To the Editor.
—Drs Lin and Ihde1 began their discussion of lung cancer therapeutics with a selected case of a 45-year-old asymptomatic male smoker with a normal physical examination who had a nodule found on a "routine" chest roentgenogram. Although he was staged as T2,N0, he developed metastatic disease soon after lobectomy. If he had been my patient and I had followed the preventive care guidelines of the American College of Physicians, the Canadian Task Force on the Periodic Health Examination, the US Preventive Services Task Force, and the American Cancer Society,2 a chest roentgenogram would not have been ordered routinely, even though he was at risk based on his smoking history. His cancer would have been discovered when he developed hemoptysis and his outcome would have been no different from what it was in this case.I wonder if Lin and Ihde chose this case for a
Hirsch RL. Screening for Lung Cancer Has No Proven Utility. JAMA. 1992;268(11):1413. doi:10.1001/jama.1992.03490110051023