SCREENING FOR LUNG CANCER among high-risk groups deserves the attention that Steven E. Vogl, MD, brought to it in his column At Microphone 1 in the February 10 issue of The ASCO Post. Subspecialist oncologists are not always attuned to the needs of their patients outside of their own specialty.1 Even when they are aware of the association of second cancers, opportunities to reduce cancer burden are not always seized.2,3
For example, lung cancer rates are elevated among women with cervical cancer.4 However, as Dr. Vogl indicated, utilization of lung cancer screening is low among patients with cervical cancer. This may be justified, as patients with a primary cancer with an associated increase in mortality may not have sufficient years of life at risk to benefit from screening for second incidence primaries. However, the shortened overall survival may at least be partly due to the lack of compliance with screening guidelines.5
One solution to consider involves a focused educational effort by oncologists. For instance, once a patient is “cured” at the proverbial 5-year mark, could an oncologist-focused screening checklist help to assure that all screening options have been considered and discussed with the patient? Could a medical oncologist send a urine sample for human papillomavirus testing? Could a gynecologic oncologist order a lung cancer screening computed tomography? Could we all do better? ■
—Giuseppe Del Priore, MD
Morehouse School of Medicine
DISCLOSURE: Dr. Del Priore reported no conflicts of interest.
1. Del Priore G, Taylor SY, Esdaile BA, et al: Urinary incontinence in gynecological oncology patients. Int J Gynecol Cancer 15:911-914, 2005.
2. De Leon MB, Del Priore G, Gudipudi DK: Synchronous primary ovarian and endometrial cancer in recent years: Changes in recent years. 2013 ASCO Annual Meeting. Abstract e16554.
3. Del Priore G: Endometrial cancer screening: The time has come. Available at www.researchgate.net/project/Endometrial-cancer-screening-the-time-has-come. Accessed April 3, 2019.
4. Vogel VG: Identifying and screening patients at risk of second cancers. Cancer Epidemiol Biomarkers Prev 15:2027-2032, 2006.
5. Lim MC, Won YJ, Lim J, et al: Second primary cancer after diagnosis and treatment of cervical cancer. Cancer Res Treat 48:641-649, 2016.
DISCLAIMER: Letters to the Editor represent the views of the author and may not necessarily reflect the views of ASCO or The ASCO Post.