To the Editor:

A few days ago, you reported that although national and statewide incidence of lung cancer in Illinois are decreasing, new cases in Southern Illinois continue to rise. In addition to an increase in incidence, smokers in this part of the state have higher mortality rates due to lung cancer and a mere 17.8 percent five-year survival rate. In your post, Dr. Rosenow, medical director at the SIH Cancer Institute, claims that “prevention, early diagnosis and community outreach/education” will help to reduce the disparate rates we see in these 16 Southern Illinois counties.

Despite this suggestion of increased screening, the National Cancer Institute warns Americans that currently, no clinical trials have been conducted to show that screenings lessen risk of lung cancer mortality. In a similar light, an article in the British Medical Journal on breast cancer screenings in Canadian women, found no reduction in mortality in women age 40 to 59 who were randomly assigned to have a mammogram.

These articles suggest that screenings may not be beneficial in decreasing one’s risk of dying from cancer. As a graduate student at the UC Berkeley School of Public Health, I believe the key to reducing disease and mortality disparities in this population is not through increased screenings but rather through changes in behaviors and environmental factors causing the disease in the first place. If the scientific literature is steering us away from screenings, perhaps a less invasive prevention approach would be suitable for this vulnerable population.

Natalie Warren

Benicia, California

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