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RE: Get your CAT Scan here!



Jim,

I think there is a big difference between having a test performed based on a prior medical evaluation based on symptoms or a familiar history, and responding to an advertisement that says you "owe it to your loved ones."  This is not screening, but effective advertising.

Of course, we will always hear about the discovered cases, not those that are false-positive.

 "Dukelow, James S Jr" <jim.dukelow@pnl.gov> wrote:

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
jim.dukelow@pnl.gov
 
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


-- John
John Jacobus, MS
Certified Health Physicist
e-mail: crispy_bird@yahoo.com



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