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Point and Counterpoint |

Rebuttal From Dr YankelevitzRebuttal From Dr Yankelevitz

David F. Yankelevitz, MD
Author and Funding Information

From the Icahn School of Medicine at Mount Sinai.

CORRESPONDENCE TO: David F. Yankelevitz, MD, Icahn School of Medicine at Mount Sinai, 1428 Madison Ave, New York, NY 10029; e-mail: david.yankelevitz@mountsinai.org


FINANCIAL/NONFINANCIAL DISCLOSURES: The author has reported to CHEST the following conflicts of interest: Cornell University has had a licensing agreement with General Electric related to intellectual property on lung nodule analysis since 2006, and as a faculty member, Dr Yankelevitz was entitled to a share of the monies. He also is involved in research funded by the Flight Attendant Medical Research Institute through Mount Sinai regarding screening and risks of second-hand tobacco smoke. Dr Yankelevitz is director of the Lung Biopsy Service at the Icahn School of Medicine at Mount Sinai and an I-ELCAP Investigator.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(2):292-293. doi:10.1378/chest.14-2813
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In the Counterpoint Editorial by Drs Courtright and Manaker,1 the pattern I had expressed concern about regarding overstating the harms and underestimating the benefits continues. Notably, the evidence regarding harms refers solely to National Lung Screen Trial (NLST) data, neglecting all the progress made in the past decade in technology as well as in developing more-efficient and safer protocols. Although the NLST was performed primarily at academic centers, there was no requirement that the follow-up studies or treatments be performed at these centers or that a certain protocol be followed. Concerns expressed about implementation in the community setting, including an inability to use best practice guidelines, seem unwarranted given the success demonstrated in developing quality standards for mammography. There is every reason to believe that similar types of implementation, by the same organizations, can also be accomplished for CT screening. Support for this also comes from the International Early Lung Cancer Action Program (I-ELCAP) report showing no difference in performance between the academic and community setting.2

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