Earlier Diagnosis Not Self-Evidently Beneficial: Natural History of Subcentimeter Lung Cancers

OBJECTIVE. We estimated the natural history of subcentimeter stage I non-small cell lung cancers detected on screening CT using a computed mean 230-day tumor volume doubling time and exponential growth. CONCLUSION. We found that the majority of patients with subcentimeter, non-small cell lung cancers would survive for more than 5 years without treatment. The benefit of cancer interdiction would be offset to some extent by the combined effects of surgical mortality and materially diminished longer-term disease-free survival among the more than 40% of patients who would be overdiagnosed.