Computed Tomography Screening for Lung Cancer

Letters16 July 2013Computed Tomography Screening for Lung CancerClaudia I. Henschke, PhD, MD, Rowena Yip, MPH, David F. Yankelevitz, MD, and James P. Smith, MDClaudia I. Henschke, PhD, MDFrom Mount Sinai School of Medicine, New York, New York; Mount Sinai Medical Center, New York, New York; Mount Sinai School of Medicine, New York, New York; and Weill Cornell Medical College, New York, New York.Search for more papers by this author, Rowena Yip, MPHFrom Mount Sinai School of Medicine, New York, New York; Mount Sinai Medical Center, New York, New York; Mount Sinai School of Medicine, New York, New York; and Weill Cornell Medical College, New York, New York.Search for more papers by this author, David F. Yankelevitz, MDFrom Mount Sinai School of Medicine, New York, New York; Mount Sinai Medical Center, New York, New York; Mount Sinai School of Medicine, New York, New York; and Weill Cornell Medical College, New York, New York.Search for more papers by this author, and James P. Smith, MDFrom Mount Sinai School of Medicine, New York, New York; Mount Sinai Medical Center, New York, New York; Mount Sinai School of Medicine, New York, New York; and Weill Cornell Medical College, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-2-201307160-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Lam and colleagues’ (1) description of the unique character of an often-misunderstood event in the process of screening for lung cancer: the initial (baseline) round. As they note, this round—performed only once—generates the greatest frequency of diagnostic work-ups because no previous CT scan is available to determine whether a nodule is new, growing, or stable, and the diagnosed cases of cancer are relatively slower-growing than those identified in subsequent rounds of screening. Thus, the definition of a “positive result” should necessarily differ at baseline from that of all subsequent rounds. In the I-ELCAP trial, the ...References1. Lam S, McWilliams A, Mayo J, and Tammemagi M. Computed tomography screening for lung cancer: what is a positive screen? [Editorial]. Ann Intern Med. 2013;158:289-90 LinkGoogle Scholar2. Gould MK, Donington J, Lynch WR, Mazzone PJ, Midthun DE, Naidich DP, et al. Evaluation of Individuals With Pulmonary Nodules: When Is It Lung Cancer?: Diagnosis and Management of Lung Cancer, 3rd ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2013;143:93S-e120S. [PMID: 23649456] CrossrefMedlineGoogle Scholar3. MacMahon H, Austin JH, Gamsu G, Herold CJ, Jett JR, Naidich DP, et al. Fleischner Society. Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society [Editorial]. Radiology. 2005;237:395-400. [PMID: 16244247] CrossrefMedlineGoogle Scholar4. Yankelevitz DF and Smith JP. Understanding the core result of the National Lung Screening Trial [Letter]. N Engl J Med. 2013;368:1460-1. [PMID: 23574139] CrossrefMedlineGoogle Scholar5. Silvestri GA. Screening for lung cancer: it works, but does it really work? Ann Intern Med. 2011;155:537-9 LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Claudia I. Henschke, PhD, MD; Rowena Yip, MPH; David F. Yankelevitz, MD; James P. Smith, MDAffiliations: From Mount Sinai School of Medicine, New York, New York; Mount Sinai Medical Center, New York, New York; Mount Sinai School of Medicine, New York, New York; and Weill Cornell Medical College, New York, New York.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2154. 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 Peter B. Bach , Michael K. Gould , and Gerard A. Silvestri Computed Tomography Screening for Lung Cancer Guglielmo M. Trovato , Marco Sperandeo , and Daniela Catalano Metrics 16 July 2013Volume 159, Issue 2Page: 156-157KeywordsBiopsyCancer screeningComputed axial tomographyDatabasesForecastingLung and intrathoracic tumorsThoraxUltrasound imaging ePublished: 16 July 2013 Issue Published: 16 July 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...