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Lung Cancer Screening
Lung cancer screening refers to cancer screening strategies used to identify early lung cancers before they cause symptoms, at a point where they are more likely to be curable. Lung cancer screening is critically important because of the incidence and prevalence of lung cancer. More than 235,000 new cases of lung cancer are expected in the United States in 2021 with approximately 130,000 deaths expected in 2021. In addition, at the time of diagnosis, 57% of lung cancers are discovered in advanced stages (III and IV), meaning they are more widespread or aggressive cancers. Because there is a substantially higher probability of long-term survival following treatment of localized (60%) versus advanced stage (6%) lung cancer, lung cancer screening aims to diagnose the disease in the localized (stage I) stage. Results from large randomized studies have recently prompted a large number of professional organizations and governmental agencies in the U.S. to now recommend lung cancer s ...
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Computed Tomography
A computed tomography scan (CT scan; formerly called computed axial tomography scan or CAT scan) is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or radiology technologists. CT scanners use a rotating X-ray tube and a row of detectors placed in a gantry to measure X-ray attenuations by different tissues inside the body. The multiple X-ray measurements taken from different angles are then processed on a computer using tomographic reconstruction algorithms to produce tomographic (cross-sectional) images (virtual "slices") of a body. CT scans can be used in patients with metallic implants or pacemakers, for whom magnetic resonance imaging (MRI) is contraindicated. Since its development in the 1970s, CT scanning has proven to be a versatile imaging technique. While CT is most prominently used in medical diagnosis, it can also be used to form images of non-living objects. The 1979 N ...
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Poverty
Poverty is the state of having few material possessions or little income. Poverty can have diverse , , and causes and effects. When evaluating poverty in statistics or economics there are two main measures: '' absolute poverty'' compares income against the amount needed to meet basic personal needs
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Length Time Bias
Length time bias (or length bias) is an overestimation of survival duration due to the relative excess of cases detected that are asymptomatically slowly progressing, while fast progressing cases are detected after giving symptoms. Length time bias is often discussed in the context of the benefits of cancer screening, and it can lead to the perception that screening leads to better outcomes when in reality it has no effect. Fast-growing tumors generally have a shorter asymptomatic In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered as ... phase than slower-growing tumors. Thus, there is a shorter period of time during which the cancer is present in the body (and so might be detected by screening) but not yet large enough to cause symptoms, that would cause the patient to seek medical care ...
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Lead Time Bias
Lead time bias happens when survival time appears longer because diagnosis was done earlier (for instance, by screening), irrespective of whether the patient lived longer. Lead time is duration of time between detection of a disease (by screening or based on a new experimental criteria) and its usual clinical presentation and diagnosis (based on traditional criteria). For instance, it is the time between early detection by screening and the time in which diagnosis would have been made clinically (without screening). It is an important factor when evaluating the effectiveness of a specific test. Relationship between screening and survival The goal of screening is earlier detection - to diagnose a disease earlier than it would be without screening. Therefore, if screening works, it needs to advance in time the moment of diagnosis. In other words, screening needs to introduce a lead time. However, the lead time itself biases survival statistics: people with disease detected by scr ...
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Chest Radiograph
A chest radiograph, called a chest X-ray (CXR), or chest film, is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in medicine. Like all methods of radiography, chest radiography employs ionizing radiation in the form of X-rays to generate images of the chest. The mean radiation dose to an adult from a chest radiograph is around 0.02 mSv (2 mrem) for a front view (PA, or posteroanterior) and 0.08 mSv (8 mrem) for a side view (LL, or latero-lateral). Together, this corresponds to a background radiation equivalent time of about 10 days. Medical uses Conditions commonly identified by chest radiography * Pneumonia * Pneumothorax * Interstitial lung disease * Heart failure * Bone fracture * Hiatal hernia Chest radiographs are used to diagnose many conditions involving the chest wall, including its bones, and also structures contained within the thoracic ...
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Mayo Clinic
The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research Research is "creative and systematic work undertaken to increase the stock of knowledge". It involves the collection, organization and analysis of evidence to increase understanding of a topic, characterized by a particular attentiveness t .... It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, across three major campuses: Rochester, Minnesota; Jacksonville, Florida; and Phoenix, Arizona, Phoenix/Scottsdale, Arizona. The practice specializes in treating difficult cases through Health care#Tertiary care, tertiary care and Medical tourism#United States, destination medicine. It is home to the top-15 ranked Mayo Clinic Alix School of Medicine in addition to many of the highest regarded residency education programs in the United States. It spends over $660 million a year on research an ...
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Memorial Sloan Kettering Cancer Center
Memorial Sloan Kettering Cancer Center (MSK or MSKCC) is a cancer treatment and research institution in the borough of Manhattan in New York City, founded in 1884 as the New York Cancer Hospital. MSKCC is one of 52 National Cancer Institute–designated Comprehensive Cancer Centers. Its main campus is located at 1275 York Avenue, between 67th and 68th streets, in Manhattan. According to U.S. News & World Report 2021-2022 Best Hospitals, Memorial Sloan Kettering Cancer Center (MSK) has been ranked as the number two hospital for cancer care in the nation. History New York Cancer Hospital (1884–1934) Memorial Hospital was founded on the Upper West Side of Manhattan in 1884 as the New York Cancer Hospital by a group that included John Jacob Astor III and his wife Charlotte. The hospital appointed as an attending surgeon William B. Coley, who pioneered an early form of immunotherapy to eradicate tumors. Rose Hawthorne, daughter of author Nathaniel Hawthorne, trained there ...
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Johns Hopkins University
Johns Hopkins University (Johns Hopkins, Hopkins, or JHU) is a private research university in Baltimore, Maryland. Founded in 1876, Johns Hopkins is the oldest research university in the United States and in the western hemisphere. It consistently ranks among the most prestigious universities in the United States and the world. The university was named for its first benefactor, the American entrepreneur and Quaker philanthropist Johns Hopkins. Hopkins' $7 million bequest to establish the university was the largest philanthropic gift in U.S. history up to that time. Daniel Coit Gilman, who was inaugurated as Johns Hopkins's first president on February 22, 1876, led the university to revolutionize higher education in the U.S. by integrating teaching and research. In 1900, Johns Hopkins became a founding member of the American Association of Universities. The university has led all U.S. universities in annual research expenditures over the past three decades. Johns Hopkins is ...
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National Cancer Institute
The National Cancer Institute (NCI) coordinates the United States National Cancer Program and is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. The NCI conducts and supports research, training, health information dissemination, and other activities related to the causes, prevention, diagnosis, and treatment of cancer; the supportive care of cancer patients and their families; and cancer survivorship. NCI is the oldest and has the largest budget and research program of the 27 institutes and centers of the NIH ($6.9 billion in 2020). It fulfills the majority of its mission via an extramural program that provides grants for cancer research. Additionally, the National Cancer Institute has intramural research programs in Bethesda, Maryland, and at the Frederick National Laboratory for Cancer Research at Fort Detrick in Frederick, Maryland. The NCI receives more than in funding eac ...
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Chronic Obstructive Pulmonary Disease
Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce mucus. COPD progressively worsens, with everyday activities such as walking or dressing becoming difficult. While COPD is incurable, it is preventable and treatable. The two most common conditions of COPD are emphysema and chronic bronchitis and they have been the two classic COPD phenotypes. Emphysema is defined as enlarged airspaces ( alveoli) whose walls have broken down resulting in permanent damage to the lung tissue. Chronic bronchitis is defined as a productive cough that is present for at least three months each year for two years. Both of these conditions can exist without airflow limitation when they are not classed as COPD. Emphysema is just one of the structural abnormalities that can limit airflow and can exist without a ...
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