The study is consistent with other trends in cancer research, for example in prostate cancer, that "suggest we do need to reclassify what we've always considered to be cancer. We know now it's a broad disease, with lots of ways it can manifest. But the problem is really trying to separate out those whom you should treat and be aggressive with, versus those who have indolent disease, and right now, there's no way of knowing that."
An accompanying piece by Russell Harris, MD, and colleagues at the University of North Carolina, Chapel Hill, proposes a way to tally the types of harm to patients who undergo lung cancer screening, "to improve our thinking about the harms of screening."
They weighed resulting physical harm, such as exposure to radiation, the workup from a positive screening test, or endurance of treatment; psychological harm; financial harm, and missed opportunities to work or be with family and friends.
The researchers said their template or taxonomy is an effort "to help investigators, policy makers, clinicians and the public think more clearly and systematically about harms and to consider harms equally with benefits in decisions about screening. We do not assert that harms always outweigh benefits, only that it is always necessary to weigh the two."