Can population data guide surveillance strategies for second primary lung cancers?

Computed tomography (CT) screening for populations at high risk for lung cancer (LC) has demonstrated improvement in LC-specific mortality and overall survival through earlier identification of potentially lethal LC (1). Similarly, CT surveillance following the radical treatment of first primary lung cancer (FPLC) is crucial, as survivors remain at risk for both recurrence as well as second malignancies, particularly second primary lung cancer (SPLC). The reported rates of SPLC vary, with a review of 10 surgical studies of non-small cell lung cancer (NSCLC) patients estimating a SPLC risk of approximately 1–2% per patient-year (2). Other reports, including a single-center study involving 1,294 NSCLC early stage surgical patients estimated a SPLC rate as high as 2–6% per patient-year (3)