Re: Lung cancer mortality in the Mayo Lung Project: impact of extended follow-up.

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Abstract
In a recent article, Marcus et al. (1) updated findings from the Mayo Lung Project, extending the follow-up period to 25 years. The authors demonstrated that, even after a long follow-up, there was no difference in lung cancer mortality between the intervention and usual-care arms, although survival for lung cancer diagnosed before 1983 was better in the intervention arm. The authors suggested that overdiagnosis is the most plausible interpretation for the excess of lung cancer incidence observed in the intervention arm. However, alternative explanations for this excess are possible.