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Low-Dose CT Screening Study Reveals Improved Diagnostic Performance for Lung Cancer

By MedImaging International staff writers
Posted on 09 Jul 2014

Image: A computed tomography (CT) scan showing lung cancer (Photo courtesy of Kevin Kavanagh, MD).

Investigators of a new study demonstrated good compliance and patient survival outcomes using a five-year low-dose computed tomography (LDCT) screening protocol in individuals at high-risk of developing lung cancer.

This COSMOS (Continuous Observation of SMOking Subjects) study protocol had fewer patients requiring additional diagnostic follow-up compared to other studies, including the US National Lung Cancer Screening Trial (NLST), with a minimal number of incorrect diagnoses.

The five-year survival rate for early diagnosed lung cancer is 50% but after the cancer has spread to distant regions it is only 4%. Recently, the NLST revealed a 20% lung cancer mortality reduction with LDCT compared to chest X-ray, which verified that early detection can decrease lung cancer deaths. However, few studies have comprehensively assessed the diagnostic performance, invasiveness and side effects of LDCT screening protocols with enduring follow-up.

The COSMOS study screened 5,203 asymptomatic high-risk subjects (age ≥ 50 and ≥ 20 pack years smoking history) who, based on the study criteria, either went on to other diagnostic procedures (CT, positron emission tomography [PET], or surgery) to verify lung cancer, or were rescreened every year for the next four years. All subjects were clinically followed for a median of 5.2 years.

The study’s findings, reported in the July 2014, issue of the Journal of Thoracic Oncology (JTO), the official journal of the International Association for the Study of Lung Cancer, show that overall, 79% of the participants remained on the study for five years and only 6.4% required a procedure beyond the yearly LDCT. Primary lung cancer was diagnosed in 175 patients and 78% of these were diagnosed with localized disease. Because of the size and long follow-up, there were 23,116 person-years of observation. Therefore, the overall lung cancer detection rate was 0.76 per 100 person-years.

Out of the 204 invasive diagnostic procedures, 29 were benign for lung cancer, 34 had minor complications, 12 major complications and one postoperative fatality was reported. There were 14 instances where the lesions were not diagnosed as cancer, but were later determined to be cancer on subsequent yearly screening. A high proportion of the cancers (87%) were treated with intent to cure and the overall five-year survival was 78%.

“The results of the COSMOS workup protocol for indeterminate nodules detected with LDCT screening are encouraging, particularly the low recall and delayed diagnosis rates as well as the good long-term survival,” said Dr. Giulia Veronesi, Dr. Giulia Veronesi from the department of thoracic surgery, European Institute of Oncology (Milan, Italy) is a member of the International Association for the Study of Lung Cancer (IASLC), and lead author of the study. “However, the workup can still be improved, possibly by tailoring the screening interval to the risk of the individual being screened using a risk evaluation algorithm that will hopefully also include in the near future molecular markers like a microRNA expression signature in serum.”

Related Links:
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64 (146.15058898926): 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 (581.02607727051): SELECT fid FROM jos_deeppockets WHERE id=294753441 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294753441 AND published='1' LIMIT 1

66 (572.91984558105): 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 (91.075897216797): select jos_twitters.link from jos_twitters where cat=10

68 (46.014785766602): select jos_facebook.link from jos_facebook where cat=10

69 (45.061111450195): select jos_google_plus.link from jos_google_plus where cat=10

70 (45.061111450195): select jos_linkedin.link from jos_linkedin where cat=10

71 (75.817108154297): SELECT fid FROM jos_deeppockets WHERE id=294753441 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294753441 AND published='1' LIMIT 1

72 (51.021575927734): 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 (464.91622924805): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (356.91261291504): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (70.095062255859): 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 (76.055526733398): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (56.028366088867): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (32.186508178711): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (35.04753112793): 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 (101.80473327637): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (61.988830566406): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

108 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

109 (77.962875366211): 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=294753441 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (100.13580322266): 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=294753441 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

112 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

113 (67.949295043945): 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=294753441 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (766.99256896973): 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=294753441 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (917.19627380371): 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 (793.9338684082): 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 (125.16975402832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

118 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

119 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

120 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

121 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

122 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

123 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

124 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

125 (535.96496582031): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 29754.161834717): 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 (791.07284545898): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753441 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753441 AND type='deeppockets_item' AND published='1' LIMIT 1

128 (!!!!! 10974.168777466): ( 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 (128.03077697754): ( 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 (92.029571533203): 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 (41.961669921875): 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 (39.815902709961): 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 (440.12069702148): 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 (174.99923706055): 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 (65.088272094727): 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 (45.061111450195): 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 (633.00132751465): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (482.08236694336): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (234.84230041504): SELECT name FROM jos_deeppockets WHERE id=211

141 (34.093856811523): SELECT name FROM jos_deeppockets WHERE id=211

142 (641.1075592041): 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 (546.93222045898): 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 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

145 (51.975250244141): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

146 (!!!!! 10993.957519531): TRUNCATE TABLE jos_trademed_module

147 (110.86463928223): 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=294753441 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (76.055526733398): 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=294753441 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (576.97296142578): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

152 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

153 (!!!!! 1505.8517456055): 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 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

155 (60.796737670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

156 (45.061111450195): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753441 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753441 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (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)

158 (36.001205444336): 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 (38.14697265625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

161 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753441 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753441 AND published='1' LIMIT 1

162 (138.99803161621): select jos_twitters.link from jos_twitters where cat=10

163 (37.908554077148): select jos_facebook.link from jos_facebook where cat=10

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

165 (36.001205444336): select jos_linkedin.link from jos_linkedin where cat=10

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