CMAJ • June 23, 2009; 180 (13). doi:10.1503/cmaj.1090036.
© 2009 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Letters

Lung cancer screening

Frederic W. Grannis, MD

Section of Thoracic Surgery, City of Hope National Medical Center, Duarte, California, USA

Matthew Stanbrook and Ken Flegel caution patience in waiting for better evidence before implementing lung cancer screening programs with computerized tomography for Canadians, despite mean survival times for screen-detected lung cancer of more than 5 years in the context of the International Early Lung Cancer Action Program (I-ELCAP).

The pattern of results of treatment of symptomatic lung cancer in Manitoba provides excellent new evidence regarding what such caution and patience will yield. 1 The data show that the mean survival time for Manitobans with non–small-cell lung cancer increased from about 7.7 months in 1985 to about 9.2 months in 2004. If my math is correct, this indicates that mean lung cancer survival in symptomatic patients has improved by 45 days over the past 2 decades (2.25 days per year). With patient, cautious, continued efforts at curative treatment of symptomatic lung cancer, the mean survival time for people with lung cancer might be expected to exceed 1 year sometime after 2040.

Footnotes

Competing interests: Frederic Grannis has been a principal investigator in the I-ELCAP trial and has received funding for data management and travel and accommodation costs to meetings. He has provided written testimony against the tobacco industry in 2 medical monitoring lawsuits in the states of New York and Massachusetts.

For the full text of these letters, go to: www.cmaj.ca/cgi/eletters/180/8/793


REFERENCES

  1. Pitz MW, Musto G, Demers AA, et al. Survival and treatment pattern of non-small cell lung cancer over 20 years. J Thorac Oncol 2009;4:492–8.[Medline]




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