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Chest X-Ray Yearly Screening Found Not to Reduce Rate of Lung Cancer Deaths

By MedImaging International staff writers
Posted on 15 Nov 2011

In a trial that included more than 150,000 individuals who underwent annual chest radiographic screening for up to four years did not have a considerably lower rate of death from lung cancer compared to participants who were not screened, according to recent research.

The study’s findings were published in the November 2, 2011, issue of the Journal of the American Medical Association (JAMA). The study was published early online to coincide with its presentation at the annual meeting of the American College of Chest Physicians (CHEST 2011) held October 22-26, 2011, in Honolulu (Hawaii, USA). “Lung cancer is the leading cause of cancer death in the United States and worldwide. Screening for lung cancer has long been studied as an approach to reducing the burden of lung cancer,” according to background information in the article. “The effect on mortality of screening for lung cancer with modern chest radiographs is unknown.”

Martin M. Oken, MD, from the University of Minnesota (Minneapolis, MN, USA), and colleagues assessed the effect on mortality of screening for lung cancer using radiographs in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. This randomized controlled trial involved 154,901 participants, ages 55 through 74 years, of whom 77,445 were assigned to annual screenings and 77,456 to usual care, at one of 10 screening centers across the United States, between November 1993 and July 2001. The groups were similar: approximately half were women (50.5%); about 45% were never smokers, 42% former smokers, and 10% current smokers.

Study participants in the intervention group were offered an annual chest radiograph for four years. Diagnostic follow-up of positive screening results was determined by participants and their healthcare practitioners. Participants in the usual care group were not offered chest radiograph screening and they received their usual medical care. All diagnosed cancers, deaths, and causes of death were established through the earlier of 13 years of follow-up or until December 31, 2009.

Adherence to screening was 86.6% at the start of the trial, decreasing to 79% by year three. The overall adherence rate was 83.5%, and 91.2% of participants had undergone at least one radiographic screening. In the usual care group, the contamination rate (i.e., rate of chest X-ray screening) during the screening phase of the trial was estimated at 11%.

During the entire 13-year study period, there were 1,696 lung cancers detected in the intervention group and 1,620 lung cancers in the usual care group. Of participants detected with lung cancer during the follow-up, stage and histology was similar by group, with about 41% being adenocarcinoma, 20% squamous cell carcinoma, 14% small cell carcinoma, 5% large cell carcinoma, and 20% other non-small-cell lung cancer.

Concerning the effect on mortality, the researchers found that yearly chest radiographic screening for up to four years did not significantly decrease lung cancer mortality compared with usual care: for the total 13-year follow-up period, 1,213 lung cancer deaths were observed in the intervention group versus 1,230 in the usual care group.

“The randomized groups in PLCO were comparable at baseline, there was relatively high screening adherence in the intervention group and low contamination in the usual care group, and the treatment distributions across the groups were similar. Therefore, these findings provide good evidence that there is not a substantial lung cancer mortality benefit from lung cancer screening with four annual chest radiographs,” the authors wrote.

In an accompanying editorial, Harold C. Sox, MD, from Dartmouth Medical School (West Lebanon, NH, USA) commented on the findings of this study, “The PLCO lung cancer study result provides convincing evidence that lung cancer screening with chest radiography is not effective. The study is important for putting this question to rest and providing strong empirical grounds for comparing low-dose computed tomography to a real-world alternative: usual care. The [US] National Lung Screening Trial showed convincingly that early detection can lower the risk of death from lung cancer, a big step forward. How that evidence will translate into policy and practice will depend on analyses still to be completed. The PLCO trial is another important step, confirming expectations rather than setting new ones.”

Related Links:
University of Minnesota
Dartmouth Medical School

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60 (!!!!! 1700.8781433105): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

61 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

62 (!!!!! 2189.8746490479): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

63 (465.86990356445): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

64 (117.06352233887): 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

65 (!!!!! 2341.0320281982): SELECT fid FROM jos_deeppockets WHERE id=294738025 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294738025 AND published='1' LIMIT 1

66 (110.14938354492): 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`

67 (!!!!! 3398.8952636719): select jos_twitters.link from jos_twitters where cat=10

68 (114.91775512695): select jos_facebook.link from jos_facebook where cat=10

69 (49.114227294922): select jos_google_plus.link from jos_google_plus where cat=10

70 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

71 (40.054321289062): SELECT fid FROM jos_deeppockets WHERE id=294738025 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294738025 AND published='1' LIMIT 1

72 (39.100646972656): 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`

73 (605.10635375977): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (298.97689819336): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (46.968460083008): 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`

76 (66.995620727539): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (!!!!! 3562.9272460938): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (121.11663818359): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (52.213668823242): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (42.200088500977): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (92.029571533203): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (44.107437133789): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (42.200088500977): 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`

93 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (93.936920166016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

108 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

109 (82.015991210938): 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=294738025 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (560.04524230957): 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=294738025 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (777.00614929199): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

112 (146.15058898926): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

113 (88.214874267578): 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=294738025 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (638.96179199219): 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=294738025 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (823.02093505859): 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

116 (602.96058654785): 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 (!!!!! 2264.0228271484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

118 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

119 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

120 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

121 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

122 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

123 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

124 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

125 (378.13186645508): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 51161.050796509): 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

127 (813.00735473633): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294738025 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294738025 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (!!!!! 18626.928329468): ( 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

129 (!!!!! 3873.1098175049): ( 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 (82.015991210938): 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

131 (49.829483032227): 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 (73.909759521484): 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

133 (41.007995605469): 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 (494.00329589844): 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

135 (59.843063354492): 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 (49.114227294922): 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

137 (39.100646972656): 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 (560.04524230957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (416.04042053223): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (61.03515625): SELECT name FROM jos_deeppockets WHERE id=211

141 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=211

142 (878.81088256836): 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

143 (704.05006408691): 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 (!!!!! 6029.1290283203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

145 (155.21049499512): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

146 (!!!!! 32407.999038696): TRUNCATE TABLE jos_trademed_module

147 (!!!!! 2996.9215393066): 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=294738025 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (!!!!! 1296.0433959961): 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=294738025 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (!!!!! 1372.8141784668): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (!!!!! 3868.8182830811): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

152 (360.96572875977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

153 (!!!!! 3332.1380615234): 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

154 (!!!!! 2355.0987243652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

155 (135.89859008789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

156 (57.93571472168): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294738025 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294738025 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (53.882598876953): 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)

158 (40.054321289062): 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 (42.915344238281): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

161 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294738025 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294738025 AND published='1' LIMIT 1

162 (68.187713623047): select jos_twitters.link from jos_twitters where cat=10

163 (313.04359436035): select jos_facebook.link from jos_facebook where cat=10

164 (59.127807617188): select jos_google_plus.link from jos_google_plus where cat=10

165 (43.153762817383): select jos_linkedin.link from jos_linkedin where cat=10

166 (!!!!! 3573.8945007324): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

167 (!!!!! 1422.8820800781): insert into jos_banners_delta values (14615,'2025-08-19 23:29:08','216.73.216.0','view'),(14202,'2025-08-19 23:29:08','216.73.216.0','view'),(14203,'2025-08-19 23:29:08','216.73.216.0','view')

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