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  1. Fabrice Bonnet M.D., Ph.D.1,
  2. Philippe Morlat M.D., Ph.D.1,
  3. Geneviève Chêne M.D., Ph.D.2,
  4. for the “Mortalite 2000 Study Group”

Article first published online: 13 DEC 2004

DOI: 10.1002/cncr.20791

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Cancer

Cancer

Volume 103, Issue 3, page 651, 1 February 2005

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Bonnet, F., Morlat, P., Chêne, G. and for the “Mortalite 2000 Study Group” (2005), Author reply. Cancer, 103: 651. doi: 10.1002/cncr.20791

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  1. 1

    Service de Médecine Interne et Maladies Infectieuses Hôpital Saint-André; INSERM U593 Université Victor Segalen Bordeaux, France

  2. 2

    INSERM U593 Université Victor Segalen Bordeaux, France

Publication History

  1. Issue published online: 20 JAN 2005
  2. Article first published online: 13 DEC 2004

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We agree with Dr. Diamond that systematic X-ray screening is not associated with a decrease in mortality from lung carcinoma in smokers who are negative for the human immunodeficiency virus (HIV).1

However, our proposal was based on the fact that lung carcinoma appears to have a higher incidence, a more aggressive nature, and a delayed diagnosis and is associated with a poorer prognosis in HIV-infected patients.2–4 Therefore, because of the severity of lung carcinoma in HIV-positive smokers, X-ray screening could result in an earlier diagnosis of lung carcinoma, as has been shown in HIV-negative patients.1 Although we agree that our daily practice should be based on the best available evidence, we believe that specific recommendations might be conceivable in this population, even if not yet supported by robust studies conducted in HIV-negative smokers. The same type of approach has been proposed for the screening of cervical dysplasia and carcinoma in patients infected with HIV.5 Of course, this theory may only be temporary while we await the results of controlled studies undertaken in the specific population of HIV-infected smokers.

REFERENCES

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    Manser RL, Irving LB, Stone C, Byrnes G, Abramson M, Campbell D. Screening for lung cancer. Cochrane Database Syst Rev. 2004; 1 CD001991.
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    Herida M, Mary-Krause M, Kaphan R, et al. Incidence of non-AIDS-defining cancers before and during the highly active antiretroviral therapy era in a cohort of human immunodeficiency virus-infected patients. J Clin Oncol. 2003; 21: 3447–3453.
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    Tirelli U, Spina M, Sandri S, et al. Lung carcinoma in 36 patients with human immunodeficiency virus infection. The Italian Cooperative Group on AIDS and Tumors. Cancer. 2000; 88: 563–569.
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  • 4
    Alshafie MT, Donaldson B, Oluwole SF. Human immunodeficiency virus infection and lung cancer. Br J Surg. 1997; 84: 1068–1071
  • 5
    US Department of Health and Human Services 2001 USPHS/IDSA Prevention of Opportunistic Infections Working Group. Guidelines for the prevention of opportunistic infections in persons infected with human immunodeficiency virus. Available from URL: http://aidsinfo.nih.gov/guidelines/ [accessed 26 November 2004].

Fabrice Bonnet M.D., Ph.D.*, Philippe Morlat M.D., Ph.D.*, Geneviève Chêne M.D., Ph.D.†, * Service de Médecine Interne et Maladies Infectieuses Hôpital Saint-André; INSERM U593 Université Victor Segalen Bordeaux, France, † INSERM U593 Université Victor Segalen Bordeaux, France.

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