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Volume 353:2194-2195 November 17, 2005 Number 20
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Lung-Cancer Screening

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by Mulshine, J. L.
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To the Editor: Mulshine and Sullivan (June 30 issue)1 note the high proportion of cancers detected by screening at stage 1. As they acknowledge, however, this proportion cannot be used to indicate the efficacy of screening, which requires a corresponding reduction in the absolute number of advanced lung cancers. Earlier controlled trials, using standard radiography,2,3 failed to achieve this effect. Preliminary analyses of trials that used low-dose computed tomography (CT),4,5 although inconclusive, show no diminution in advanced cancers in the incidence screens as compared with controls. This failure may reflect the proximal endobronchial origin of many cancers (for which CT . . . [Full Text of this Article]



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