfel TE, Wolfe PW, Schragin J, McDonough K, Antico DA, Bee MT, Bittner DF, Corey WT, Hawkins RA, Herbick WT, Karwat MP, Leonard KJ, Petrochko CN, Pickering SF, Smart PE, Walters PJ, Zehner JA, Augustine K, Misko S, Richel M, Riley MA, Warren L, Rozanok B, Schragin J, Helms J, Olson P, Uttecht S, Wirth M, Atkins R, Clement L, Gurtner D, Jones L, Buys SS, Mann H, Drosten R, Murray K, Nowers K, Jenkins P, Tripp D, Herron G, Van Stam E, Varner J, Neilson B, O'Toole K, Olson C, Omori D, Varner J, Jones T, Andersen A, Argyle N, Avrin J, Bacon J, Broschinsky M, Montalbo C, Nolan K, Randall A, Schleip K, Sheltra SJ, Tischner R, Toyn C, Turner K, Whittaker B, Wicklander E, Wolf J, Dalton C, Doi B, Childs J, Gren L, Randall A, Watson D, Ahumada H, Bourija H, Brown C, Ferris B, Hadfield L, Hansen K, Koford J, Kopesec S, Lloyd A, Lofthouse M, Matinkhah S, May V, Nichols S, Nieves A, Oviatt M, Richardson N, Rowley AL, Sandberg E, Scholl D, Seguin SL, Shea D, Smith S, Street PA, Walters M, Weiben R, Wilcox L, Zisum R, Beck TM, Waltz JS, Fairbanks J, Wohlers B, Heinz J, Marshall R, Berreth K, Brekke J, Jones K, Ball S, Burt TB, Daniel EN, DeMordaunt QA, Fisher MT, Fuchs MA, Hubler BE, Jennings CJ, Lane RH, Leymaster CE, Macey LC, Marx SV, Maxwell JR, Nelson BD, Barrow A, Bashford D, Clot B, Cook T, Dobson L, Hamilton-Foss A, Hanson W, Hyder JE, Lewis-Burke C, Mitchell S, Osterhout M, Patella K, Peterson P, Schornak-Curtis S, Sirianni L, Stoller L, Vigeant K, Whistle C, Yates J, Andriole G, Gierada DS, Engelhart D, Fletcher G, Anderson D, Bhalla S, Bierhals AJ, Bronfman J, Glazer HS, Gutierrez FR, Geisse G, Kotner LM, Javidan-Nejad C, Rezai K, Sagel SS, Semenkovich JW, Siegel MJ, Sorrel D, Woodard PK, Campbell A, Gardner V, Gherardini D, Hoese L, Holdener R, Ledbetter L, Nieters P, Reiners C, Wade J, Wiseman M, Haverman R, Rueweler P, Williams R, Chi D, Budd T, Laster S, Webb J, Stolin C, Garrett K, Fleming E, Pilgram T, Freesmeier E, Frye J, Graham D, Kaemmerer H, Nevilles J, Taylor K, Blaine J, Clark K, Gierada D, Koppel P, Maffitt D, Moore S, Moulton J, Phillips S, Prior F, Wolfsberger M, Haas A, Hartwell D, Roeshe D, Lowery A, Meese S, Naughton K, Yoffie R, Cosas A, Kim S, Kim M, Liang Y, Rueweler P, Williams R, Blaine J, Clark K, Koppel P, Maffitt D, Moore S, Prior F, Phillips S, Smith K.

Abstract

BACKGROUND:

The National Lung Screening Trial was conducted to determine whether three annual screenings (rounds T0, T1, and T2) with low-dose helical computed tomography (CT), as compared with chest radiography, could reduce mortality from lung cancer. We present detailed findings from the first two incidence screenings (rounds T1 and T2).

METHODS:

We evaluated the rate of adherence of the participants to the screening protocol, the results of screening and downstream diagnostic tests, features of the lung-cancer cases, and first-line treatments, and we estimated the performance characteristics of both screening methods.

RESULTS:

At the T1 and T2 rounds, positive screening results were observed in 27.9% and 16.8% of participants in the low-dose CT group and in 6.2% and 5.0% of participants in the radiography group, respectively. In the low-dose CT group, the sensitivity was 94.4%, the specificity was 72.6%, the positive predictive value was 2.4%, and the negative predictive value was 99.9% at T1; at T2, the positive predictive value increased to 5.2%. In the radiography group, the sensitivity was 59.6%, the specificity was 94.1%, the positive predictive value was 4.4%, and the negative predictive value was 99.8% at T1; both the sensitivity and the positive predictive value increased at T2. Among lung cancers of known stage, 87 (47.5%) were stage IA and 57 (31.1%) were stage III or IV in the low-dose CT group at T1; in the radiography group, 31 (23.5%) were stage IA and 78 (59.1%) were stage III or IV at T1. These differences in stage distribution between groups persisted at T2.

CONCLUSIONS:

Low-dose CT was more sensitive in detecting early-stage lung cancers, but its measured positive predictive value was lower than that of radiography. As compared with radiography, the two annual incidence screenings with low-dose CT resulted in a decrease in the number of advanced-stage cancers diagnosed and an increase in the number of early-stage lung cancers diagnosed. (Funded by the National Cancer Institute; NLST ClinicalTrials.gov number, NCT00047385.).

PMID:
24004119
PMCID:
PMC4307922
DOI:
10.1056/NEJMoa1208962
[Indexed for MEDLINE]
Free PMC Article

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