David W. Johnstone, MD

Radiologic screening for lung cancer had a long and unsuccessful history until the advent of low-dose computed tomography (CT) screening and the completion of the National Lung Screening Trial, which demonstrated an improvement in lung cancer–specific mortality in a high-risk population.

Advances in the treatment of lung cancer have been precious and few over the past 40 years, as reflected in the minimal rise in overall survival from this disease since 1960. Significant progress has occurred in staging accuracy, surgical morbidity, radiation delivery, and new chemotherapeutics. And yet, patients with stage II disease have a 5-year survival rate of 50% or less, while patients with stage III disease fare poorly overall.