Rebuttal From Dr Mazzone Peter J. Mazzone, MD, MPH, FCCP  CHEST  Volume 153, Issue 6, Pages 1306-1308 (June 2018) DOI: 10.1016/j.chest.2018.03.016 Copyright © 2018 American College of Chest Physicians Terms and Conditions

Figure 1 Equal risk of developing lung cancer does not equate to an equal balance of benefit and harms. A, A 60-year-old white smoker with a BMI of 28 kg/m2, some college, one pack per day for 40 years, with a family history of lung cancer, no COPD, no coronary artery disease, and no prior cancers. Calculated risk of developing lung cancer in the next 6 years is 3.5% according to the PLCOM2012 risk calculator. Favorable balance of benefit to harm. B, A 75-year-old white former smoker with a BMI of 28 kg/m2, some college, one pack per day for 20 years (quit 15 years ago), COPD, coronary artery disease, prior cancer, and no family history of lung cancer. Calculated risk of developing lung cancer in the next 6 years is 3.6% according to the PLCOM2012 risk calculator. Unclear balance of benefit to harm. CHEST 2018 153, 1306-1308DOI: (10.1016/j.chest.2018.03.016) Copyright © 2018 American College of Chest Physicians Terms and Conditions