Lung-Cancer Screening and the NELSON Trial

To the Editor: At 10 years of follow-up in the NELSON (Nederlands–Leuvens Longkanker Screenings Onderzoek) trial, de Koning et al. (Feb. 6 issue) 1 found that lung cancer–related mortality was 24% lower among current and former smokers who underwent repeated computed tomographic (CT)–based screening than among those who underwent no screening. However, neither the researchers in this well-conducted trial nor those in the previous National Lung Screening Trial (NLST) 2 reported relevant aspects of harm. 3,4 For example, in the NELSON trial, letters that were sent to persons who were invited to participate may have had psychological consequences. These letters, which were sent . . .