To the Editor.
—The provocative article by Drs Collins and Barry1 deserves careful scrutiny. These authors liken sereening for prostate cancer to lung cancer screening. In so doing, they continue to embrace the dogma of lung cancer screening studies of the mid 1970s, which concluded that lung cancer screening does not improve outcome. They do not apparently recognize that the conclusions of these studies are being reconsidered, owing in part to the fact that these studies failed to diagnose cancers that could later be found in preserved samples using newer marker techniques.2 Thus, these screening studies underdiagnosed lung cancers. It is also a fact that the National Cancer Institute studies, which were done only in men, did not require a history of heavy smoking, nor was it appreciated that the risk of lung cancer is far greater in patients with airflow obstruction than with normal airflow. More recent studies have shown
Petty TL. Is Prostate Cancer Screening Analogous to Lung Cancer Screening?. JAMA. 1997;277(14):1120-1121. doi:10.1001/jama.1997.03540380034016