title: High-resolution computed tomography screening for lung cancer: unexpected findings and new controversies regarding adenocarcinogenesis.
abstract: BACKGROUND
  Recent advances in human imaging technologies reawakened interest in lung cancer screening. Although historic and current preliminary and noncontrolled studies have not shown a decrease in lung cancer mortality in screened populations, many explanations have been proffered while the lung cancer community awaits the results of several large controlled population studies.
  
  
  OBJECTIVE
  To critically review the current model of adenocarcinoma development against the background of lung cancer screening results combined with observational pathologic and radiographic studies.
  
  
  METHODS
  Published articles pertaining to lung cancer screening, lung adenocarcinoma pathology, and radiology accessible through PubMed form the basis for this review.
  
  
  CONCLUSIONS
  The current adenocarcinogenesis model is probably valid for many but not all lung adenocarcinomas. Screening data combined with radiographic and pathologic studies suggest that not all lung adenocarcinomas are clinically aggressive, and it is uncertain whether all aggressive adenocarcinomas arise from identified precursors.
authors.affiliation: Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Lucian R
authors.initials: LR
authors.lastname: Chirieac
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Flieder
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000209:etiology; D018450:Disease Progression; D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods*