Communications to the Editor |

Low-Dose Spiral CT Screening FREE TO VIEW

Karen Parles, MLS
Author and Funding Information

Lung Cancer Online Setauket, NY

Correspondence to: Karen Parles, MLS, Editor and Webmaster, Lung Cancer Online, 6 Vingut Lane, Setauket, NY; e-mail: kparles@lungcanceronline.org

Chest. 2001;120(3):1042-1043. doi:10.1378/chest.120.3.1042
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Published online

To the Editor:

I applaud Frederic W. Grannis, Jr., MD, for his views on the subject of lung cancer screening (February 2001).1 As a lung cancer survivor, I have followed the debate over low-dose spiral CT screening closely and with great interest. I have been dismayed by the backlash against the Early Lung Cancer Action Project (ELCAP) study (and the ongoing research by the International Collaboration to Screen for Lung Cancer [ICScreen]), led by the National Cancer Institute (NCI), and by several physicians in the lung cancer field. I have read the numerous admonitions against jumping on the low-dose CT screening bandwagon. These cautionary tales have often been delivered in condescending tones aimed at those of us who can’t possibly understand what good science entails, and why these studies are necessary. There is no doubt that a prospective, randomized, controlled trial would be the ideal study for evaluating low-dose spiral CT screening for lung cancer. There is no doubt that additional studies are needed to further characterize and quantify the risks involved in screening for lung cancer using low-dose spiral CT. What are the costs of waiting to pursue widespread screening research based on the ELCAP findings until a prospective trial such as the one proposed by the NCI can be completed? In answering this question, Dr. Grannis provides a context for this debate that has heretofore been missing, or at best, gratuitously acknowledged—that the devastation wrought by lung cancer is relevant. The high incidence and abysmally low survival rate associated with lung cancer is relevant. The fact that progress in preventing and treating lung cancer has occurred at a glacial pace (over decades) is relevant.

We know what the world looks like without low-dose spiral CT screening. The human toll and economic burden of lung cancer is enormous and unrelenting. I ask those lung cancer specialists who caution against moving forward until a prospective, randomized, controlled study can be conducted: just what world are you living in that affords you such a luxury? From my view, the ongoing ELCAP/ICScreen research deserves our full support.

Grannis, FW, Jr (2001) Lung cancer overdiagnosis bias: “the gyanousa am loose!”Chest119,322-323. [CrossRef]




Grannis, FW, Jr (2001) Lung cancer overdiagnosis bias: “the gyanousa am loose!”Chest119,322-323. [CrossRef]
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