Simple Lung Cancer Scans That Could Save Thousands of Lives a Year

Cancer can be exponentially easier to treat or cure when it’s caught early.

A new study found that fewer than 2 percent of heavy smokers in the U.S. get recommended lung cancer screenings, an imaging test that can catch tumors when they are small and potentially curable. The numbers fall far short of screening for other types of cancer, including mammograms and colonoscopies—both procedures that are much more uncomfortable than the CT scan used to detect tiny tumors in the lungs.

Lung cancer is the leading cause of cancer death in the U.S., killing an estimated 150,000 Americans each year. For the past five years, such groups as the U.S. Preventive Services Task Force and the American Society of Clinical Oncology have urged people aged 55 or older who have smoked a pack a day (or the equivalent) for three decades or more to get checked for early stage disease. Medicare, the U.S. government’s insurance program for the elderly, pays for the procedure. None of it has made an impact.

“It’s still truly abysmal,” said Danh Pham, chief fellow of hematology/oncology at the University of Louisville’s cancer center in Kentucky, who will present the findings at the ASCO cancer meeting next month in Chicago. “We would like to make this a true call to action, whether it’s for more education or more research, to know why this disparity exists for lung cancer.”

It took a while for public health officials to start recommending routine lung cancer screening, because of questions about its accuracy and its ability to make a difference once the disease was detected. Subsequent studies confirmed the benefits for the heaviest smokers, with the use of screening intended for those most vulnerable to tumors.

The researchers analyzed registry data for everyone who underwent lung cancer screening in 2016 and found that 141,260 of the 7.6 million people eligible, or 1.9 percent, received it. By comparison, from 60 percent to 80 percent of eligible people get screening for breast, cervical and colon cancer, said Bruce Johnson, president of the American Society of Clinical Oncology and chief clinical research officer at the Dana-Farber Cancer Institute in Boston.

The testing shortfall could stem from primary care doctors’ failure to refer high-risk patients to one of 1,800 approved centers nationwide which provide the service. Psychological issues could also play a role, including fear of being diagnosed with a disease that smokers are constantly reminded of, Pham said.

“It’s very difficult to get patients to have this conversation with their doctors because of the stigma,” he said. “People may not want to know if they have lung cancer because it could confirm they’ve made bad lifestyle choices.”

Lung cancer deaths exceed those from breast, colon, pancreas and prostate cancer combined. There are very compelling reasons to get screened, said Johnson.

“If you screened the entire population of the U.S. who fit the criteria for having smoked enough and being the appropriate age, which is about 8 million people, you could save about 12,000 lives a year,” he said. “The majority of lung cancers picked up are early stage,” and finding them before the malignant cells spread reduces the risk of dying by about 20 percent, he said.

Study: Alcohol Use Disorders are the Biggest Risk Factor for Dementia

Alcohol use disorders — defined by the authors as disorders involving hospitalization — must have a neurodegenerative effect at causing dementia.

Alcohol use disorders are the most important preventable risk factors for the onset of all types of dementia, especially early-onset dementia. This according to a nationwide observational study, published in The Lancet Public Health journal, of over one million adults diagnosed with dementia in France.

This study looked specifically at the effect of alcohol use disorders, and included people who had been diagnosed with mental and behavioural disorders or chronic diseases that were attributable to chronic harmful use of alcohol.

Of the 57,000 cases of early-onset dementia (before the age of 65), the majority (57%) were related to chronic heavy drinking.

The World Health Organization (WHO) defines chronic heavy drinking as consuming more than 60 grams pure alcohol on average per day for men (4-5 Canadian standard drinks) and 40 grams (about 3 standard drinks) per day for women.

As a result of the strong association found in this study, the authors suggest that screening, brief interventions for heavy drinking, and treatment for alcohol use disorders should be implemented to reduce the alcohol-attributable burden of dementia.

“The findings indicate that heavy drinking and alcohol use disorders are the most important risk factors for dementia, and especially important for those types of dementia which start before age 65, and which lead to premature deaths,” says study co-author and Director of the CAMH Institute for Mental Health Policy Research Dr. Jürgen Rehm. “Alcohol-induced brain damage and dementia are preventable, and known-effective preventive and policy measures can make a dent into premature dementia deaths.”

Dr. Rehm points out that on average, alcohol use disorders shorten life expectancy by more than 20 years, and dementia is one of the leading causes of death for these people.

For early-onset dementia, there was a significant gender split. While the overall majority of dementia patients were women, almost two-thirds of all early-onset dementia patients (64.9%) were men.

Alcohol use disorders were also associated with all other independent risk factors for dementia onset, such as tobacco smoking, high blood pressure, diabetes, lower education, depression, and hearing loss, among modifiable risk factors. It suggests that alcohol use disorders may contribute in many ways to the risk of dementia.

“As a geriatric psychiatrist, I frequently see the effects of alcohol use disorder on dementia, when unfortunately alcohol treatment interventions may be too late to improve cognition,” says CAMH Vice-President of Research Dr. Bruce Pollock. “Screening for and reduction of problem drinking, and treatment for alcohol use disorders need to start much earlier in primary care.” The authors also noted that only the most severe cases of alcohol use disorder — ones involving hospitalization — were included in the study. This could mean that, because of ongoing stigma regarding the reporting of alcohol-use disorders, the association between chronic heavy drinking and dementia may be even stronger.

Thinktank: Risk of Cyberattack on Nuclear Weapons Systems Relatively High

Quite concerning, and all the more reason that the NSA and GCHQ should primarily be focused on defending the population instead of engaging in harmful mass surveillance.

US, British and other nuclear weapons systems are increasingly vulnerable to cyber attacks, according to a new study by the international relations thinktank Chatham House.

The threat has received scant attention so far from those involved in nuclear military planning and the procurement of weapons, the report said.

It blames this partly on failure to keep up with fast-moving advances, lack of skilled staff and the slowness of institutional change.

“Nuclear weapons systems were developed before the advancement of computer technology and little consideration was given to potential cyber vulnerabilities. As a result, current nuclear strategy often overlooks the widespread use of digital technology in nuclear systems,” the authors of the study said.

Nuclear weapons systems are at threat from hostile states, criminal groups and terrorist organisations exploiting cyber vulnerabities.

“The likelihood of attempted cyber-attacks on nuclear weapons systems is relatively high and increasing from advanced persistent threats from states and non-state groups,” the report said.

It cited examples such as a report the US could have infiltrated the supply chain of North Korea’s missile system that contributed to a test failure in April last year. The silos of US nuclear-tipped Minuteman intercontinental ballistic missiles “are believed to be particularly vulnerable to cyber attacks”.

The study also recorded illicit trafficking in Moldova and Georgia of radioactive and nuclear materials; a group in Belgium affiliated to Islamic State monitoring the movements of a nuclear scientist; and German-owned Patriot missiles reported to have been hacked in 2015.

The report, Cybersecurity of Nuclear Weapons Systems: Threats, Vulnerabilities and Consequences, was written by Beyza Unal, a research fellow at London-based Chatham House who previously worked on strategic analysis at Nato, and Patricia Lewis, research director of the international security department at Chatham House.

“There are a number of vulnerabilities and pathways through which a malicious actor may infiltrate a nuclear weapons system without a state’s knowledge,” the report said. “Human error, systems failures, design vulnerabilities and susceptibilities within the supply chain all represent common security issues in nuclear weapons systems.”

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“Many aspects of nuclear weapons development and systems management are privatised in the US and in the UK, potentially introducing a number of private-sector supply chain vulnerabilities.”

It added: “Presently, this is a relatively ungoverned space and these vulnerabilities could serve to undermine the overall integrity of national nuclear weapons systems. For example, the backdoors in software that companies often maintain to fix bugs and patch systems are targets for cyber-attacks once they are discovered and become known.”

Potential artificial intelligence (AI) applications, while creating new opportunities for cybersecurity, add another layer of complexity for nuclear weapons that could be exploited.

The authors criticise military failures to – so far – take the issue seriously. “Military procurement programmes tend not to pay adequate consideration to emerging cyber risks – particularly to the supply chain – regardless of the government regulations for protecting data against cyber attacks. This could be due to constantly lagging behind the fast-moving nature of cyber attacks, a lack of skilled personnel and the slow institutional and organisational implementation of changes.”

Unprecedented Oil Spill in the East China Sea

Another dangerous risk of the continued usage of fossil fuels.

Over the last two weeks, the maritime world has watched with horror as a tragedy has unfolded in the East China Sea. A massive Iranian tanker, the Sanchi, collided with a Chinese freighter carrying grain. Damaged and adrift, the tanker caught on fire, burned for more than a week, and sank. All 32 crew members are presumed dead.

Meanwhile, Chinese authorities and environmental groups have been trying to understand the environmental threat posed by the million barrels of hydrocarbons that the tanker was carrying. Because the Sanchi was not carrying crude oil, but rather condensate, a liquid by-product of natural gas and some kinds of oil production. According to Alex Hunt, a technical manager at the London-based International Tanker Owners Pollution Federation, which assists with oil spills across the world, there has never been a condensate spill like this.

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While studies of condensate’s environmental effects are limited, one lab study found that its toxicity to corals, for example, was greater than expected based on its molecular components.

In the best-case scenario, the fuel will come to the surface in a slick that is massive but thousandths-of-millimeters thin. From there, it would evaporate into the atmosphere. However, as Richard Steiner, an Alaska-based environmental consultant, told BuzzFeed News, “there’s a lot we don’t know about a major condensate spill since we’ve never seen one.” He described a scenario where there was an “invisible, subsurface toxic plume that is spreading outward from the site.”