Reich is within his rights to worry that personal financial benefit (COI) may introduce bias and mendacity into public policy on LCS. Because Dr. Reich has raised this question of me, despite my clear, prior statement that “surgeons (like myself) might benefit financially from screening,” I am informing the editors and readers of CHEST that I have been paid a salary of $225,000 by the California Cancer Specialists Medical Group/City of Hope National Medical Center for the past 6 years, and last year, for the first time, received a bonus of $7,000, unrelated in any way to screening.2
I have been a principal co-investigator in the International-Early Lung Cancer Action Project (I-ELCAP) study since 1999. In this capacity, we have received a $30,000 grant for data collection, and receive travel and accommodations to I-ELCAP meetings twice each year. My advocacy of lung cancer radiographic screening antedates these financial considerations by more than 2 decades, dating back to residency tutelage under Robert Fontana, MD, and his colleagues during the Mayo Lung Trial in the 1970s. In private practice, my medical records and lecture notes show that I have consistently advocated radiographic screening of high-risk patients since 1978.