Not Ready For Prime Time

I am done with my school work for today and want to take a moment to address an issue which had me literally incensed this morning. It was a headline story in the WSJ, which I had seen on my home page last night ( Yahoo and AP).

Most readers know that I have some expertise in regards to tobacco and disease. Most of you also know that I have a strong concern regarding the use or overuse of medical radiation. As a health educator, I am aware that lung cancer is nearly always caused by cigarette smoking and that lung cancer is the most deadly of the many cancers that we have identified. It is NOT the most prevelant - meaning - a lot of people do not get lung cancer. The lifetime risk for nonsmokers is very low (less than 2%) and in smokers it is about 16 percent for men and 12 percent for women.

Lung Cancer kills people because it is detected late and there is no cure. Treatment can involve chemotherapy and surgery. Some scientists and oncologists suggest that a screening tool which could find this cancer sooner would save lives. They are often basing their argument on the success of the mammogram. Breast cancer is one of the most prevalent cancers but not the deadliest.

For several years there has been a call to use CT scans for lung cancer screening and a push against it. I have been and continue to be against this screening. My two main reasons have stayed the same. The radiation is too much of a risk and this is the wrong smoker disease to be focused on. Lung cancer incidence is much lower than COPD which also causes more death in smokers.

This week the authors/scientists of a study that began in 2002 and ended this year have released some early findings from their National Lung Screening Trial. The popular message is that the CT screening saved lives. Of the 53,000 smokers (current or former but with at least 30 years of one pack per day use) in the study it SEEMS some got X rays and some got CTs - (did anyone get no screens??). Each participant received three - one per year. In that total sample of persons, the current available data does not say how many were actually diagnosed with lung cancer, only that 88 fewer deaths occured in the CT group. The number of deaths in the eight years is 354 compared to 442 (thanks to lauren neergaard for including that fact her story).

I have so many questions, but the research has not been published. It is also said in the two press articles, that 33 sites were used to conduct the study - so there will be variability in radiation dose amongst them - 33 sites, 33 machines.

The data has not yet been analyzed which will tell us about the added risk of the radiation - if it contributed to the lung cancer development. Also, the persons in the study were 55 to 74 years old in 2002 - which ones got sick and which died and how were they put into the separate groups?

I MUST read this study when it is published.

Everyone still agrees on this ONE thing - the best thing to do is NOT SMOKE>