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



But they do make good press.



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

> 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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=====

+++++++++++++++++++

"To be persuasive, we must be believable,

To be believable, we must be credible,

To be credible, we must be truthful."

Edward R. Murrow



-- John

John Jacobus, MS

Certified Health Physicist

e-mail:  crispy_bird@yahoo.com





		

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