• Lucian R Chirieac and Douglas B Flieder.
• Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
• Arch. Pathol. Lab. Med. 2010 Jan 1; 134 (1): 41-8.

ContextRecent 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.ObjectiveTo critically review the current model of adenocarcinoma development against the background of lung cancer screening results combined with observational pathologic and radiographic studies.Data SourcesPublished articles pertaining to lung cancer screening, lung adenocarcinoma pathology, and radiology accessible through PubMed form the basis for this review.ConclusionsThe 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.

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