Lung cancer screening in the NELSON trial: balancing harms and benefits

Abstract

In this thesis, the harms and benefits of lung cancer screening using low-dose computed tomography were investigated. Data of the Dutch-Belgian NELSON trial were used to quantify its harms and benefits and develop strategies to improve the balance between them. If the NELSON trial demonstrates that low-dose CT screening is an effective method to reduce mortality from lung cancer, balance between harms and benefits is a perquisite for the implementation of a lung cancer screening program. Background information on relevant aspects of epidemiology, medical ethics, pulmonary medicine, radiology, and pathology are essential for the interpretation of the studies in this thesis. In this chapter an overview of relevant background information is presented, as well as a description of the design of the NELSON trial.