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Secondary Analysis of the NLST data with simpler comparative methods between CXR and LDCT
Wissam Al-Janabi MD, MPH/Biostat, Yasir Duraid Mohammed Fawzi, MD, Ziad DM Fawzi, MD Show More...

Public Health

Abstract: The death rate from lung cancer is highest amongst all cancers; it comprises approximately 20% of all cancer death. After decades of striving to find a screening tool similar to Chest x-ray (CXR) and blood biomarkers for the deadliest cancer in the world, three decades ago, the screening with Low Dose Computed Tomography (LDCT) began. Unless the patient becomes symptomatic with a cough, hemoptysis, weight loss, this cancer was hard to detect.

Even though smoking cessation is the best way to reduce mortality and morbidity from lung cancer, LDCT showed its ability to identify lung cancer earlier and thus decrease the death rate from lung cancer in countries that can afford to use this tool. LDCT can decrease all-cause mortality by approximately 7% and lower lung cancer mortality by about 20%. LDCT has high sensitivity when compared to the CXR.  In addition to detecting late-stage cancer, LDCT can also detect early-stage lung cancer (stage I), which can decrease mortality as well as morbidity. When first introduced as a screening tool for lung cancer, clinicians and scientists raised concerns about radiation exposure, cost, psychological effects, and high false-positive rates. Due to these concerns, countries like the USA and some European countries were hesitant to approve LDCT as a screening tool for two decades. Notwithstanding, in 2013, the United State Preventive Services Task Forces (USPSTF) gave the LDCT a B recommendation as a screening tool for lung cancer.

Genetic alteration preceding any chronic diseases: using Human Genomic Project
Wissam Al-Janabi MD, MPH/Biostat

Public Health

Abstract: Since the human genomic project had been completed in 2003, scarce research studies have been done to evaluate the clinical relevance of this project to public health, specifically in the arena of prevention of chronic diseases. Utilizing the structural equation model, with a random sample from National Lung Screening Data. Using SAS software and Proc CALIS for the analysis to assess whether there is a genetic alteration/expression transpires prior to any chronic disease. And to encourage more research studies in this rookie field that merges both public health and prevention of chronic diseases with the human genome.

The results of all three proposed models boost the alternative theory, which indicates there is gene alteration/expression anterior to any chronic disease. Therefore, the results stimulate the use of the human genome project in the area of public health in a way that can curtail many dangerous chronic diseases before they hit.