The use of low-dose CT screening to detect primary lung cancer was associated with a reduced risk of developing brain metastasis, according to a study published in the Journal of Thoracic Oncology.

The study was based on a subset of 1502 patients from the National Lung Screening Trial ( Identifier: NCT00047385) who had received a diagnosis of primary lung cancer from 2002 to 2009.

In all, 41.4% of patients had their lung cancer detected via low-dose CT screening, and 58.6% had their cancer detected via a different method, such as chest x-ray.

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The incidence of brain metastasis at 3 years was significantly lower in the CT group than in the other group — 6.5% and 11.9%, respectively (hazard ratio [HR], 0.53; 95% CI, 0.36-0.78; P =.001).

The reduced risk of brain metastasis in the CT group was seen in subgroups of patients with stage I to III disease (HR, 0.47; 95% CI, 0.29-0.75; P =.002), stage I and II disease (HR, 0.35; 95% CI, 0.18-0.68; P =.002), and patients who had lung cancer surgery (HR, 0.37; 95% CI, 0.21-0.68; P =.001).

An exploratory analysis revealed a difference in margins and nodule size between patients who disease was detected during CT screening and patients whose disease was detected during an interval scan performed between planned CT screenings.

The study authors wrote that a “possible explanation” for the “persistent reduction” in the risk of brain metastasis — even when restricted to early-stage lung cancers — is that the tumors detected by CT screening may have a “potentially different tumor biology that are slower-growing and less aggressive compared to those detected otherwise.”

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Su CC, Wu JT, Neal JW, et al. Impact of low-dose computed tomography screening for primary lung cancer on subsequent risk of brain metastasis. J Thorac Oncol. Published online June 2, 2021. doi:10.1016/j.jtho.2021.05.010