Can we now vaccinate against lung cancer?

Not so fast.  The report below suggests that we can but it is misleading.

The story starts with a remarkable product that originated in the early 20th century: BCG vaccine. Some patient French scientists produced a weakened bacillus from the form of tuberculosis that cattle get. They used their product as an effective vaccine  against TB for humans. It is actually a live bacterium that they and their successors inject into you as a vaccination.  But it is a real life-saver. Once injected with it, you mostly don't get TB at all and you mostly recover well in a worst case scenario.  It is very widely used so it keeps a large lot of Third-worlders alive.

So is it itself dangerous to your health?  The studies of that differ in their conclusions but the general conclusion is that it is pretty safe.  The study below aimed to settle that for once and for all.  And it did.  With a follow-up of thousands of people across a remarkable 60 year period, people who had been given the vaccine were no more likely to die than anyone else.  You seldom get conclusions as solid as that.

While analysing their data however the authors noticed something interesting. There were a lot fewer lung cancer deaths among those who had received the BCG vaccine.  They cried Eureka and said we now know how to prevent lung cancer.  They were able to show statistical significance for their findings so that is that!

But it isn't. The effect they found is exceptionally small statistically (a hazard ratio of 0.38) and was shown as statistically significant only because of the large sample size.  It has no precedent so is clearly one of those adventitious findings that you often get when analysing a large and complex body of data:  Findings that will never emerge again.

Because you can do it so easily, it is actually regarded as bad science to report such adventitious findings. You are supposed to report the significance or not of only those correlations you have predicted from theory. A lot of last minute theory revisions happen of course.

So all the work behind that study was well-justified by the findings that BCG -- as predicted -- is very safe but the "findings" about lung cancer should be ignored.


Association of BCG Vaccination in Childhood With Subsequent Cancer Diagnoses: A 60-Year Follow-up of a Clinical Trial

Nicholas T. Usher et al.

Abstract

Importance:  The BCG vaccine is currently the only approved tuberculosis vaccine and is widely administered worldwide, usually during infancy. Previous studies found increased rates of lymphoma and leukemia in BCG-vaccinated populations.

Objective:  To determine whether BCG vaccination was associated with cancer rates in a secondary analysis of a BCG vaccine trial.

Design, Setting, and Participants  Retrospective review (60-year follow-up) of a clinical trial in which participants were assigned to the vaccine group by systematic stratification by school district, age, and sex, then randomized by alternation. The original study was conducted at 9 sites in 5 US states between December 1935 and December 1998. Participants were 2963 American Indian and Alaska Native schoolchildren younger than 20 years with no evidence of previous tuberculosis infection. Statistical analysis was conducted between August 2018 and July 2019.

Interventions:  Single intradermal injection of either BCG vaccine or saline placebo.

Main Outcomes and Measures:  The primary outcome was diagnosis of cancer after BCG vaccination. Data on participant interval health and risk factors, including smoking, tuberculosis infection, isoniazid use, and other basic demographic information, were also collected.

Results:  A total of 2963 participants, including 1540 in the BCG vaccine group and 1423 in the placebo group, remained after exclusions. Vaccination occurred at a median (interquartile range) age of 8 (5-11) years; 805 participants (52%) in the BCG group and 710 (50%) in the placebo group were female. At the time of follow-up, 97 participants (7%) in the placebo group and 106 participants (7%) in the BCG vaccine group could not be located; total mortality was 633 participants (44%) in the placebo group and 632 participants (41%) in the BCG group. The overall rate of cancer diagnosis was not significantly different in BCG vaccine vs placebo recipients (hazard ratio, 0.82; 95% CI, 0.66-1.02), including for lymphoma and leukemia. The rate of lung cancer was significantly lower in BCG vs placebo recipients (18.2 vs 45.4 cases per 100 000 person-years; hazard ratio, 0.38; 95% CI, 0.20-0.74; P = less than .005), controlling for sex, region, alcohol overuse, smoking, and tuberculosis.

Conclusions and Relevance:  Childhood BCG vaccination was associated with a lower risk of lung cancer development in American Indian and Alaska Native populations. This finding has potentially important health implications given the high mortality rate associated with lung cancer and the availability of low-cost BCG vaccines.

JAMA Netw Open. 2019;2(9):e1912014. doi:10.1001/jamanetworkopen.2019.12014

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U.S. unemployment falls to 50 year low of 3.5% with 136,000 jobs added in September, Donald Trump takes sarcastic victory lap

President Donald Trump gloated on Friday after the Labor Department released a rosy summary of America's employment picture during the month of September, tweeting a sarcastic jab about Democrats' desire to impeach him despite the nation's economic health.

'Breaking News: Unemployment Rate, at 3.5%, drops to a 50 YEAR LOW,' the president tweeted. 'Wow America, lets impeach your President (even though he did nothing wrong!).'

U.S. employers added a modest 136,000 jobs in September, but it was enough to help lower the unemployment rate to a new five-decade low of 3.5 per cent.

President Donald Trump gloated on Friday after the Labor Department released a rosy summary of America's employment picture during the month of September

Hiring has slowed this year as the U.S.-China trade war has intensified, global growth has slowed and businesses have cut back on their investment spending. Even so, hiring has averaged 157,000 in the past three months, enough to absorb new job seekers and lower unemployment over time.

Despite the ultra-low unemployment rate, which dropped from 3.7 per cent in August, average hourly wages slipped by a penny, the Labor Department said Friday in its monthly jobs report. Hourly pay rose just 2.9 per cent from a year earlier, below the 3.4 per cent year-over-year gain at the beginning of the year.

The unemployment rate for Latinos fell to 3.9 per cent, the lowest on records dating from 1973.

With the U.S. economic expansion in its 11th year and unemployment low, many businesses have struggled to find the workers they need. That is likely one reason why hiring has slowed since last year.

But it's likely not the only reason. The jobs figures carry more weight than usual because worries about the health of the U.S. economy are mounting. Manufacturers have essentially fallen into recession as U.S. businesses have cut spending on industrial machinery, computers and other factory goods.

And overseas demand for U.S. exports has fallen sharply as President Donald Trump's trade conflicts with China and Europe have triggered retaliatory tariffs.

A measure of factory activity fell in September to its lowest level in more than a decade. And new orders for manufactured items slipped last month, the government reported.

Persistent uncertainties about the economy in the face of Trump's trade conflicts and a global economic slump are also affecting hotels, restaurants and other service industries.

A trade group's measure of growth in the economy's vast services sector slowed sharply in September to its lowest point in three years, suggesting that the trade conflicts and rising uncertainty are weakening the bulk of the economy.

The job market is the economy's main bulwark. As long as hiring is solid enough to keep the unemployment rate from rising, most Americans will likely remain confident enough to spend, offsetting other drags and propelling the economy forward.

But a slump in hiring or a rise in the unemployment rate in coming months could discourage consumers from spending as freely as they otherwise might during the holiday shopping season.

Consumers are still mostly optimistic, and their spending has kept the economy afloat this year. But they may be growing more cautious. Consumer confidence dropped sharply in September, according to the Conference Board, a business research group, although it remains at a high level.

Americans also reined in their spending in August after several months of healthy gains. The 0.1 per cent increase in consumer spending that month was the weakest in six months.

Other parts of the U.S. economy are still holding up well. Home sales, for example, have rebounded as mortgage rates have fallen, helped in part by the Federal Reserve's two interest rate cuts this year. Sales of existing homes reached their highest level in nearly 18 months in August. And new home sales soared.

Americans are also buying cars at a still-healthy pace. Consumers would typically be reluctant to make such major purchases if they were fearful of a downturn.

SOURCE

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Young Snowflakes observed

by Elisa David.  She writes from Germany but what she says is recognizable elsewhere

When I was studying in gymnasium [academic High School], I got into a “strings” class. That means my class had an extra two hours when we learned to play a string instrument. Today I know I will definitely not be another Anne-Sophie Mutter.[2]. Those years were not useless, however, for I learned something quite different. Since the idea of extra strings practice did not appeal to many boys, we had a rather unusual gender division, with three boys and twenty girls. So for five years in my class, a collective of puberty-driven teenage girls set the tone — for my own self at the time, it was an absolute horror. But now I know what the consequences can be when women gain the upper hand.

I am no longer amazed at any political movement. My time in school has, to a certain extent, prepared me perfectly for Fridays for Future, #MeToo, and all these trends which my generation has absorbed, because they are tailor-made for them. Generation Snowflake is sensitive, does not wish to be confronted by unfamiliar opinions, is united in “otherness”. Because that is the point — being “other” but “belonging” to it; a certain uncertainty, coupled with the habit of considering oneself important; the need to be seen and simultaneously to conform. My observation is that these completely new views, this strange, contradictory behavior — which major portions of society and above all my generation display — depend on it.

One result seems to be the inflationary increase of psychic illnesses. Not being quite right in the head seems to be the first and decisive step to welcoming otherness. In my class, it was a proven method in the constant battle for sympathy. Passing through distinct stages of puberty is normal, but many took this to a higher level. I still remember how we discussed eating disorders like anorexia in biology class, and shortly thereafter, half the class was anorexic. The imaginary ill predictably announced their new suffering loudly to the world.

The Cutting Trend

Our teacher showed us pictures of an anorexic patient and explained that it is definitely unhealthy for the rib cage and the spine to show so clearly, and that help is needed urgently. Before the very next sports hour, a bunch of girls were standing in front of the mirror, lamenting loudly that their bones were not showing, so they must be overweight and would eat nothing for the entire rest of the day.

Our teacher explained the food pyramid and why a balanced diet is important for the body. My fellow female students were already planning what foods they would avoid to reach the desired weight loss through deficient nutrition. At some point, the attention they received for these actions was no longer enough. When, every hour on the hour, somebody runs out to throw up, it is no longer anything special.

Then, as if by divine will, there came a conference day on the explanation and recognition of depression. There is no denying how important it is to recognize depression. But a side effect of presentations which explain in detail what the symptoms of these illnesses are is that these symptoms are served to young attention-needy girls on a silver platter. All they have to do is write it down and act it out. And in fact, even writing it down isn’t necessary, since glossy brochures are passed out at the end.

If you think a mob of supposedly anorexic girls is bad, just wait until you see what artificially depressed girls can do. It started when half of them had bandages on their arms and because of that, wore short sleeves in winter, so everyone would ask what had happened. “I cut myself” was the answer, and that was the beginning of the cutting trend. Later, the bandages came off and countess scars appeared. Still in short or rolled-up sleeves, they bore the scars proudly, until they noticed someone looking at them, then they theatrically hid them behind their backs. I felt like I was in a madhouse, and there was no other time that deadened me to this junk pile of feelings like this one did.

Otherness Through Sympathy

Biology wasn’t the only dangerous class for us. One of the most important studies was geography. Before that, we led a dull existence, and ate what tasted good. Then, in geography, we saw a film about the meat industry and my little snowflakes realized that even the gelatin in gummy bears did not grow on trees, but came from sweet little piggies. At a stroke, all of them were vegetarians. And it is not enough to just be a vegetarian, you have to live it. To the shock of how cute cutlets were when alive came a second, more important one — that almost no one was a vegetarian at the time.

The situation was brilliant for my classmates. They were special again with their new insight and could set themselves off from the masses, see themselves as better, more enlightened. What I find comforting is that, of those where prepared to go under the axe with every dead piglet, hardly any of them today will give up her schnitzel. Not eating meat has become quite normal, and nobody wants to be that conformist. The little bit of attention is not enough reward for the sacrifice. So, either go right to being vegan, or forget food altogether, and declare yourself a non-binary, pansexual, rainbow person. Since there are now over sixty genders, there is not much competition.

So what can be learned from my classmates? First and foremost, that they would do anything for attention, whatever the price. Approximately following Madonna’s byword: “Even bad publicity is publicity”, they take what they can get. They get this attention through otherness. Apparently, my classmates wanted sympathy above all. At any rate, group pressure must be factored in. We are, after all, herd animals. Aside from that, the tone of the Snowflake Generation is set by girls, and it isn’t just going to the powder room that they don’t like to do alone — they don’t become anorexic, depressed or bisexual alone. They always like to have like-minded people around them. Just so long as they are not those who are considered normal and boring.

The question remains: why is something like this happening now? In the 21st century, we are living in a time when technical, medical and scientific advances — at least in the West — have secured prosperity. We have never had it so good. I am not one of twenty children, of whom only three have survived. I have had my shots and have grown to the age of eighteen without fear or problems. My grandmother is not worshipped as the oldest in the tribe, although she can no longer light candles on her birthday cake. It would look like the Atlanta fire. That is, many people nowadays grow “old” (quotation marks because of her vanity). I did not write this article on a typewriter and so did not have to start fresh after every mistake.

The ability to read is not a privilege, but normal. Almost all of us carry small devices that give us access to boundless knowledge. But not all of us use this knowledge. Our quality of life has never been so good, yet some cultivate starvation and conjure up psychic disturbances that we would not wish on our worst enemy. And how contemptuous this behavior is of those who actually suffer from these illnesses, the seekers of attention do not care.

But where does this sudden self-destructive urge come from? Why is it striking the very generation that has everything? I think the lack of responsibility and challenge has made us incapable of living. We no longer have to worry about ourselves, there are no expectations of us, and if we have no real problems or don’t even care to see them, then we make some up for ourselves.

SOURCE 

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IN BRIEF

IRS WHISTLEBLOWER: The Washington Post claims, "An Internal Revenue Service official has filed a whistleblower complaint reporting that he was told that at least one Treasury Department political appointee attempted to improperly interfere with the annual audit of the president's or vice president's tax returns."

MCCARTHY COUNTERATTACKS: "Minority Leader Kevin McCarthy (R., Calif.) on Thursday called for Speaker Nancy Pelosi to halt the House's impeachment inquiry into President Trump 'until transparent and equitable rules and procedures are established to govern the inquiry, as is customary,'" National Review reports, while Trump is issuing his own floor-vote dare.

SAN FRAN ADMONISHED: "The U.S. Environmental Protection Agency on Wednesday sent a notice that San Francisco is violating the federal Clean Water Act." (NBC Los Angeles)

THANKS, OBAMA: Survey: Family health insurance now averages more than $20,000 a year (The Federalist)

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For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated), A Coral reef compendium and an IQ compendium. (Both updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on THE PSYCHOLOGIST.

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