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October 25, 1985

Cardiothoracic Surgery

JAMA. 1985;254(16):2305-2307. doi:10.1001/jama.1985.03360160137036

Mortality rates from lung cancer in women have exceeded those from breast cancer. In some states, lung cancer is already the most important single cause of death from cancer in women. Among male cigarette smokers studied at Memorial Sloan-Kettering, early screening for lung cancer yielded a higher complete resectability rate than later diagnosis after symptoms occurred. Earlier diagnosis resulted in a five-year survival of 35%, an 8% to 9% improvement over survival of nonscreened men.1

Treatment for non—small-cell lung cancer is contingent on TNM staging. Apparently, none of the noninvasive staging procedures singly or collectively is sensitive enough to replace totally mediastinoscopy for accurate preoperative staging of lung cancer. The value of magnetic resonance imaging has yet to be defined. Whereas T3 tumors exclusive of those invading the chest wall have a reasonable chance of cure with radical resection, associated N2 disease yields a much poorer prognosis.2 Of