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Comments: Uncovering the Preclinical and Precancerous State

Philip Rubin, MD
JAMA. 1966;195(8):662-663. doi:10.1001/jama.1966.03100080102030.
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The upsurge in lung cancer incidence and lethality dictates increasing concern in its cause. Until careful research or serendipity allows investigators to identify the etiological factor or factors, the clinician is primarily charged with the task of early detection in order to cure lung cancer. The value of chest survey techniques has proved disappointing in the early diagnosis of lung cancer for numerous reasons. Surveys should be directed to men over 45 years of age and repeated at sixmonth intervals rather than given during the indiscriminate examination of young people and females who have little risk of developing lung cancer. Retrospective analysis of chest surveys shows that the lack of follow through by patient and physician alike negates any advantages of early discovery of unexplained chest lesions. The chief limitation of chest filming is that the frequently occurring main stem bronchial cancer is difficult to recognize in its early stages;

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