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Mammography Every Other Year Has Same Benefits of Yearly Screening, But Less Harm

By MedImaging International staff writers
Posted on 04 Dec 2009

A comprehensive analysis of various mammography-screening schedules suggests that biennial screening of average risk women between the ages of 50 and 74 achieves most of the benefits of yearly screening, but with less harm. More...

The study's findings represent a unanimous consensus of six independent research groups from various academic institutions.

The study's findings were published in the November 17, 2009, in the journal Annals of Internal Medicine. Researchers from CISNET, the U.S. National Cancer Institute (NCI; Bethesda, MD, USA)-funded Cancer Intervention and Surveillance Modeling Network, utilized independent models to examine 20 screening strategies with different starting and stopping ages and intervals. Modeling estimates the lifetime impact (outcomes including benefits and harms) of breast cancer screening mammography. The CISNET models link known data across the course of life and include national data on age-specific breast cancer incidence, mortality, mammography characteristics, and treatment effects.

"It's reassuring that all CISNET modeling groups came to the same conclusion even when applying different models to these data,” said the study's lead author, Jeanne S. Mandelblatt, M.D., MPH, of Georgetown [University] Lombardi Comprehensive Cancer Center (Washington DC, USA), a CISNET member. "While the findings represent a comprehensive review of existing data, decisions about the best screening strategy depend on individual and public health goals, resources, and tolerance for false-positive mammograms, unnecessary biopsies, and over-diagnosis.”

The CISNET analysis revealed that screening every other year maintains nearly all of the benefit (an average of 81%) of annual screening with almost half the number of false-positives. Compared with no screening, mammography screening every other year from ages 50 to 69 achieves a median reduction in breast cancer mortality of 16.5% over a lifetime. If screening is started at age 40 versus 50 and performed every other year, there is a median mortality reduction of 19.5% (an additional one woman per 1,000), but an increase in false-positives, unnecessary biopsies, and anxiety.

False-positives represent mammograms read as abnormal that often require additional follow-up in women who are found to not have cancer. An unnecessary biopsy occurs after a false-positive mammogram when the biopsy is normal. Over-diagnosis is the detection of a cancer through screening that otherwise never would have produced symptoms or affected the woman's health. Since typically it is not possible to determine which tumors will progress, almost all tumors detected during screening are treated.

According to Dr. Mandelblatt, the benefits of biennial screening are consistent with what is known about the breast cancer's biology. In most women, most tumors are slow growing and this proportion increases with age, so that there is little loss in survival benefit across the population for screening every year versus every other year. For women with aggressive, faster growing tumors, annual screening is not likely to make a difference in survival. For these women, different approaches may be needed and is an important area of on-going research.

While the model results validated that mammography saves lives, Dr. Mandelblatt explained that there are smaller overall benefits from starting screening earlier than age 50 because few women develop breast cancer in the younger age groups, and screening younger women is accompanied by a large number of false-positive mammograms. "This can lead to stress for women and unnecessary biopsies. We need more research to understand how to tailor screening by individual risk,” she said. "These modeling data represent an average finding regarding the population of women so it can't be emphasized enough that women need to talk to their healthcare provider for a screening program that is best for them,” Dr. Mandelblatt concluded.

The CISNET analysis was one of many sources of evidence that the U.S. Preventive Services Task Force (an independent scientific panel convened by the Agency for Healthcare Research and Quality) relied upon in developing the new mammography screening guidelines just announced.

Related Links:
U.S. National Cancer Institute
Georgetown Lombardi Comprehensive Cancer Center

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60 (617.02728271484): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726728 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

61 (!!!!! 1433.8493347168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

62 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

63 (135.18333435059): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

64 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

65 (141.14379882812): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

66 (607.96737670898): SELECT fid FROM jos_deeppockets WHERE id=294726728 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294726728 AND published='1' LIMIT 1

67 (53.882598876953): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

68 (46.968460083008): select jos_twitters.link from jos_twitters where cat=10

69 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

70 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

71 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

72 (31.948089599609): SELECT fid FROM jos_deeppockets WHERE id=294726728 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294726728 AND published='1' LIMIT 1

73 (33.140182495117): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

74 (327.82554626465): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (238.89541625977): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (43.869018554688): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

77 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (51.975250244141): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (34.093856811523): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

94 (63.180923461914): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (79.870223999023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

109 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

110 (51.975250244141): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726728 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (50.067901611328): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726728 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

113 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

114 (51.975250244141): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294726728 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (594.8543548584): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294726728 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (746.01173400879): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (437.02125549316): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (132.08389282227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

119 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

120 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

121 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

122 (64.13459777832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

123 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

124 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

125 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

126 (385.99967956543): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

127 (!!!!! 24158.954620361): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

128 (571.01249694824): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726728 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726728 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 8611.2022399902): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (176.90658569336): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (77.009201049805): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

132 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

133 (73.19450378418): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

134 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

135 (583.88710021973): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

136 (121.8318939209): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

137 (53.882598876953): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

138 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

139 (607.96737670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (483.98971557617): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (53.882598876953): SELECT name FROM jos_deeppockets WHERE id=211

142 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=211

143 (608.20579528809): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

144 (545.02487182617): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

145 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

146 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

147 (!!!!! 18414.02053833): TRUNCATE TABLE jos_trademed_module

148 (106.0962677002): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726728 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (59.843063354492): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294726728 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

150 (545.97854614258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

152 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

153 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

154 (!!!!! 1663.2080078125): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

155 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

156 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

157 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294726728 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294726728 AND type='deeppockets_item' AND published='1' LIMIT 1

158 (35.04753112793): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

159 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

160 (36.001205444336): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

161 (207.90100097656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

162 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294726728 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294726728 AND published='1' LIMIT 1

163 (41.007995605469): select jos_twitters.link from jos_twitters where cat=10

164 (36.954879760742): select jos_facebook.link from jos_facebook where cat=10

165 (37.908554077148): select jos_google_plus.link from jos_google_plus where cat=10

166 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

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