Executive and Medical Director
American Council on Science and Health
you did not read my oped carefully,
you have mischaracterized my argument for the benefit of your argument.
I never said that mortality wasn't a worthy endpoint warranting further study, i said it shouldn't be a "solo" endpoint.
I am also not alone among the thousands of internists and pulmonologists who use screening chest ct as part of a strategy for early detection, and then together with a team of top level radiologists, figure out what to do with the results. This is very clearly described in my oped, and you have distorted it.
You also should have admitted to the Journal that you know me personally, that I have done consulting work for your organization, and that this may have affected your motivation in writing this letter.
I have heard from many practicing physicians and top level researchers who have agreed with me and praised my oped. Everyone agrees that the great advances in CT technology have let to a situation where it is capable of diagnosing cancers before they leave the lung, and in the right hands, are much less likely to cause unmanageable false positives.
we can see the advantage of advanced technological screening of breast cancer, a less aggressive cancer, with the current news about MRI.
My core premise is that a practicing clinical physician like myself needs diagnostic tools like this in his arsenal that can be used in conjunction with a proper knowledge of the medical literature.
I always welcome debate with you, and appreciate your invitation for further debate, but i feel that should have occurred before you published an inaccurate letter.
Marc Siegel MD