Computed Tomography Screening for Lung Cancer
Authors: Peter B. Bach, Michael K. Gould, Gerard A. Silvestri
Journal: Annals of Internal Medicine (2013)

Letters16 July 2013Computed Tomography Screening for Lung CancerPeter B. Bach, MD, MAPP, Michael K. Gould, MD, MS, and Gerard A. Silvestri, MD, MSPeter B. Bach, MD, MAPPFrom Memorial Sloan-Kettering Cancer Center, New York, New York; Kaiser Permanente Southern California, Pasadena, California; and Medical University of South Carolina, Charleston, South Carolina.Search for more papers by this author, Michael K. Gould, MD, MSFrom Memorial Sloan-Kettering Cancer Center, New York, New York; Kaiser Permanente Southern California, Pasadena, California; and Medical University of South Carolina, Charleston, South Carolina.Search for more papers by this author, and Gerard A. Silvestri, MD, MSFrom Memorial Sloan-Kettering Cancer Center, New York, New York; Kaiser Permanente Southern California, Pasadena, California; and Medical University of South Carolina, Charleston, South Carolina.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-2-201307160-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We believe that the participants in Henschke and colleagues’ study (1) are not representative of persons who should be considered for screening; thus, the quantitative estimates for the effect of changing cutoffs for nodule size are not generalizable. The median number of pack-years of smoking in the study was 26, meaning that fewer than one half of participants would be eligible for screening on the basis of most major guidelines or the entry criteria for the benchmark NLST (National Lung Screening Trial) (2–4).The participants are also much younger and have a lower degree of smoking exposure ...References1. Henschke CI, Yip R, Yankelevitz DF, and Smith JP; International Early Lung Cancer Action Program Investigators. Definition of a positive test result in computed tomography screening for lung cancer: a cohort study. Ann Intern Med. 2013;158:246-52 LinkGoogle Scholar2. Aberle DR, Adams AM, Berg CD, Clapp JD, Clingan KL, Gareen IF, et al. National Lung Screening Trial Research Team. Baseline characteristics of participants in the randomized national lung screening trial. J Natl Cancer Inst. 2010;102:1771-9. [PMID: 21119104] CrossrefMedlineGoogle Scholar3. Bach PB, Mirkin JN, Oliver TK, Azzoli CG, Berry DA, Brawley OW, et al. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA. 2012;307:2418-29. [PMID: 22610500] CrossrefMedlineGoogle Scholar4. Wender R, Fontham ET, Barrera E, Colditz GA, Church TR, Ettinger DS, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin. 2013;63:107-17. [PMID: 23315954] CrossrefMedlineGoogle Scholar5. Henschke CI, McCauley DI, Yankelevitz DF, Naidich DP, McGuinness G, Miettinen OS, et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet. 1999;354:99-105. [PMID: 10408484] CrossrefMedlineGoogle Scholar6. Henschke CI, Yankelevitz DF, Libby DM, Pasmantier MW, Smith JP, and Miettinen OS; International Early Lung Cancer Action Program Investigators. Survival of patients with stage I lung cancer detected on CT screening. N Engl J Med. 2006;355:1763-71. [PMID: 17065637] CrossrefMedlineGoogle Scholar7. New York Early Lung Cancer Action Project Investigators. CT Screening for lung cancer: diagnoses resulting from the New York Early Lung Cancer Action Project. Radiology. 2007;243:239-49. [PMID: 17392256] CrossrefMedlineGoogle Scholar8. Bach PB and Gould MK. When the average applies to no one: personalized decision making about potential benefits of lung cancer screening. Ann Intern Med. 2012;157:571-3 LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Peter B. Bach, MD, MAPP; Michael K. Gould, MD, MS; Gerard A. Silvestri, MD, MSAffiliations: From Memorial Sloan-Kettering Cancer Center, New York, New York; Kaiser Permanente Southern California, Pasadena, California; and Medical University of South Carolina, Charleston, South Carolina.Disclosures: Dr. Bach: Payment for lectures including service on speakers bureaus: Genentech. Dr. Gould: Grants/grants pending (money to institution): National Institutes of Health, National Cancer Institute; Royalties: UpToDate. Dr. Silvestri: Consultancy: Olympus America, Broncus; Grants/grants pending (money to institution): Broncus, Indi, Allegro Diagnostics; Payment for lectures including service on speakers bureaus: Verian, BI Pharmaceuticals; Payment for development of educational presentations: Olympus America. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDefinition of a Positive Test Result in Computed Tomography Screening for Lung Cancer Claudia I. Henschke , Rowena Yip , David F. Yankelevitz , and James P. Smith , for the International Early Lung Cancer Action Program Investigators* Computed Tomography Screening for Lung Cancer Claudia I. Henschke , Rowena Yip , David F. Yankelevitz , and James P. Smith Computed Tomography Screening for Lung Cancer Guglielmo M. Trovato , Marco Sperandeo , and Daniela Catalano Metrics 16 July 2013Volume 159, Issue 2Page: 155-156KeywordsCancer screeningDecision makingDiagnostic radiologyFallsLung and intrathoracic tumorsLung cancer screeningLungsMedical risk factors ePublished: 16 July 2013 Issue Published: 16 July 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...