LAUSR

After demonstrating, in large trials, that low-dose computed tomography (LDCT) screening decreases lung cancer (LC) mortality in smokers and former smokers, establishing screening programs in high-risk subjects has become a priority for health systems. LC associated with cystic airspaces (LCCA) is a distinct although uncommon presentation of screen-detected LC, accounting for 2% of LCs identified at baseline and for 12% of LCs identified at annual repeat LDCT. In a recent paper published in Annals of Surgical Oncology, Jung et al. proposed a stepwise disease progression model of lung adenocarcinoma with cystic airspaces (LACA). The study deserves merit as it provides, for the first time, information about the natural history of this variety of tumor and its prognostic implications. However, considering the screening perspective, the following considerations are in order.