{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:49:22Z","timestamp":1790279362334,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The US National Lung Screening Trial (NLST) and Dutch\u2010Belgian NELSON randomized controlled trials have shown significant mortality reductions from low\u2010dose computed tomography (CT) lung cancer screening (LCS). NLST, ITALUNG, and COSMOS trials have provided detailed dosimetry data for LCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>LCS trial mortality benefit results, organ dose and effective dose data, and Biological Effects of Ionizing Radiation, Report VII (BEIR VII) organ dose\u2010to\u2010cancer\u2010mortality risk data are used to estimate benefit\u2010to\u2010radiation\u2010risk ratios of the NLST, ITALUNG, and COSMOS trials. Data from those trials also are used to estimate benefit\u2010to\u2010radiation\u2010risk ratios for longer\u2010term LCS corresponding to scenarios recommended by United States Preventive Services Task Force and the American Cancer Society.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Including only screening doses, NLST benefit\u2010to\u2010radiation\u2010risk ratios are 12:1 for males, 19:1 for females, and 16:1 overall. Including both screening and estimated follow\u2010up doses, benefit\u2010to\u2010radiation\u2010risk ratios for NLST are 9:1 for males, 13:1 for females, and 12:1 overall. For the ITALUNG trial, the benefit\u2010to\u2010radiation\u2010risk ratio is 58\u201363:1. For the COSMOS trial, assuming sex\u2010specific mortality benefits like those of the NELSON trial, the benefit\u2010to\u2010radiation\u2010risk ratio is 23:1. Assuming a conservative 20% mortality benefit, annual screening in people 50\u201379 years old with a 20+ pack\u2010year history of smoking has benefit\u2010to\u2010radiation\u2010risk ratios of 23:1 (with follow\u2010up doses adding 40% to screening doses) to 29:1 (with follow\u2010up adding 10%) based on COSMOS dose data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on linear, no threshold BEIR VII dose\u2010risk estimates, benefit\u2010to\u2010radiation\u2010risk ratios for LCS are highly favorable. Results emphasize the importance of using modern CT technologies, maintaining low diagnostic follow\u2010up rates, and minimizing both screening and diagnostic follow\u2010up doses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Plain Language Summary<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The benefits of lung cancer screening significantly outweigh estimates of future harms associated with exposure to radiation during screening and diagnostic follow\u2010up examinations.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Our findings emphasize the importance of lung cancer screening practices using state\u2010of\u2010the\u2010art computed tomography scanners and specialized low\u2010dose lung screening and diagnostic follow\u2010up techniques.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34855","type":"journal-article","created":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T10:00:55Z","timestamp":1698832855000},"page":"216-223","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Benefit\u2010to\u2010radiation\u2010risk of low\u2010dose computed tomography lung cancer screening"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9971-2651","authenticated-orcid":false,"given":"R. 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