The VA is conducting a limited lung cancer screening pilot at 8 VA hospitals to better understand how to implement screening nationwide. Through this pilot, VA is attempting to identify the right physicians to offer screening during the course of routine care; determine the uptake of screening and what resources will be needed to meet the demand; establish appropriate screening and follow-up with accuracy, efficiency, and safety; and answer whether the overall outcomes of patients with early-stage cancer (especially those who are older with comorbid conditions) benefit from early detection.
Among many of the World Health Organization’s screening principles, Michael J. Kelley, MD, called attention to the organization’s concern that the natural history of the condition should be adequately understood. “I think the key word there is adequately,” said Dr. Kelley. “When you look at the development of disease from precursor lesions, do we really understand what is going to become a cancer that causes disease as opposed to that which is a cancer only to the pathologist?”