"The Shootist" was Wayne's final cinematic role, concluding a 50-year career that began during the silent film era in 1926. Wayne was not, as sometimes reported, terminally ill when the film was made in 1976. A heavy cigarette smoker for most of his life, he had been diagnosed with lung cancer in 1964, and underwent surgical removal of his left lung and several ribs. He remained clinically cancer-free until early 1979, when metastases were discovered in his stomach, intestines, and spine; he died in June of that year. Nonetheless, following the release of "The Shootist", Wayne appeared in a television public service announcement for the American Cancer Society that began with the scene in which Wayne's character is informed of his cancer. Wayne then added that he had enacted the same scene in real life 12 years earlier.