Study Ties Genes to Lower Urinary Tract Symptoms, Prostate Cancer Risk

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Screening for Lung Cancer Might Benefit Those at Highest Risk

SUNDAY, May 20 (HealthDay News) -- Using low-dose CT scans to screen for lung cancer might save the lives of patients at the greatest risk for the disease, a new analysis suggests.

However, the risks of screening for others aren't clear, the researchers added.

"We have insight into risks, but they are hard to weigh and estimate," said lead researcher Dr. Peter Bach, from Memorial Sloan-Kettering Cancer Center in New York City.

"It's clear that when you screen you find cancers that otherwise wouldn't appear, and that leads to overtreatment," he said. "It is clear that CTs find lots of things that aren't cancer. About one in five people have something found that will require some sort of follow-up."

There is also an excess radiation risk. In one trial, screening prevented about three deaths per 1,000 people screened, while one in 2,500 might develop cancer from the CT scan, Bach said.

However, in the right population it could theoretically prevent thousands of deaths a year, he explained.

Namely, that population is the heaviest smokers, those who smoke for 30 pack-years or more. A pack-year is the number of cigarettes smoked over time. This means at least a pack a day for 30 years or two packs a day for 15 years.

"For these patients, we recommend that doctors might suggest screening and discuss the risks and benefits," Bach said. "But, no one should be telling people that they must have this test or advertise that it's a lifesaving procedure that will prevent you from dying from lung cancer."

In the end, "there is no substitution for smoking cessation in terms of health benefits," Bach noted.

The report was published online May 20 in the Journal of the American Medical Association.

For the study, Bach's team reviewed 21 studies about the benefits and risks of low-dose CT screening for lung cancer.

One of the studies, the National Lung Screening Trial, included more than 53,000 people and found that screening reduced deaths from lung cancer by 20 percent, the researchers said.

The results of that trial were published last June in the New England Journal of Medicine.

However, the other, smaller trials found no benefit from screening, Bach's team noted.

The study authors found that, overall, 20 percent of patients had a scan that needed follow-up, but only 1 percent had lung cancer.

The studies were done in teaching hospitals with experienced radiologists and cancer doctors, Bach noted.

This report is the basis of the screening recommendations adopted by the American College of Chest Physicians and the American Society of Clinical Oncology.

The recommendations state that heavy smokers aged 55 to 74, and those who have quit in the past 15 years, should be offered screening.

But screening should only be done at hospitals that do a lot of this kind of screening. These are usually large or teaching hospitals, because the value of this screening at community hospitals is not known, Bach added.

Dr. Norman Edelman, chief medical officer at the American Lung Association, called the new study a "thoughtful analysis of an important topic."

The American Lung Association conducted a similar review and came to similar conclusions, he said.

The data suggest that screening heavy smokers is likely to reduce death from lung cancer by about 20 percent and all-cause mortality by about 10 percent, he said.

"Given the large cohort to which it pertains, this would be a significant public health achievement," Edelman stated.

However, there remain many unsettled issues, he said.

"One major issue is whether the same results would be observed in the community as opposed to the controlled academic settings in which the study was done," Edelman said. "Accordingly, the American Lung Association report emphasizes the need for screening to be done in centers which can provide low-dose CT screening and a comprehensive multi-specialty environment, so that finding of suspect nodules can be followed up with appropriate [care] rather than undue risk."

Robert Smith, director of cancer screening at the American Cancer Society, said, "These recommendations are consistent" with screening guidelines from similar medical groups.

However, he believes these guidelines will be refined over the years as new data become available.

"The question remains, who else might you endorse lung cancer screening for," Smith said. "Suppose someone had a 35 pack/year history and they were 35 years old, or what if they were 45 years old and had started smoking at the age of 12."

There may be other levels of risk where screening might be beneficial, Smith said: "We will probably learn a lot from trials that are currently under way."

More information

For more on lung cancer, visit the American Lung Association.

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Obama-Casey Policies Hurting Americans at the Pump ...

By Chairman Rob Gleason

Our economic recovery has been a slow and delicate?one, threatened in Washington, D.C.?every step of the way by runaway?spending, taxes and regulation from?the Obama Administration and?Democratic Senate. ?U.S. Senator Pat Toomey and Pennsylvania?Republicans in the U.S. House have?worked hard to reduce spending and?create a pro-job growth environment?for business. ?Unfortunately, they?re?great work has been met with rejection by a do-nothing Senate led by Harry Reid and President Obama?s?veto stamp.

Our victories and bright spots for the future have?come from state capitols around the country, where?Republicans like Governor Tom Corbett and majorities in the General Assembly in Pennsylvania have?passed policies to help reverse the ailing economy. ?For all of their credit in helping Pennsylvania, only?so much can be done when we have a White House?administration that is fighting us tooth-and-nail every?step of the way.

Now, Americans face more barriers to recovery, as?rising gas prices threaten our way of life. ?Working?families rely on their cars to transport them to and?from their place of work so they can bring home a?paycheck, support their family and hopefully have?something left to spend for themselves. ?But that reality only becomes a dream when the national average?for gasoline has risen 12 cents in two weeks to almost?$3.81 a gallon. ?Pennsylvania isn?t much better off,?with an average around $3.68 a gallon.

Those extra costs don?t just hurt families directly, but?also by increasing costs on business. ?The manufacturing sector relies on energy and transportation when?they move their merchandise from production to?market. ?Increasing their costs to do business means?less production, higher costs and fewer jobs. ?This?is a reality that we are facing as President Obama?s?energy policies and lack of response to rising gas?prices hurts the bottom line of small businesses and?American families.

We don?t have to look far to see the results. ?Just recently GenOn Energy announced it would close five?coal-fired power plants in Pennsylvania over the next?four years because of environmental rules that have?made their business unprofitable. ?Senator Casey is a?staunch, consistent supporter of President Obama?s?cap-and-trade proposal and regulation policies that?cost Pennsylvanian?s their jobs. ?The president?s?rejection of the Keystone XL pipeline blocked new?energy production that would have reduced prices?and created jobs. ?When Republicans in the Senate?moved to speed up the pipeline, Democrats blocked it?yet again.

In Pennsylvania, we have seen a stark contrast. ?Governor Corbett and Republican leaders in the State?Senate and House last month passed legislation to?expand the development of the Marcellus Shale region and natural gas industry. ?This was done in a safe?way, with attention to local needs, without preventing?job creation and the expansion of new technology and?energy. ?Pennsylvania families have been fortunate?enough to see their electricity rates decline dramatically in the last year. ?Provider PPL Electric Utilities?has made consistent cuts since a record increase two?years ago. ?The increase in supply of natural gas has?made for cheaper energy prices and less expensive?costs for families to power their homes.

Governor Corbett has been leading from the front?to prevent skyrocketing fuel and energy costs for?middle class working families and small business. ?The Obama administration?s actions are making these?times more difficult than they should be and jeopardizing the health of our financial recovery.

This next election will mark a new direction in our?country. ?Here in Pennsylvania we have a great?opportunity and responsibility to replace President?Obama and U.S. Senator Bob Casey when we go to?the ballot box in November. ?In their place we can?send a Republican President to the White House and?send Tom Smith to join Pat Toomey in the U.S. Senate and have a federal government that will help our?states in protecting American and Pennsylvania families from rising costs, foreign dependence, burdensome regulations, wasteful spending, and unnecessary?debt, not undo their hard work and progress.

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Video: Georgia hit by 3rd case of flesh-eating bacteria

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Lawyer says soldier doesn't remember Iraq killings

SEATTLE (AP) ? An Army sergeant charged with killing four other soldiers and a Navy officer in May 2009 at a mental health clinic in Iraq should not face a possible death penalty, his lawyer said Monday.

Sgt. John Russell has no memory of being inside the Camp Liberty Combat Stress Center near Baghdad, attorney James Culp said.

"We believe strongly that John went to kill himself in front of the doctor who had mocked him and antagonized him," Culp said. "And the doctors say he was suffering from major depression with psychotic features and chronic post-traumatic stress disorder."

The facts do not warrant a death penalty, he said.

Premeditated murder charges were filed Wednesday against Russell, 47, of Sherman, Texas.

The lawyer from Austin, Texas, said he had tried to avert the possibility of a death sentence.

"The delays were all requested by the defense in the hopes we would end up with a non-capital referral," Culp said.

If convicted, the maximum punishment is death, but the court martial jury will have options short of the death penalty, he said.

"We do not believe now that when a military panel is seated, this is the type of punishment they will seek to impose on John, once the facts are heard," Culp said.

Russell's lack of memory will be a problem for the defense, he said.

No date for the court martial has been set, but Culp said he asked for a date in December and the government wants an earlier date.

The shootings are believed to be the worst case of soldier-on-soldier violence of the Iraq War, said Culp and Lewis-McChord spokesman Lt. Col. Gary Dangerfield.

Russell also has an Army defense attorney, but it is standard procedure for them not to comment to the media, Dangerfield said.

The military trial will focus on the mental stress of combat, Culp said.

"The court martial will tell us a lot about the lack of mental health care in the combat zone," he said.

A hearing on possible charges held in August 2009 at Fort Leavenworth, Kan., established that Russell was nearing the end of his third tour when his behavior changed. Members of his unit testified that he became more distant in the days before the May 11, 2009, attack, and that he seemed paranoid that his unit was trying to end his career.

On May 8, 2009, Russell sought help at a combat stress clinic at Camp Stryker, where his unit was located. On May 10, 2009, Russell was referred to the Camp Liberty clinic, where he received counseling and prescription medication to treat his symptoms.

Witnesses said the following day they saw Russell crying and talking about hurting himself. He went back to the Camp Liberty clinic, where a doctor told him he needed to get help or he would hurt himself. Russell tried to surrender to military police to lock him up so he wouldn't hurt himself or others, witnesses said.

Military prosecutors said Russell left the clinic and later returned with a rifle he took from his unit headquarters and began firing. He was arrested afterward.

Killed in the shooting were Navy Cmdr. Charles Springle, 52, of Wilmington, N.C., and four Army service members: Pfc. Michael Edward Yates Jr., 19, of Federalsburg, Md.; Dr. Matthew Houseal, of Amarillo, Texas; Sgt. Christian E. Bueno-Galdos, 25, of Paterson, N.J.; and Spc. Jacob D. Barton, 20, of Lenox, Mo.

Russell deployed to Iraq with the 370th Engineer Company, 54th Engineer Battalion from Bamberg, Germany. In Iraq the 54th was assigned to the 555th Engineer Brigade, based at Lewis-McChord, which is responsible for the court martial.

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Morgan Stanley works on Facebook IPO orders: source

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Former Israeli PM: Jerusalem must be partitioned

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