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Letters | September 15, 2010

Patient Decisions to Undergo Surgery for Early-Stage Lung Cancer

Mitchell Margolis, MD; Larry Kaiser, MD; Jason Christie, MD, MS

JAMA. 2010;304(11):1165. doi:10.1001/jama.2010.1311.

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To the Editor: The cohort study by Dr Cykert and colleagues¹ investigated the decision to undergo surgery for patients with early-stage lung cancer. It may have underemphasized one of the more significant factors contributing to the poorer outcomes seen in African American patients.

There is a belief that exposure to air during surgery spreads lung cancer, perhaps the most common misconception about cancer in the United States.² The study by Cykert et al noted in Table 3 that this belief was associated with a statistically significant lower proportion of participants who actually underwent surgery, much as we observed in a previous study.³ However, in Table 4 it appears that the authors found that this association was present only in white patients, not in African American patients, a finding that seems to contradict our multicenter study.

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September 15, 2010

Patient Decisions to Undergo Surgery for Early-Stage Lung Cancer—Reply

Samuel Cykert, MD

JAMA. 2010;304(11):1165. doi:10.1001/jama.2010.1312.

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Margolis M, Kaiser L, Christie J. Patient Decisions to Undergo Surgery for Early-Stage Lung Cancer. JAMA. 2010;304(11):1165. doi:10.1001/jama.2010.1311.

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