Page 24 - Delaware Medical Journal - November/December 2019
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Early Lung Cancer Screening in Delaware:
Controversies and Reminiscences
James F. Lally, MD
Editor’s Note: This article is a response to “Early Lung Cancer Screening in Delaware: Providers and Public Health, Partnering to Save Lives,” which ran in the September/October 2019 issue.
“Bob” Frelick was alarmed at the increasing incidence of lung cancer
in Delaware and the dismal survival statistics. He was aware of this more than most physicians as, over several decades, he had treated many of the patients with lung cancer who invariably presented with advanced disease.
Bob was always congenial and most pleasant in hallway conversations,
but when he had an idea that he was promoting, he became the proverbial burr in the saddle. He wanted me to consider joining him in setting up a lung-cancer screening program using chest X-rays. While I respected greatly
I resisted. I told him that studies (from the ‘70s and ‘80s), particularly The Mayo Lung Project, showed that screening programs were ineffective and I subsequently wrote a follow- up editorial in the Delaware Medical Journal that presented my opinion opposing such a proposal.1
Several years later, notes and articles from Bob began appearing in my mailbox. Technology had advanced and articles from New York suggested that the recently introduced spiral CT scanning technique (single breath-hold procedure) might be of value in screening for early lung cancers.2 Although the data was preliminary, press releases caught the attention of the National NCI scheduled a conference in Washington that addressed the question whether NCI should fund Weill Cornell Medical Center’s existing Early Lung Cancer Action Project (ELCAP), or whether a separate larger study should be started. Bob was invited
to the conference and he asked me to join him. Subsequently, I received a phone call
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Del Med J | November/December 2019 | Vol. 91 | No. 6
