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A Compelling Reason Why
John Gofman is Correct
in Identifying
Medical X-rays as a Major Cause of Cancer
Copyright 2001 by Darrell Stoddard
Suggesting that medical doctors cause cancer may seem as wrong as criticizing crippled children for being impaired, but I believe the January 2000 Lancet article, summarized below, presents credible evidence that medical X-rays are a major cause of cancer.
Never does Gofman say X-rays should not be used, especially exams with modern mammography instruments that have reduced radiation exposure by a factor of 10 times. Gofman cites this reduction as the model for what should be done, but has not yet occurred with any other X-ray instrument or test. One CT scan exposes the patient to as much radiation as 5 to 25 mammograms. One fluoroscopy exam (a common X-ray test where the beam stays on) exposes the patient to as much or more radiation than 125 mammograms. There are 700,000 fluoroscopy exams each year in the U.S.
If with low dose mammography, the total number of deaths per thousand women screened is increased by six for each breast cancer death avoided, what does this suggest for X-ray examinations that expose patients to more than 250 times as much radiation as mammography? Answer: One death for every 16 such examinations, or in the U.S., 43,680 excess deaths each year from fluoroscopy examinations alone. The number of deaths could be more than this or less, but the total is significant - even momentous, when this is radiation that could be easily reduced by 50% or more, with no loss of information and no reduction in the quality of health care. (Calculation based on the maximum total radiation exposure of 24 mammograms, 2 each year for 12 years, for 1000 women; compared to the minimum exposure of one fluoroscopy examination each for 1000 patients, and 700,000 such exams in the U.S. each year. In practice, the difference is often 2 times as great as this calculation.)
Reducing X-ray exposure and smoking cessation are by far the most important measures that can be taken to save people from heart disease and cancer! It costs nothing to do either.
(For more information see Lancet article below or Better than a Cure for Breast Cancer on this website)
Footnote: The magnitude of deaths caused from tobacco use, can be perceived by a declaration in a recent address by Dr. Gro Harlem Brundtland, Director General of the World Health Organization -- "The current annual toll of 4 million tobacco deaths world-wide will rise to 10 million each year by 2030.... tobacco is set to be the biggest killer of them all -- causing more deaths than both malaria, HIV/AIDS, and TB together." These death estimates are world wide. The death estimates given for medical X-rays are only for the United States.)
Summary from Jan. 2000 Lancet article
Is Screening for Breast Cancer
with Mammography Justifiable?
(Includes an analysis of all eight identified Breast Cancer Mammography Trials)
by Peter C Gtzsche, Ole Olsen
"Background
A 1999 study found no decrease in breast-cancer mortality in Sweden, where screening has been recommended since 1985. We therefore reviewed the methodological quality of the mammography trials and an influential Swedish meta-analysis, and did a meta-analysis ourselves.
Methods
We searched the Cochrane Library for trials and asked the investigators for further details. Meta-analyses were done with Review Manager (version 4.0).
Findings
Baseline imbalances were shown for six of the eight identified trials, and inconsistencies in the number of women randomised were found in four. The two adequately randomised trials found no effect of screening on breast-cancer mortality (pooled relative risk 104 [95% CI 084-127]) or on total mortality (099 [094-105]). The pooled relative risk for breast-cancer mortality for the other trials was 075 (067-083), which was significantly different (p=0005) from that for the unbiased trials. The Swedish meta-analysis showed a decrease in breast-cancer mortality but also an increase in total mortality (106 [104-108]); this increase disappeared after adjustment for an imbalance in age.
Interpretation
Screening for breast cancer with mammography is unjustified. If the Swedish trials are judged to be unbiased, the data show that for every 1000 women screened biennially throughout 12 years, one breast-cancer death is avoided whereas the total number of deaths is increased by six. If the Swedish trials (apart from the Malm trial) are judged to be biased, there is no reliable evidence that screening decreases breast-cancer mortality."
Lancet 2000; 355: 129-34
Footnote: To appreciate the importance of the Lancet article on breast cancer and mammography, it needs to be pointed out that Lancet is one of the most conservative and respected medical journals in the world. The editors of Lancet would not have published the study if they did not believe the conclusions were valid. A previous breast cancer study concluded the benefit of mammography screening exceeded the risk only for women between 50 and 65 years of age. The new Lancet study analyzed that data, plus all previous risk/benefit mammography studies and concluded, "there is no reliable evidence that screening decreases breast-cancer mortality." (We assume this means at any age. We must also assume that the editors of Lancet believed this study superseded previous studies.) Thomas Kuhn, in his book The Structure of Scientific Revolutions, refers to this kind of a shift in science, as a "paradigm discovery" - a theory that replaces previously held beliefs, usually with much resistance.
Darrel Stoddard
stoddard@healpain.net
http://www.healpain.net
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