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Previous Volume 344:935-936 March 22, 2001 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: The review by Patz et al. (Nov. 30 issue)¹ on screening for lung cancer omits mention of a major historical change over the past three decades: the most common cell type has shifted from squamous-cell to adenocarcinoma — a shift that appears to result from the physicochemical changes in late-20th-century cigarette smoke (e.g., increased levels of tobacco-specific nitrosamines).² For example, 21 of the 27 (78 percent) peripheral stage I carcinomas detected by computed tomography (CT) among the 1000 smokers in the recent Early Lung Cancer Action Project screening study were adenocarcinoma, 3 (11 percent) were adenosquamous, and . . . [Full Text of this Article]

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