To the Editor We read with interest the article by Patz et al1 investigating overdiagnosis in the National Lung Screening Trial (NLST). In their investigation, the authors found the upper bound for probability of overdiagnosis to be 11.0% to 18.5% for all lung cancers and even higher for bronchioloalveolar carcinoma (BAC) (67.6% to 78.9%). However, this risk assessment did not consider the lead- and the length-time biases.2
Couraud S, Greillier L, Milleron B, for the IFCT Lung Cancer Screening Group. Estimating Overdiagnosis in Lung Cancer Screening. JAMA Intern Med. 2014;174(7):1197. doi:10.1001/jamainternmed.2014.1532
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