Jim L. Mulshine, MD of Rush University explains that the national lung screening trial had a more diverse population than perceived. For the National Lung Screening Trial, there is a comparison between results of just x-ray alone versus CT scan for screening population especially on the tobacco-exposed older population. There was a concern that perhaps the National Lung Screening Trial is only done is major centers for thoracic surgery and not representative of the general population. However, in reality, the National Lung Screening Trial has community-based management. Theres a community-based standard for the lung cancer care across the country. Anyone who signed up for the trial becomes the center where the screening can be done. Hence, the suggestion that the screening was done in a very specialized center was not true.
The reason why people are convinced of the screening process is because of the good results in the United States, Canada, the Netherlands and more apparently in Japan. Internationally, there are many reinforcements because of the positive outcome from the screen trial, which allow people to believe that the screening has substantial benefit and it is something to be continued.