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Is screening for early lung cancer worthwhile?

Screening an at-risk population for early-stage lung cancer—a practice that has been declared ineffective by the American Cancer Society (ACS) because studies have not shown that it lowers mortality rates—nonetheless received emphatic support at the recent annual meeting of the Radiological Society of North America in Chicago. In defense of radiological screening, John R. Muhm, MD, director of diagnostic radiology at the Mayo Clinic, Rochester, Minn, cited results of the ongoing Mayo Lung Project, and Robert T. Heelan, MD, assistant attending radiologist, Memorial Sloan-Kettering Cancer Center, New York City, presented data from the National Lung Program (NLP). These programs, as well as a third conducted at Johns Hopkins University in Baltimore, are sponsored by the National Cancer Institute (NCI), Bethesda, Md. Both Muhm and Heelan emphasized that the value of radiography in detecting early-stage disease is limited to certain forms of the disease—adenocarcinoma, squamous cell carcinoma, and large-cell carcinoma—that are