Author Affiliations: University of Colorado Health Sciences Center and National Lung Health Education Program, Denver, and Rush-Presbyterian-St Luke's Medical Center, Chicago, Ill.
Controversies Section Editor: Phil B. Fontanarosa,
MD, Executive Deputy Editor.
Current knowledge and available technology could change the outcome
of lung cancer. But screening and even case finding in patients at high risk
is still not recommended. No major medical organization in the United States
recommends any form of screening for lung cancer. For this reason, lung cancer
is not diagnosed until it is symptomatic and usually when it is in advanced
and incurable stages. Assume that the following facts are true: In the year
2000, approximately 172,000 patients will be diagnosed as having lung cancer,
which represents the most common fatal malignancy in both men and women in
the United States (based on 1996 data),1 and
the 5-year survival rate will be only 15%, which is a generous estimate. Simple
arithmetic results in 25,800 patients who will survive and 146,200 patients
who will have progressive, rapid, and painful deaths from lung cancer, often
with bone and brain metastases. However, the survival rate in early-stage
lung cancer, that is, in situ and stage IA, is 60%, which also is a conservative
estimate. Thus, if all 172,000 patients could be diagnosed at this early stage,
this would result in 103,200 survivors and 68,800 deaths in 2000. Diagnosing
and treating lung cancer in the early stages of the disease could save tens
of thousands of lives each year.
Petty TL. Screening Strategies for Early Detection of Lung CancerThe Time Is Now. JAMA. 2000;284(15):1977-1980. doi:10.1001/jama.284.15.1977