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I will
offer a personal experience to this discussion.
My
father suffered a ruptured abdominal aortic aneurysm a couple of years
ago. Because of the stoicism of his mid-Western farm upbringing, he
delayed going to the emergency room and passed away a couple of months after the
operation to repair his aneurysm. Most people who experience a ruptured
aortal aneurysm never make it to the hospital. When the surgeon was
debriefing the family after father's operation, he pointed at me and said, "You
must get this checked". My doctor decided on NMR rather than a CAT scan,
which provided reassurance of lack of aneurysm and other
problems.
Aortic
aneurysms are not rare, tend to worsen asymptomatically, and tend to be
discovered in time to repair them only by accident, while the doctor is looking
for something else. In my case, I had a family history (on both sides,
actually), but given the number of different conditions that a CAT scan or NMR
can identify, I tend to be more sympathetic with the proponents of screening
than with the cost/benefit arguments against.
Best
regards.
Jim
Dukelow
Pacific Northwest National
Laboratory
Richland, WA
These
comments are mine and have not been reviewed and/or approved by my management or
by the U.S. Department of Energy.
-----Original Message-----
From: High Plains Drifter [mailto:magna1@jps.net] Sent: Tuesday, February 11, 2003 9:41 AM To: John Jacobus; Jerry Cohen; Susan McElrath; 'Franz Schoenhofer'; radsafe@list.vanderbilt.edu Subject: Re: Get your CAT Scan here! John, et al, evidently there is a debate on the
overall cost versus life extending benefits of the mass CAT scanning. Here
is a leader from EPIMonitor.net:
CAT Scan Screening Poses Public Health Dilemma
Similar To That In The Mammography Debate The banner reads 1-87-R-U-AT-RISK. Get Scanned Early Detection of Cancer and Heart Disease Can Mean A Cure! The easy availability (mobile vans) and relatively low cost of CAT scanning the whole body (under $1000) are increasing the number of persons being screened, and increasing the number of lumps, tumors and cysts being detected throughout the body, according to a NY Times report today. Many of these are benign, but some are not. As a result, the vexing question of whether or not the rate of false positives is too high to justify the procedure on a mass scale is being raised. This is reminiscent of the recent debate about routine screening for breast cancer among women under 50. Where you stand on this issue may depend on where you
sit. From a public health or societal perspective, the cost to the health care
system of working up so many individuals who may be false positives is of
concern. Also, for these individuals, the pain and anxiety surrounding the
follow up tests may be considerable. On the other hand, for those individuals
who have a cancer detected early, the benefits may be life saving. Where do you
draw the line? How do you decide as an individual? How do we decide
collectively? Dean Chaney, CHP
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