In Reply We thank Wiener and Slatore for their letter and for informing us of their excellent research to examine the psychological harms of detecting indeterminate pulmonary nodules. Although their studies do not deal with screen-detected nodules, we agree that their findings are relevant to similar nodules found on lung cancer screening. And, as we suspected, their findings are sobering. Clearly there are human costs to extended surveillance and prolonged uncertainty. As one of their patients stated so well: “the thing is not knowing.”1 This type of research needs to be conducted more widely, and for more screening situations, to help us better quantify the effects of screening on real people’s lives.
Harris RP, Sheridan SL, Lewis CL. Real-World Evidence About Potential Psychosocial Harms of Lung Cancer Screening—Reply. JAMA Intern Med. 2014;174(8):1416-1417. doi:10.1001/jamainternmed.2014.1636