We enrolled participants from August 2002 through April 2004; screening took place from August 2002 through September 2007. Participants were followed for events that occurred through December 31, 2009 (Fig. 1 in the Supplementary Appendix, available at NEJM.org).
Eligible participants were between 55 and 74 years of age at the time of randomization, had a history of cigarette smoking of at least 30 pack-years, and, if former smokers, had quit within the previous 15 years. Persons who had previously received a diagnosis of lung cancer, had undergone chest CT within 18 months before enrollment, had hemoptysis, or had an unexplained weight loss of more than 6.8 kg (15 lb) in the preceding year were excluded. A total of 53,454 persons were enrolled; 26,722 were randomly assigned to screening with low-dose CT and 26,732 to screening with chest radiography. Previously published articles describing the NLST10 (link),12 (link) reported an enrollment of 53,456 participants (26,723 in the low-dose CT group and 26,733 in the radiography group). The number of enrolled persons is now reduced by 2 owing to the discovery of the duplicate randomization of 2 participants.
Participants were enrolled at 1 of the 10 LSS or 23 ACRIN centers. Before randomization, each participant provided written informed consent. After the participants underwent randomization, they completed a questionnaire that covered many topics, including demographic characteristics and smoking behavior. The ACRIN centers collected additional data for planned analyses of cost-effectiveness, quality of life, and smoking cessation. Participants at 15 ACRIN centers were also asked to provide serial blood, sputum, and urine specimens. Lung-cancer and other tissue specimens were obtained at both the ACRIN and LSS centers and were used to construct tissue microarrays. All biospecimens are available to researchers through a peer-review process.