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Letters19 May 2020Cost-Effectiveness Analysis of Lung Cancer Screening in the United StatesSteven D. Criss, BS, Harry J. de Koning, MD, PhD, Sylvia K. Plevritis, PhD, Rafael Meza, PhD, and Chung Yin Kong, PhDSteven D. Criss, BSHarvard Medical School and Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts (S.D.C., C.Y.K.)Search for more papers by this author, Harry J. de Koning, MD, PhDErasmus University Medical Center, Rotterdam, the Netherlands (H.J.D.)Search for more papers by this author, Sylvia K. Plevritis, PhDStanford University, Stanford, California (S.K.P.)Search for more papers by this author, Rafael Meza, PhDUniversity of Michigan, Ann Arbor, Michigan (R.M.)Search for more papers by this author, and Chung Yin Kong, PhDHarvard Medical School and Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts (S.D.C., C.Y.K.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L20-0072 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Young and Ms. Hopkins that the high prevalence of chronic obstructive pulmonary disease and other comorbidities among persons eligible for lung cancer screening limits the effectiveness of risk-based screening. The detection of lung cancer in patients who are ineligible for curative surgical treatment certainly attenuates the benefits of screening, as do the shorter life expectancy and higher rate of non–lung cancer deaths associated with comorbid disease. We also agree that it would be valuable for chronic obstructive pulmonary disease status to be part of conversations between patients and their physicians around the potential benefits ...References1. Chua GWY, Chua KLM. Which patients benefit most from stereotactic body radiotherapy or surgery in medically operable non-small cell lung cancer? An in-depth look at patient characteristics on both sides of the debate. Thorac Cancer. 2019;10:1857-1867. [PMID: 31389163] doi:10.1111/1759-7714.13160 CrossrefMedlineGoogle Scholar2. Takeda A, Enomoto T, Sanuki N, et al. Reassessment of declines in pulmonary function ≥1 year after stereotactic body radiotherapy. Chest. 2013;143:130-137. [PMID: 22722234] doi:10.1378/chest.12-0207 CrossrefMedlineGoogle Scholar3. Warren GW, Alberg AJ, Kraft AS, et al. The 2014 Surgeon General's report: “The health consequences of smoking—50 years of progress”: a paradigm shift in cancer care [Editorial]. Cancer. 2014;120:1914-1916. [PMID: 24687615] doi:10.1002/cncr.28695 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School and Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts (S.D.C., C.Y.K.)Erasmus University Medical Center, Rotterdam, the Netherlands (H.J.D.)Stanford University, Stanford, California (S.K.P.)University of Michigan, Ann Arbor, Michigan (R.M.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0322. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness Analysis of Lung Cancer Screening in the United States Steven D. Criss , Pianpian Cao , Mehrad Bastani , Kevin ten Haaf , Yufan Chen , Deirdre F. Sheehan , Erik F. Blom , Iakovos Toumazis , Jihyoun Jeon , Harry J. de Koning , Sylvia K. Plevritis , Rafael Meza , and Chung Yin Kong Cost-Effectiveness Analysis of Lung Cancer Screening in the United States Robert P. Young and Raewyn J. Hopkins Metrics Cited byBlood-Based Biomarker Panel for Personalized Lung Cancer Risk AssessmentContemporary issues in the implementation of lung cancer screening 19 May 2020Volume 172, Issue 10Page: 706-707KeywordsCancer screeningCancer treatmentChronic obstructive pulmonary diseaseDisclosureLife expectancyLung and intrathoracic tumorsLung cancer screeningRespiratory system proceduresSurgeryType 2 diabetes ePublished: 19 May 2020 Issue Published: 19 May 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...