Monthly Archives: December 2009

CT Scans and Cancer Risk: Been There, Done That

Two articles and an editorial in this week’s issue of the Archives of Internal Medicine should give all of us pause about the potential risk of increased cancer cases and deaths caused by the overuse and inappropriate use of CT scans.


According to this research, it is possible that 1-2% of cancer deaths every year in the future may be due to a cancer caused by a CT scan performed years previously.  In addition, the researchers found that the amount of radiation per CT scan differed substantially for the same type of scan performed on different machines in the same or other institutions.


For me, this is not some abstract discussion.  Two years ago I had to decide between getting several CT scans recommended by a radiologist or avoid the scans and take the chance I had a serious disease that might progress undetected.  I decided against the scans for the very reasons noted by these researchers. 


Looking back, it was clearly the right decision.


In the first study as reported in the Archives, the authors determined the number of CT scans performed currently in the United States. Then, they estimated … Continue reading →

Mammography Guidelines: You Can’t Dress It Up

I don’t like to keep kicking the proverbial can down the road, but a column in yesterday’s Wall Street Journal about the statistics in the recent mammogram guideline recommendations from the U S Preventive Services Task Force is worthy of comment.


Aside from “getting it right” in my opinion, Carl Bialik’s (“The Numbers Guy”) discussion highlights the imperfection of the statistics that the Task Force relied on in making a recommendation to the public that we should abandon a long standing (and, in my opinion, effective) public health recommendation that women at average risk of breast cancer get a screening mammogram every year beginning at age 40.


The reality is that the fall out from the Task Force recommendations is just beginning, with one state government cutting mammograms for women in their 40’s and insurers concerned that their contracts with companies to provide health insurance benefits for employees will require them to do the same.


Mr. Bialik points out that one of the key statistics was not as perfect as one might think.  In fact, the statistic is so imperfect in this case as to make it meaningless. 


As Mr. Bialik reported, the “number … Continue reading →

Cancer Incidence and Deaths Continue Decline

If you hear good news often enough, does it become “no news?” 


That’s my concern with today’s release of the 2009 version of the Annual Report to the Nation on the status of cancer incidence and deaths in the United States from 1975 to 2006.  The “news” is still good—with some caveats—but will people still pay attention to the message? I certainly hope so. 


If someone had told me years ago about the successes we could achieve in reducing cancer incidence and deaths I would have had serious reservations about our ability to accomplish that task.  Here we are 35 years later, and we have done just that.


This report—which was published in the journal Cancer and is a collaborative effort between the American Cancer Society, the National Cancer Institute, the Centers for Disease Control and Prevention and North American Association of Central Cancer Registries–brings us the same message as last year: overall the rates of cancer incidence and death continue to decline in men and women.  At the same time, some types of cancer are increasing in frequency, and while death rates from lung cancer are dropping in men, the same cannot … Continue reading →