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Peter B. Bach, Response: Re: Inconsistencies in Findings from the Early Lung Cancer Action Project Studies of Lung Cancer Screening, JNCI: Journal of the National Cancer Institute, Volume 104, Issue 3, 8 February 2012, Pages 255–256, https://doi.org/10.1093/jnci/djr522
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In their letters, both Henschke and Seijo et al. cite the results of previously published studies that were part of the Early Lung Cancer Action Program (ELCAP) as validation of related ELCAP publications. In my commentary, I compared ELCAP reports to those from investigators independent of ELCAP and found discrepancies that I thought were concerning.
The authors’ correspondence leaves unanswered a number of questions. For instance, neither letter addresses (or even mentions) the extent to which ELCAP researchers have reclassified diagnosed lung cancers as stage I that were, in fact, more advanced according to accepted staging rules. I noted that this might explain why ELCAP publications reported a higher rate of stage I cancers found through screening than other investigators. In addition, neither letter addresses my concern about the statistically highly improbable lack of censoring in the analyses of untreated subjects nor explains how more subjects could enter the analysis than would have been possible given the time allotted.
