Estimating Overdiagnosis of Lung Cancer
Authors: Robert P. Young, Raewyn J. Hopkins
Journal: Annals of Internal Medicine (2013)

Letters16 April 2013Estimating Overdiagnosis of Lung CancerRobert P. Young, MD, PhD and Raewyn J. Hopkins, RN, MPHRobert P. Young, MD, PhDFrom School of Biological Sciences and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. and Raewyn J. Hopkins, RN, MPHFrom School of Biological Sciences and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-8-201304160-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We agree with Veronesi and colleagues (1)> that risk models for lung cancer should help to identify smokers at greatest risk for aggressive lung cancer. This would minimize the investigation and treatment of indolent cancer (overdiagnosis) and improve the cost-effectiveness of computed tomography (CT) screening.Using data from the PLuSS (Pittsburgh Lung Screening Study) CT screening trial (2), we show that "low-risk" smokers are overrepresented among those with indolent lung cancer. We have previously shown that lung cancer detection rates are 4- to 5-fold greater in current or former smokers with spirometry-defined chronic obstructive pulmonary disease (COPD) ...References1. Veronesi G, Maisonneuve P, Bellomi M, Rampinelli C, Durli I, Bertolotti R, et al. Estimating overdiagnosis in low-dose computed tomography screening for lung cancer: a cohort study. Ann Intern Med. 2012;157:776-84. [PMID: 23208167] LinkGoogle Scholar2. Wilson DO, Ryan A, Fuhrman C, Schuchert M, Shapiro S, Siegfried JM, et al. Doubling times and CT screen-detected lung cancers in the Pittsburgh Lung Screening Study. Am J Respir Crit Care Med. 2012;185:85-9. [PMID: 21997335] CrossrefMedlineGoogle Scholar3. Young RP, Hopkins RJ. Diagnosing COPD and targeted lung cancer screening [Letter]. Eur Respir J. 2012;40:1063-4. [PMID: 23024333] CrossrefMedlineGoogle Scholar4. Saghir Z, Dirksen A, Ashraf H, Bach KS, Brodersen J, Clementsen PF, et al. CT screening for lung cancer brings forward early disease. The randomised Danish Lung Cancer Screening Trial: status after five annual screening rounds with low-dose CT. Thorax. 2012;67:296-301. [PMID: 22286927] CrossrefMedlineGoogle Scholar5. Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD. COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J. 2009;34:380-6. [PMID: 19196816] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert P. Young, MD, PhD; Raewyn J. Hopkins, RN, MPHAffiliations: From School of Biological Sciences and Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.Disclosures: Dr. Young: Consultancy and patents (planned, pending, or issued): Synergenz BioScience Ltd; Other: Dr. Young and the funding of his research have been supported by grants from the University of Auckland, Health Research Council of New Zealand, and Synergenz BioScience Ltd. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEstimating Overdiagnosis in Low-Dose Computed Tomography Screening for Lung Cancer Giulia Veronesi , Patrick Maisonneuve , Massimo Bellomi , Cristiano Rampinelli , Iara Durli , Raffaella Bertolotti , and Lorenzo Spaggiari Estimating Overdiagnosis of Lung Cancer Patrick Maisonneuve , Giulia Veronesi , and Raffaella Bertolotti Metrics Cited byAirflow limitation and mortality during cancer screening in the National Lung Screening Trial: why quantifying airflow limitation mattersEffects of Sustained and Intermittent Hypoxia on Human Lung Cancer CellsSequential screening for lung cancer in a high-risk group: randomised controlled trialLung cancer and chronic obstructive pulmonary disease: From a clinical perspectiveReduced Expiratory Flow Rate among Heavy Smokers Increases Lung Cancer Risk. Results from the National Lung Screening Trial–American College of Radiology Imaging Network CohortResults of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk ProfilingAirflow Limitation and Histology Shift in the National Lung Screening Trial. The NLST-ACRIN Cohort SubstudyCT screening in COPD: Impact on lung cancer mortalityStage Shift in Computed Tomography Screening: Possible Role of Indolent Cancers, "Histology Shift," and OverdiagnosisTargeted CT Image Screening and Its Effect on Lung Cancer Detection Rate 16 April 2013Volume 158, Issue 8Page: 635KeywordsAdenocarcinomaBiomarkersCancer screeningCancer treatmentChronic obstructive pulmonary diseaseComputed axial tomographyConflicts of interestEmphysemaLung and intrathoracic tumorsResearch funding ePublished: 16 April 2013 Issue Published: 16 April 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...