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Comment & Response |

Estimating Overdiagnosis in Lung Cancer Screening—Reply

Edward F. Patz Jr, MD1; Paul Pinsky, PhD2; Barnett S. Kramer, MD2
[+] Author Affiliations
1Department of Radiology, Duke University Medical Center, Durham, North Carolina
2National Cancer Institute, Bethesda, Maryland
JAMA Intern Med. 2014;174(7):1198-1199. doi:10.1001/jamainternmed.2014.1525.
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In Reply We appreciate the letters by Drs Marcus, Couraud et al, and Gelbman and Libby in response to our recent study on estimating overdiagnosis in low-dose computed tomographic screening for lung cancer.1 We agree with Dr Marcus that not all cases of overdiagnosis in a cancer screening program are necessarily caused by indolent tumors and should have made this clearer in our article. Given the natural history of most clinically apparent lung cancers, however, we estimate that the majority of overdiagnosis cases in the National Lung Cancer Screening Trial (NLST) were indolent tumors but acknowledge that this may not be exactly the case in other cancers or in population-based screening programs, with extended follow-up.

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Correspondence

July 1, 2014
Sébastien Couraud, MD, MSc; Laurent Greillier, MD, PhD; Bernard Milleron, MD; for the IFCT Lung Cancer Screening Group
1Service de Pneumologie Aiguë Spécialisée et Cancérologie Thoracique, CH Lyon Sud, Hospices Civils de Lyon, Pierre Bénite, France2Faculté de Médecine Lyon-Sud, Université Lyon 1, Oullins, France
3Aix Marseille Univ–Assistance Publique–Hôpitaux de Marseille, Multidisciplinary Oncology & Therapeutic Innovations Department, Marseille, France
4Respiratory Disease Department, Tenon Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France5Intergroupe Francophone de Cancérologie Thoracique (IFCT), Paris, France
JAMA Intern Med. 2014;174(7):1197. doi:10.1001/jamainternmed.2014.1532.
July 1, 2014
Brian D. Gelbman, MD; Daniel M. Libby, MD
1Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical Center, New York, New York
JAMA Intern Med. 2014;174(7):1197-1198. doi:10.1001/jamainternmed.2014.1535.
July 1, 2014
Pamela M. Marcus, PhD, MS
1National Cancer Institute, Bethesda, Maryland
JAMA Intern Med. 2014;174(7):1198. doi:10.1001/jamainternmed.2014.1546.
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