H1N1: GlaxoSmithKline pulls vaccine in CanadaSWINE FLU CENTRAL: Interactive maps, quiz, FAQ, latest news and videoHOW TO: Get through flu season unscathedOutbreaks Near Me, a new, free application developed by non-profit HealthMap, is among a slew of flu-themed applications available on the iTunes App Store for iPhone and iPod Touch owners.

 A couple of dozen other flu-related apps have been created recently, including HMSMobile Swine Flu Center, by Harvard Medical School, which offers medical advice with animations. Others include flu games and jokes such as Swine Scan, which supposedly scans your body to detect infection.

 Outbreaks Near Me works like a GPS. It finds your location and tells you where H1N1 and other infectious outbreaks are occurring nearby with a display of pushpins on a map. Click on a pushpin and you can read news reports as well as personal accounts submitted by users. It also lets you set up an alert system, so if H1N1 arrives in your area, you’ll get a heads-up.

 ”Our app is all about giving people real-time alerts. We didn’t develop this to increase fear. It’s about helping people arm themselves,” says John Brownstein, an assistant professor of pediatrics at Children’s Hospital Boston and Harvard Medical School, who developed the app with colleagues at Massachusetts Institute of Technology‘s Media Lab.

 H1N1, popularly known as swine flu, has infected an estimated 22 million Americans this year from April to October, according to the Centers for Disease Control and Prevention. The CDC has reported that the outbreak is linked to almost 4,000 deaths, including 540 children.

 Since Outbreaks Near Me launched Sept. 1, about 100,000 people have downloaded it, Brownstein says. Though the app also reports recent E. coli, malaria and other outbreaks, H1N1 has by far been the most-searched disease, he says.

 Brownstein says the app has received more than 2,000 submissions. “People take photos of themselves in bed sick, or e-mail in to say their school is closed, or that there’s a vaccine shortage in their area,” he says.

 Outbreaks Near Me co-developer Clark Freifeld, a graduate student in media art and sciences at Massachusetts Institute of Technology, says developers are analyzing submissions now and say the information appears to correlate with CDC data. It suggests the iPhone may be a sensitive tool for monitoring early outbreak trends, Freifeld says.

 For big-picture influenza news, most people probably get information the traditional way, from CDC reports, says influenza expert William Schaffner, chair of the department of preventive medicine at Vanderbilt Medical Center in Nashville. Apps may be best when you want more focused information, he says. “Like what is happening in grandma’s town, where you’re going for Thanksgiving.”

 The CDC does not comment on products such as apps, spokeswoman Karen Hunter says. Hunter says the agency is in the prototype stage of several new flu apps for iPhone and the Google Android, and they’re already using mobile text messaging (to sign up, text HEALTH to 87000) and a mobile website (http://m.cdc.gov) to distribute flu updates to tens of thousands of subscribers.

Knowledge is power, unless that knowledge comes with so much baggage that it becomes crippling. Such is the trouble with many cancer and health screening tests.

Last week the U.S. Preventive Services Task Force unleashed a maelstrom with its recommendations that women need mammograms less frequently, with regular breast-cancer screening starting at age 50, not 40, and only biennially, not yearly.

The Task Force said it was responding to data showing that routine mammograms starting at age 40, as long recommended, rarely save lives and more often result in a misdiagnosis — detection of a breast cancer that’s either benign or growing too slowly to be of worry. This, in turn, leads to unnecessary anxiety and debilitating treatment.

Not everyone agreed with the new recommendations, published on November 17 online in the Annals of Internal Medicine. The American Cancer Society, for now, is sticking to its recommendation of yearly mammograms for women starting at age 40.

Yet nearly all health experts will agree that the benefits of most health screening techniques are either exaggerated by the health community or misunderstood by the public. A few discounted ones are below.

Five questionable tests

PSA testing: A PSA blood test looks for prostate-specific antigen, a protein produced by the prostate gland. High levels are associated with prostate cancer. The problem is that the association isn’t always correct, and when it is, the prostate cancer isn’t necessarily deadly. Nearly 20 percent of men will be diagnosed with prostate cancer, which sounds scary, but only about 3 percent of all men die from it. The PSA test usually leads to overdiagnosis — biopsies and treatment in which the side effects are impotence and incontinence.

DEXA: Dual energy X-ray absorptiometry (DEXA or DXA) in a technique developed in the 1980s that measures, among many things, bone mineral density. The scans can determine bone strength and signs of osteopenia, a possible precursor to osteoporosis. Limitations abound, though. Measurements vary from scan to scan of the same person, as well as from machine to machine. DEXA doesn’t capture the collagen-to-mineral ratio, which is more predictive of bone strength than just mineral density. And higher bone mineral density doesn’t necessarily mean stronger bones, for someone with more bone mass will have more minerals but could have weaker bones.

Full-body scans: If you got extra cash, usually more than $1,000, you may be tempted to get a full-body CT scan to find everything wrong with you. Avoid that temptation. For the most part, these are done so poorly by purely commercial enterprises that the results are useless. The scan will definitely find something abnormal that is likely of little concern. And it could very likely miss something that is a concern. For example, these scans aren’t done with special contrast agents to look for specific types of tumors or organ damage. You’re left only with a false sense of confidence. CT technology is excellent but only in the hands of an expert focused on a specific medical concern.

Home menopause test: The home menopause test is almost in the realm of hokum, despite its popularity with a generation of women who grew up with the home pregnancy test. The test measures levels of FSH, or follicle-stimulating hormone, in the urine. Not only doesn’t the kit measure this well, FSH in the urine is a poor indicator of menopause status. Perhaps of little surprise is that FSH levels, like many female hormones, vary from day to day, particularly for pre-menopausal women. The home test kit may sound innocent enough, but some women might use this to assess whether they still need birth control.

Home Alzheimer’s test: The home Alzheimer’s test is a scratch-and-sniff test, useful according to the manufacturers because a loss of smell can be an early signs of Alzheimer’s disease. There’s a little truth here. Anosmia, a loss of smell, has been associated with Alzheimer’s disease and Parkinson’s disease. But that association seems rare; most anosmics don’t have a degenerative brain disease. Your failure of the smell test is likely indicative of, well, a smelling problem. Yet while the home test verges on the naive, serious research continues on whether anosmia serves as some sort of canary in the coal mine for burgeoning neurological disorders.

Two good tests

Aside from self-examination for skin cancer, colon and cervical cancer screens are the only screens strongly recommended by most doctors.

Colonoscopies are very effective in finding and removing precancerous polyps. Colon cancer takes nearly a decade to develop, and starting a decadal colonoscopy routine at age 50 would significantly eliminate your risk for colon cancer. Similarly, Pap smears are highly effective identifying precancerous and malignant cervical cancer cells. Women should get a Pap smear at least every other year starting at age 20.

Health screenings aren’t entirely useless. They are essential, in fact, for people at high risk of developing a disease, such as women with a clear family history of breast cancer. Screening is simply imperfect, and the public needs to understand the benefits and limitations of each one.

HONG KONG (Reuters) – China must be alert to any mutation or changes in the behavior of the H1N1 swine flu virus because the far deadlier H5N1 bird flu virus is endemic in the country, a leading Chinese disease expert said.

Zhong Nanshan, director of the Guangzhou Institute of Respiratory Diseases in China’s southern Guangdong province, said the presence of both viruses in China meant they could mix and become a monstrous hybrid — a bug packed with strong killing power that can transmit efficiently among people.

“China, as you know, is different from other countries. Inside China, H5N1 has been existing for some time, so if there is really a reassortment between H1N1 and H5N1, it will be a disaster,” Zhong said in an interview with Reuters Television.

“This is something we need to monitor, the change, the mutation of the virus. This is why reporting of the death rate must be really transparent.”

The World Health Organization warned on Tuesday that H5N1 had erupted in poultry in Egypt, Indonesia, Thailand and Vietnam, posing once again a threat to humans.

“First, it places those in direct contact with birds — usually rural folk and farm workers — at risk of catching the often-fatal disease. Second, the virus could undergo a process of “reassortment” with another influenza virus and produce a completely new strain,” it said.

“The most obvious risk is of H5N1 combining with the pandemic … (H1N1) virus, producing a flu virus that is as deadly as the former and as contagious as the latter.”

Zhong told the Chinese media last week that China may have had more H1N1 flu deaths than it has reported, with some local governments possibly concealing suspect cases.

The doctor is known for his candor and work in fighting Severe Acute Respiratory Syndrome in 2003, when nationwide panic and international alarm erupted after it emerged that officials hid or underplayed the spreading epidemic.

Cover-ups by local governments in 2003 during the SARS epidemic led to the sackings of several officials. More than 300 people died in that outbreak.

China, the world’s most populous country, has reported around 70,000 cases of H1N1 and 53 death from the virus.

While some regions simply lack the technology to test for H1N1, other areas have been treating deaths as cases of ordinary pneumonia without a question, Zhong said.

“Some local healthcare authorities are reluctant, unwilling to test patients with severe pneumonia because there’s some latent rule which says the more H1N1 deaths, the less effective the control and prevention work in your area,” Zhong said.

Zhong said China’s health minister Chen Zhu rang him up last week and agreed with his views. A notice then appeared on the ministry’s website threatening severe punishment for officials caught concealing deaths from H1N1 swine flu.

WHO reported more than 526,060 laboratory confirmed cases of H1N1 worldwide on November 15, with at least 6,770 deaths. However, it has stressed for months now that the figures were only the tip of the iceberg.

It urged countries to place more resources on mitigating the disease rather then on costly prevention measures or testing everyone. All WHO and the U.S. CDC will say is that “millions” have been infected.

KIEV – One night at the height of the panic over what people here call the California flu, as 24-hour news stations tracked a rising death toll and politicians speculated about a mystery lung plague, Ukraine’s prime minister rushed to the airport to greet a shipment of Tamiflu as if it were a foreign dignitary.

Not to be outdone, the president, a bitter political foe, dispatched a top aide to meet the plane, too.

In neighboring Belarus, the government took an opposite tack, accusing drug companies of fanning hysteria over swine flu to boost profit. In Poland, the health minister is under fire for refusing to stock up on a vaccine, while doctors in Hungary are resisting orders to administer the shot. In Turkmenistan, the authorities have been accused of covering up an epidemic, with infectious-disease wards reportedly full and people being turned away.

As the pandemic H1N1 influenza surges with the onset of winter, the nations of Eastern Europe and the former Soviet Union appear particularly vulnerable to the deadly virus. Burdened with weak health care systems, relatively inexperienced news media outlets, and shaky governments that have little public trust, the region also seems ripe for panic and political strife over the flu.

The potential for trouble is already on display in Ukraine, where 1.5 million of its 46 million people have had diagnoses of flu and respiratory illnesses since the start of the outbreak and 356 have died, according to the government. The World Health Organization suspects that most of the cases are swine flu, making Ukraine among the hardest-hit countries in Europe, including Russia, Bulgaria, Moldova, and Poland.

More telling than the numbers, however, has been the widespread fear the virus has caused in Ukraine, and the outsize impact it has had on the nation’s political landscape.

In the weeks since Prime Minister Yulia Tymoshenko announced measures against the spread of the flu – shutting the nation’s schools and banning public gatherings – anxious residents have overwhelmed hospitals and pharmacies, buying up supplies of medicine, gauze masks, and home remedies such as lemons and garlic. Rumors have proliferated that people are dying of a new, more lethal strain of the virus.

Semyon Gluzman, a psychiatrist and Soviet-era dissident in Kiev, said the fear was a rational response in a nation with a dysfunctional health care system and a corrupt, ineffective government.

Ukraine’s news media – which gained new freedoms after the Orange Revolution – have provided round-the-clock, often sensational coverage of the outbreak. The nation’s leading politicians are jockeying for advantage ahead of the January presidential election, accusing one another of exploiting the crisis by doing too much or endangering lives by doing too little.

President Viktor Yushchenko, running far behind in his reelection bid, accused the prime minister of failing to prepare for the outbreak, saying that she left the national flu center staffed with only one employee, put doctors in danger, and allowed the H1N1 virus to mutate into a “more aggressive’’ strain. Aides floated the idea of postponing the election because of the outbreak.

Tymoshenko, who was a Yushchenko ally in the Orange Revolution, fought back, criticizing him for blocking $125 million in emergency spending to fight the flu and saying he would be “responsible for every person who is ill today or dies.’’ 

By Tracy Jan, Globe Staff  |  November 24, 2009

A group of part-time community college instructors filed a lawsuit yesterday against the state, saying that hundreds of adjunct faculty in Massachusetts’ public higher education system are unfairly denied health care coverage.

The lawsuit, filed in Suffolk Superior Court on behalf of five instructors, follows nearly a decade of unsuccessful wrangling with state legislators to get an adjunct health insurance bill enacted into law. It also comes as schools, particularly community colleges, are increasingly turning to adjuncts amid burgeoning enrollment.

“We’ve been trying on the Hill to persuade the state to do the right thing, and, to be frank, I just ran out of patience,’’ said Joseph T. LeBlanc, president of the Massachusetts Community College Council, which is a plaintiff in the suit, along with the Massachusetts Teachers Association. “It’s a case of justice. The state ought to be providing a large chunk of these people with a health insurance plan.’’

The situation is particularly startling, the plaintiffs say, given the 2006 state law mandating health insurance coverage for all residents. The Teachers Association estimates that about 500 adjunct faculty members meet the state’s longtime definition of part-time employees – those who working at least 18.75 hours a week – and should be eligible for state health insurance because they work at least that amount, including classroom, grading, and preparation time.

If successful, the lawsuit would set a legal precedent that would extend to adjunct faculty at all the state colleges and universities, said Matthew Jones, attorney for the Massachusetts Teachers Association.

Extending coverage to adjunct faculty at community colleges alone could cost upwards of $2 million a year as the state is struggling to make ends meet. Officials of the Department of Higher Education and the state’s Group Insurance Commission, who are among the parties named in the lawsuit, declined to comment on the lawsuit yesterday.

As colleges scramble to meet rising enrollment by hiring cheaper, part-time faculty, the adjunct ranks have expanded to about 4,300 instructors in the state’s 15 community college campuses, a 13 percent increase from six years ago.

More than half of undergraduate courses at community colleges across the state are taught by part-time instructors, who make up two-thirds of community college faculty, according to the Massachusetts Community College Council.

“We’re the best deal going for the schools,’’ said Patrick Lochelt, a plaintiff and an English instructor who teaches eight classes a semester at Northern Essex Community College in Haverhill, Middlesex Community College in Lowell, and the University of Massachusetts at Lowell. “In some ways, it really is exploitation.’’

Lochelt’s class load, with nearly 200 students per semester, is nearly twice as much as a full-time instructor, but he is paid far less, about $2,700 per course. He said he spends 23 hours a week in class and an additional 15 hours a week grading papers. He also serves as the faculty adviser for the award-winning student literary magazine at Northern Essex, an unpaid position.

Many adjunct professors, like Lochelt, patch together a full-time living teaching multiple courses at several colleges and shell out hundreds of dollars each month for private health insurance.

“Luckily, I’m only 30 and don’t have any health issues, but if I did, I’d be in big trouble,’’ Lochelt said.

But as insurance rates skyrocket, some instructors say, they can no longer afford the premiums.

Cynthia Duda, another plaintiff and an English instructor who teaches six classes at North Shore Community College and Bunker Hill Community College, said she recently switched from a $910 a month health plan to a bare-bones $638 a month plan that does not cover urgent care.

“At my age, I need all the insurance I can get,’’ said Duda, 61. “I am killing myself teaching all these courses trying to scrape up this health insurance money, trying to make it to Medicare. This is not right.’’

When Duda fell ill on a recent weekend and lost her voice, she said, she avoided going to the doctor because she could not afford to do so.

“I just had to take a chance that it wasn’t something serious,’’ Duda said.

In comparison, full-time community college instructors who are covered by the state’s plans for individuals pay between $80 and $220 a month for health insurance, or about 20 percent to 25 percent of the cost.

Duda estimates that even as a part-time instructor, she works about 40 hours a week in and out of the classroom.

She said that since 1990, she has taught a full schedule, including summers, nights, and weekends, though she is still considered a temporary contract worker.

“I’m working full time for the state of Massachusetts, the only state with so-called universal health care,’’ Duda said. “Great, where’s mine? In the end, it takes a toll on you inside. That’s when I think, why don’t I matter? It’s scary.’’

Amy Whitcomb Slemmer – executive director of Health Care For All, a consumer advocate group – said health care is “a basic human right.’’

“To deny it to educators, whom we entrust to cultivate and enrich the state’s young minds, seems unkind and unfair,’’ said Slemmer.

WASHINGTON – A technology originally developed for premature babies might be helping to save some of the sickest swine flu patients by rerouting their blood so their lungs can rest.

It’s a risky approach using equipment that only certain specialized hospitals have. But faced with children and young adults struggling to breathe despite ventilators, intensive-care doctors are dusting off these machines, named ECMO for extracorporeal membrane oxygenation.

“It was pretty scary knowing that was his blood flowing through those tubes in and out of his body,’’ said Susie Damm of Omaha, whose 19-year-old son, Ryan, survived a life-threatening bout after 10 days on ECMO.

No one knows which patients are most likely to benefit – not everyone does. But ECMO is gaining attention after Australian researchers reported that the machines helped during that country’s outbreak. A voluntary US-based registry counts 107 critically ill swine flu patients recently treated with ECMO, most from this country.

Estimates from the federal Centers for Disease Control and Prevention suggest that swine flu has hospitalized 98,000 Americans in the past six months, and killed nearly 4,000. 

By Raf Casert, Associated Press  |  November 25, 2009

BRUSSELS – With a caretaker holding his hand, a Belgian man who was diagnosed as comatose for 23 years typed out a message yesterday that he felt reborn after decades of loneliness and frustration.

A leading bioethicist, however, expressed skepticism that the man was truly communicating on his own.

Car-crash victim Rom Houben was diagnosed as being in a vegetative state but appears to have been conscious the whole time, doctors here said.

An expert using a specialized type of brain scan that was not available in the 1980s says he finally realized Houben was conscious and provided him with the equipment to communicate.

Assisted by a speech therapist who rapidly moved his finger letter by letter along a touch-screen keyboard, Houben told AP Television News that years of being unable to move or communicate left him feeling “alone, lonely, frustrated, but also blessed with my family.’’

The therapist, Linda Wouters, told APTN that she can feel Houben guiding her hand with gentle pressure from his fingers, and that she feels him objecting when she moves his hand toward an incorrect letter.

“It was especially frustrating when my family needed me. I could not share in their sorrow. We could not give each other support,’’ Houben wrote during the interview at the ‘t Weyerke institute in eastern Belgium.

“Just imagine. You hear, see, feel, and think but no one can see that. You undergo things. You cannot participate in life.’’

Arthur Caplan, a bioethics professor at the University of Pennsylvania, said he is skeptical of Houben’s ability to communicate after seeing video of his hand being moved along the keyboard.

“That’s called ‘facilitated communication,’ ’’ Caplan said. “That is ouija board stuff. It’s been discredited time and time again. When people look at it, it’s usually the person doing the pointing who’s doing the messages, not the person they claim they are helping.’’

Caplan also said that the statements Houben allegedly made with the computer strike him as unnatural for someone with such a profound injury and an inability to communicate for decades.

Asked how he felt when his consciousness was discovered, Houben responded through the aide that: “I especially felt relief. Finally be able to show that I was indeed there.’’

“Just like with a baby, it happens with a lot of stumbling,’’ he wrote.

The doctor who discovered that Houben had been wrongly diagnosed said that he is re-examining dozens of other cases.

Dr. Steven Laureys said he has discovered some degree of consciousness using state-of-the-art equipment in other patients but won’t say how many. He looks at about 50 cases from around the world a year but none are as extreme as that of Rom Houben, who was fully conscious inside a paralyzed body. Many center on the fine distinction between a vegetative state and minimal consciousness.

He said yesterday that: “It is very difficult to tell the difference.’’

His studies showed that some 40 percent of patients with consciousness disorders are wrongly given a diagnosis of a vegetative state.

“It is clearly unacceptable. It is four times out of ten 10 that they think the patient is in a vegetative state but in reality he is minimally conscious,’’ Laureys said. 

By Liz Kowalczyk, Globe Staff  |  November 9, 2009

For the 42 percent of Americans who smoke cigarettes or once did, a ruling from the state’s highest court last month seemed to offer hope that a simple screening tool could help them ward off advanced lung cancer.

The judges decided that Philip Morris USA may have to pay for lung scans for smokers so they can get early warning if they’ve developed cancer – and get treatment before it spreads into a deadly mass. (A federal court would have to affirm the state’s decision before the company would have to pay.)

Even before the court weighed in, advocates had been pressing politicians for money to pay for CT scans for high-risk but asymptomatic people – insurers generally don’t cover the test for screening – particularly since a group of New York researchers published results in 2006 suggesting that screening is saving the lives of smokers, former smokers, and people exposed to secondhand smoke and other hazards, such as asbestos. Some smokers are so convinced of the benefits of CTs they pay the $400 screening fee themselves.

“Our movement is really taking hold,’’ said Joanne O’Connor, cochair of the Lung Cancer Alliance in Massachusetts, which is lobbying legislators for funding. “I wouldn’t want to find out [I had lung cancer] like my sister did when she was already stage four. She died six months later.’’

But even as pressure for CT scanning builds, many of the country’s top cancer specialists are saying not so fast. While advocating early detection may seem like a no-brainer, they dispute the 2006 study and argue that there is no evidence that screeningscans actually save lives. Even worse, they say scanning can be inaccurate and end up harming patients by exposing them to unnecessary procedures and surgery, which carry their own risks.

In fact, the federal government and most major health organizations, including the American Cancer Society and the American Lung Association, recommend against CT screening exams for lung cancer for both smokers and former smokers, calling into question the wisdom of the state court’s ruling.

“There’s an emotional appeal [to CT scanning]; there are people who are dying and you want to help them,’’ said Dr. Steven Woloshin, a professor at Dartmouth Medical School. “But we’ve been fooled again and again in medicine. Right now the only way to make a rational decision is to look at evidence.’’

The debate over CT scanning is of intense personal importance to smokers and former smokers – 96.5 million Americans – and to the thousands of people who get lung cancer each year but who never smoked. Lung cancer is among the most deadly cancers, because it is most often detected after it has metastasized, or spread, leading to a dismal 5-year death rate of 85 percent. The hope is that early detection will improve these terrible odds, just as mammography has decreased mortality for women with breast cancer by alerting them to the need for treatment earlier in the illness. Two large national studies may finally provide definitive answers as soon as next year.

Lynne Petty, 44, of Newburyport, said that as a former smoker she would “absolutely want’’ CT screening if it were covered by her insurance plan. It’s not just the cost that’s kept her from having the test, however, it’s that scanning is not part of mainstream medicine; she would not know how often to get screened or what to expect.

“CT scanning should become as commonplace as a mammogram and colonoscopy where people discuss it like they’re going to dentist’s office,’’ she said. “Did you have your lung scan this year?’’

The search for effective early detection for lung cancer dates to the 1960s. Since then, three randomized trials of lung cancer screening comparing X-rays with regular care found no difference in mortality between the two groups. Contrary to what one would expect, two of the trials actually reported small increases in death rates among patients who were screened; they had more lung cancer surgery, which carries a significant risk of death.

The search for a screening tool was revived in the 1990s with the widespread arrival of CT scans, which are more sensitive than X-rays.

The leading proponents of screening are a group of radiologists from New York Presbyterian Hospital-Weill Medical College of Cornell University, who published a hopeful but controversial study in the New England Journal of Medicine three years ago. Led by Dr. Claudia Henschke, researchers screened 31,567 asymptomatic people at risk for lung cancer using CT scans between 1993 and 2005. They found lung cancer in 484 participants, most of whom had stage 1 cancer. Their estimated 10-year survival rate was 80 percent – an unheard of success rate for people diagnosed with lung cancer.

“I have no doubt we are saving lives,’’ said Dr. Albert Miller, a professor at New York Medical College, and an investigator in the study.

The Massachusetts Supreme Court relied in part on Miller’s expert testimony during the lawsuit brought against Philip Morris by two Massachusetts smokers. Since the 2006 study was published, however, the New England Journal has published three corrections, including one from Henschke revealing that some of the funding for the study came from cigarette-maker Liggett Tobacco.

Dr. Barnett Kramer, associate director for disease prevention at the National Institutes of Health, said the study was faulty, partly because it did not compare patients who were screened to a control group. Kramer, who along with Woloshin, coauthored a rebuttal to Henschke’s study two years ago in the Archives in Internal Medicine, said that screening always will make it appear that people survived longer than those who were not screened.

They put it this way: Imagine a group of patients diagnosed with lung cancer at age 67 who all die at age 70. Their 10-year survival rate is 0 percent. If that same group of patients is diagnosed earlier by CT, at age 59, and they still all die at age 70, their 10-year survival rate is 100 percent. But no matter when they were diagnosed, they still died at the same age.

Annual screening, added Kramer, is always better at picking up slow growing cancers, because aggressive cancers make themselves known with symptoms, so the patients whose cancer was discovered by a CT scan probably would have done better anyway. And they may have cancers that would never become fatal.

“You’re treating and curing people who didn’t need to be treated and cured in the first place,’’ he said, and exposing those people to harm from pneumonia or other risks of surgery.

For now, he said, the best way to lower one’s risk of advanced lung cancer is to stop smoking and not resume – and to stay tuned for the results of the National Lung Screening Trial and the Prostate, Lung, Colorectal & Ovarian Cancer Screening Trial, both sponsored by the National Cancer Institute.

These trials will compare lung cancer death rates for people screened annually with CT scans to those not screened and to those screened with a chest X-ray. “If the trials show that [CT scanning] works that would be wonderful, but they may not,’’ Woloshin said.