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Comment & Response
August 2014

Real-World Evidence About Potential Psychosocial Harms of Lung Cancer Screening—Reply

Author Affiliations
  • 1Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
  • 2Division of General Medicine and Epidemiology, University of North Carolina at Chapel Hill
  • 3Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill
JAMA Intern Med. 2014;174(8):1416-1417. doi:10.1001/jamainternmed.2014.1636

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.

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