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Medical Forum / General / General / March 2007

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Computed Tomography Screening and Lung Cancer Outcomes

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Steven Bornfeld - 09 Mar 2007 03:27 GMT
    Read the article yesterday in the NY Times before perusing the source
in JAMA.  Very sobering.
    I'm hardly an expert in epidemiology, but the vastly different
assessment methods in the studies out there could make me even more
cynical than I am already.
    In the context of this study, just what are the differing inferences
one can make from "survival" vs. death rates?
    I understand that this seems to be pointing to a rational basis for
public health policy, but what does it mean for clinical decision making
on patients?
    My personal interest is that my dad had a lobectomy 5 months ago for
what was diagnosed as stage 1B primary adenoca.  He is doing well.

http://tinyurl.com/369dfa

TIA for your thoughts.

Steve
Bob - 09 Mar 2007 04:56 GMT
>    Read the article yesterday in the NY Times before perusing the source
>in JAMA.  Very sobering.
[quoted text clipped - 8 lines]
>    My personal interest is that my dad had a lobectomy 5 months ago for
>what was diagnosed as stage 1B primary adenoca.  He is doing well.

Interestingly, in the Sigma Xi news bulletin yesterday there were two
items on lung cancer -- the one you noted, plus one that was more
encouraging. Here are both:

SCIENCE IN THE NEWS
from Sigma Xi, The Scientific Research Society

Today's Headlines - March 7, 2007

Researchers Dispute Benefits of CT Scans for Lung Cancer

from the New York Times (Registration Required)

Lung cancer screening with CT scans does not appear to save lives and
exposes people to serious risks of injury and even death from needless
surgery, researchers are reporting today.

The results are a disappointment, the researchers say. Lung cancer is
the
leading cause of cancer deaths among men and women and kills more
Americans
than the four next most deadly cancers combined. For decades, cancer
specialists have hoped to show that early detection and treatment can
save
lives.

The first efforts, using chest X-rays, were disappointing. But many
hoped
that the more sensitive CT scans could find cancers early enough to
make a
difference. "When we took this study on, we were expecting that CT
might do
the job where chest X-rays couldn't," said Dr. Peter B. Bach, the
study's
lead author and a lung specialist and epidemiologist at Memorial
Sloan-
Kettering Cancer Center in New York. But, Dr. Bach added, his hopes
were
dashed.

To read more: http://www.nytimes.com/2007/03/07/health/07lung.html

Or: http://tinyurl.com/yt8jfg

...

Lung Cancer Screening Test Called Exciting

from the Chicago Tribune (Registration Required)

Scientists may be close to being able to predict who will develop lung
cancer, a development that could prevent tens of thousands of deaths a
year
in the U.S.

Using a molecular test called a microarray, a research team from
Boston
University has come up with an 80-gene "signature" that can identify
lung
cancer in smokers at a very early stage. More important, the team
showed
that it is possible to detect precancerous changes in normal tissue.

"It's like a molecular Pap smear," said Dr. Avrum Spira, who led the
investigation. ...His preliminary study appears in this month's issue
of
the journal Nature Medicine. The next step, Spira said, is a large
clinical
trial "to get FDA approval for an early detection tool."

To read more: http://www.chicagotribune.com/news/nationworld/chi-
0703070076mar07,1,6508711.story

Or: http://tinyurl.com/yrmyhk

********************************************************************

"Science in the News" is produced daily by Sigma Xi as a service for
its
members and the public. It highlights science and technology news
stories
appearing in the mainstream media. The accompanying Web links provide
access to the full text of the articles on the Web sites of the
individual
media outlets from which they are taken.

For accurate instructions on how to subscribe or unsubscribe to the
listserv, follow this link:
<http://www.mediaresource.org/instruct.htm>

bob
Steven Bornfeld - 09 Mar 2007 16:32 GMT
> Lung Cancer Screening Test Called Exciting
>
[quoted text clipped - 24 lines]
>
> Or: http://tinyurl.com/yrmyhk

    There are a lot of early detection tools of one sort or another that
have come out or are in development.  I hear about them on the Bulletin
Board of Oral Pathology (I am a dentist) where there is a high level (I
think justified) in the potential of some of these.  Hopefully some good
tests will make it through.
    My dad enrolled in a research study at MSKCC where he gets bloods drawn
periodically.  They are looking at an immunologic marker for some lung
ca and particularly the levels found in the circulating blood, and how
it responds to surgical resection--the aim being I suppose not only as a
detection tool for primary cancer but also for recurrence.

Steve

> ********************************************************************
>
[quoted text clipped - 12 lines]
>
> bob
 
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