Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: We feel obliged to comment on the study of CT screening and lung cancer outcome by Dr Bach and colleagues1 because we are responsible for the conduct and follow-up of the Italian trial carried out by the European Institute of Oncology, from which data were used in this study.
Their analysis is based on the unproved belief that lung cancers can be divided into 2 distinct groups of indolent and aggressive tumors, while lung cancer aggressiveness is largely correlated, on a continuous scale, to the size of the tumor.2 Aggregating stage III with stage IV tumors also constitutes an arbitrary oversimplification since patients with stage III tumors and minimal nodal invasion are amenable to curative treatment.3
Spaggiari L, Veronesi G, Bellomi M, Maisonneuve P. Computed Tomography Screening for Lung Cancer. JAMA. 2007;298(5):513-516. doi:10.1001/jama.298.5.514-a