Soccer headers and memory, unplanned hospital admissions, chronic illness and school and lung cancer screening

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What health topics are introduced at the start of the episode?

Unknown 0:02

This is an ABC Podcast.

Dr. Norman Swan 0:06

Hello and welcome to this week's health report with me Norman Swann. Today, if you're a soccer mom or dad, or indeed a weekend player yourself, listen up, some news for you on heading the ball. Can a robot help a child stay socialized with friends if he or she is missing school due to an ongoing illness? Disturbing findings from a study of people turning up at hospital unannounced, and reducing the chances of dying from lung cancer. Lung cancer causes nearly one in five cancer deaths worldwide. That's more than any other tumor. When someone's diagnosed with lung cancer, on average they've only a fifteen percent chance of still being alive in five years. The main reason is that the diagnosis is made too late for surgery to be effective, and it's still the case that surgery is the best hope for curing lung cancer.

How does heading a soccer ball affect memory and Alzheimer’s risk?

Dr. Norman Swan 0:52

For the last decade or two, there's been an at times ac acrimonious debate about whether high-risk smokers should be offered CT scan screening in the hope of more people being cured. A few days ago a paper was published in the New England Journal of Medicine which may change that debate. Now, around nine thousand people died of lung cancer in Australia last year. If the findings of this Belgian Netherlands study were to apply here, that would mean up to two thousand of these people might still be alive. Cancer Australia is Australia's peak body formulating cancer policy and they've been conducting an inquiry into what's called high volume C D screening for lung cancer. Its chief executive is oncologist Professor Dorothy Keefe.

Dr. Norman Swan 1:32

Thanks for coming into the Health Report. Thank you for having me. So tell us about this study.

Professor Dorothy Keefe 1:36

This is a really interesting study and we've all been waiting for the results for quite some time. Why it's so interesting is it was a large number of people, about fifteen thousand people, mainly men, but a a a small significant uh number of women. And it was done over a long period of time. They followed these people up over a ten-year period.

Why is low‑dose CT screening important for lung cancer mortality?

Professor Dorothy Keefe 1:54

They did multiple screens with um low-dose CT scan. And they found that there was a 25% reduction in the screening group. in men, it was thirty

Dr. Norman Swan 2:04

three percent in women, wasn't it?

Professor Dorothy Keefe 2:06

It was, but I think the numbers are a little small in women, so we are not try not to be too o over optimistic there.

Dr. Norman Swan 2:11

So let's get into the weeds a little bit because there are various controversies about lung cancer screening. So there was a study a few years ago in America, 50,000 people, not 15, but 50,000 people, comparing CT scanning with chest x-rays. And it showed the similar mortality reduction. But their problem was they had a high rate of finding these things called nodules in the lung, which meant that people had to go for more scans and maybe even a bronchoscopy. risking a collapsed lung, in other words, and cost. What was the finding here? Because that's what put people off is well it's fine you find you you save twenty five percent of people, but you also cause harm to a lot more.

Professor Dorothy Keefe 2:49

Well, that was very interesting in this study. They find um found a much lower rate of other nodules that didn't need treatment, and they found a lot lower rate of what they call overdiagnosis, which is where you diagnose something that might not kill you in your lifetime. So These these results are much better. They probably did a better sort of C T scan. They looked at volume of the nodule, not two dimensional size. And I think that's made a big difference too.

3:16

Right.

Dr. Norman Swan 3:16

And obviously the radiologists get a bit better at reading it.

Professor Dorothy Keefe 3:19

And the introduction of AI helps the radiologists and all sorts of things are making it easier.

Dr. Norman Swan 3:24

Now, f if I remember rightly from this study, they I think they had five CT scans over five years and then they followed them up for ten years. Now, with breast cancer screening, with bowel cancer screening, it's basically annual or you know, and with with survival cancer screening it's now ready to be five years, but it's a regular screening interval. Let's jump ahead and imagine you were implementing this.