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Testing has its downside as well

The Day provides a useful service to the community when it reports on medical advances, such as the recent article on low-dose CT screening for lung cancer in high-risk patients. However, it is important to present both the pros and cons of screening to help readers weigh the risks and benefits. The downsides of screening for lung cancer were absent from the article.

Screening can save 3 lives for every 1,000 persons screened. However, for every 1,000 persons screened who do not have lung cancer, 250 will have a false alarm reported by the scan. This false alarm will require additional testing, including invasive procedures like a lung biopsy and bronchoscopy that carry with them a small risk of complications and death.

Of the cancers detected by screening, 20% would have never harmed the patient if left alone. This overdiagnosis of lung cancer will expose those patients to potentially dangerous treatments with radiation and chemotherapy with no benefit.

Some patients will decide that the potential benefits outweigh the risks, and for others, the opposite will be true. Patients should discuss the pros and cons with their doctors. They may also use decision aids provided by the Agency for Healthcare Research and Quality to help them decide. (

Dr. Stephen R. Smith

New London



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