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Re: Does CT lung cancer screening LOWER lung cancer risk?



Yes, John,

Smoking is the main cause of lung cancer and every day I help patients kick

that adrenalin fix.



As Otto points out also, the small numbers don't evidence much here.



Howard Long



----- Original Message ----- 

From: "John Jacobus" <crispy_bird@YAHOO.COM>

To: "Howard Long" <hflong@pacbell.net>; "John Jacobus"

<crispy_bird@YAHOO.COM>; "Keith Welch" <welch@jlab.org>;

<radsafe@list.vanderbilt.edu>

Sent: Sunday, June 20, 2004 7:16 PM

Subject: Re: Does CT lung cancer screening LOWER lung cancer risk?





> Howard,

> I would say that since the differences between actual

> and expected cancers is so small, neither a

> detrimental or beneficial effect can be demonstrated.

>

> I would say stop smoking would provide a greater

> benefit than any supposed CT radiation dosage.  As a

> physician, wouldn't you agree?

>

> --- Howard Long <hflong@pacbell.net> wrote:

> > "4,687 non-leukemic cancer deaths occurred in 50,115

> > [exposed] survivors

> > where we estimated 4,306 would have occurred, had

> > they not been exposed [to

> > 1 to 10 cSv or rads]." (ref below). Indeed, that

> > would suggest a slight

> > INCREASE in cancer deaths from CT, (c 1 rad).

> >

> > However, the small difference (8%) might be

> > explained by many variables.

> >

> > Mostly I doubt the conclusion because it is

> > inconsistent with other data:

> > The Breast Cancer Incidence Among Atomic Bomb

> > Survivors (Land CE, McGrgor

> > DH, JNatl Cancer Inst 1979 Jan;62(1):17-21 table 2

> > shows "average tissue

> > dose, rads Observed 109 vs Expected 127.8 p,0.0001",

> > but broken down,

> > rads 1-9, Observed 34 breast cancers, Expected 42.3

> > breast cancers!

> >

> > Thus for that dosage, there is evidence that 1-9 rad

> > acute exposure may

> > LOWER breast cancer risk. I abandoned design for a

> > study using mammography

> > and CT

> > because the 1 rad acute from the CT would lower the

> > power to detect

> > significant differences, since it would have much

> > the same benefit as the

> > exposure (no good placebo). This is much the same

> > problem as drug companies

> > are having with placebo in anti depressants (Wall St

> > Journal, 6/18/04).

> >

> > I think CT may LOWER lung cancer risk.

> >

> > Howard Long

> >

> > ----- Original Message ----- 

> > From: "John Jacobus" <crispy_bird@YAHOO.COM>

> > To: "Keith Welch" <welch@jlab.org>;

> > <radsafe@list.vanderbilt.edu>

> > Sent: Friday, June 18, 2004 1:43 PM

> > Subject: Re: Article: Lung cancer screening raises

> > lung cancer risk

> >

> >

> > > The Radiation Effects Research Foundation show 63

> > > deaths (2% of 3391 cancer deaths) between 5 mSv

> > and

> > > 200 mSv

> > >

> > http://www.rerf.or.jp/eigo/radefx/late/cancrisk.htm

> > >

> > > Of course I have not read any of the reports which

> > > might have more current information.  However, it

> > > appears to be a bit of data mining

> > (word-smithing?) to

> > > enhance the risk value.

> > >

> > > Keith, the HPS position paper I think you are

> > > referring to is at

> > > http://hps.org/documents/radiationrisk.pdf

> > >

> > > --- Keith Welch <welch@jlab.org> wrote:

> > > > Is this really right?  Are the bomb survivor

> > > > statistics correct?  How does the cancer risk in

> > the

> > > > atomic bomb cohort reconcile with the HPS

> > position

> > > > paper on "radiation risk in perspective" which

> > > > states that quantitative risk estimates should

> > not

> > > > be used below 10 rem?  (coincidentally, it seems

> > > > that position paper is no longer on the HPS

> > website.

> > > >  Is it under revision?)

> > > >

> > > > "For example, 10 low-dose CT lung screening

> > > > examinations would produce lung doses in the

> > range

> > > > of

> > > > 25 to 90 mGy," he wrote. "Among approximately

> > 30,000

> > > > individuals in the cancer incidence cohort of

> > atomic

> > > > bomb survivors who received doses between 5 and

> > 100

> > > > mSv (mean dose, 29 mSv), there was a

> > statistically

> > > > significant increase in cancer risk (77 excess

> > > > cancers, p = 0.05) compared to that in the

> > control

> > > > population."

> > > >

> > > >

> > > > Keith Welch



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