Last month, when I (and others) noted the ominous ads appearing in NYC subways, urging riders to "demand a CAT scan" -- I looked into the foundation that supported the ads. While the mass-market message was completely irresponsible (the use of CT scans for lung cancer screening has only been tested in smokers over 40, so there's no apparent reason for most riders to 'demand a CAT scan' from their doctors) I was nonetheless impressed by the credentials of their medical advisory board:

I see a medical advisory board full of oncologists, thoracic surgeons, and indeed, the author of the aforementioned 2006 NEJM study touting early detection via CT. Several board members are themselves lung cancer survivors.

I can't doubt this group's dedication or integrity (I originally expected "" would be backed by GE Lightspeed scanners or something similar).

But I must ask, were these board members behind the subway ad campaign? Do they really want the general public demanding a CT scan? Because it's hard to believe such an informed and experienced group could endorse this approach.

Well, it turns out I wasn't cynical enough. The Lung Cancer Foundation is not backed by CT scanner manufacturers -- it's backed by cigarette companies.

Today's NYTimes drops the bomb:

In October 2006, Dr. Claudia Henschke of Weill Cornell Medical College jolted the cancer world with a study saying that 80 percent of lung cancer deaths could be prevented through widespread use of CT scans.

Small print at the end of the study, published in The New England Journal of Medicine, noted that it had been financed in part by a little-known charity called the Foundation for Lung Cancer: Early Detection, Prevention & Treatment. A review of tax records by The New York Times shows that the foundation was underwritten almost entirely by $3.6 million in grants from the parent company of the Liggett Group, maker of Liggett Select, Eve, Grand Prix, Quest and Pyramid cigarette brands.

The foundation got four grants from the Vector Group, Liggett’s parent, from 2000 to 2003.

Dr. Jeffrey M. Drazen, editor in chief of the medical journal, said he was surprised. "In the seven years that I’ve been here, we have never knowingly published anything supported by" a cigarette maker, Dr. Drazen said.

An increasing number of universities do not accept grants from cigarette makers, and a growing awareness of the influence that companies can have over research outcomes, even when donations are at arm’s length, has led nearly all medical journals and associations to demand that researchers accurately disclose financing sources.

Dr. Henschke was the foundation president, and her longtime collaborator, Dr. David Yankelevitz, was its secretary-treasurer. Dr. Antonio Gotto, dean of Weill Cornell, and Arthur J. Mahon, vice chairman of the college board of overseers, were directors.

So, after decades of denying the link between smoking and lung cancer, now a cigarette company has chosen to fund research in cancer detection. That's a good thing, right? It's even charitable, isn't it? Again it's necessary to ratchet up the cynicism:

Dr. Jerome Kassirer, a former editor of The New England Journal of Medicine and the author of a book about conflicts of interest, said he believed that Weill Cornell had created the foundation to hide its receipt of money from a cigarette company. "You have to ask yourself the question, 'Why did the tobacco company want to support her research?' " Dr. Kassirer said. "They want to show that lung cancer is not so bad as everybody thinks because screening can save people; and that’s outrageous."

Dr. Henschke’s work, while controversial among cancer researchers, has been embraced by many lung-cancer advocacy organizations, which have pushed for legislation in California, New York and Massachusetts to create trust funds to pay for lung cancer screening — often with language tailored to benefit Dr. Henschke’s group.

From this perspective, a mass-market campaign for lung cancer screening, instead ads targetted to smokers over 40, makes much more sense. What better way to build the association, in the public mind, that lung cancer is detectable and treatable if caught early? You could even imagine tobacco companies trying to limit future medical liability by pointing to the research they funded. "Everybody knows smoking causes cancer," they'd say -- "but everybody also knows a screening CT would have caught this early, while it was treatable."

So, the millions Liggett gave to Dr. Henschke wasn't motivated by charity or guilt, but rather, looks like a wise investment. Similarly, the misleading subway ads were never designed to protect the public -- the exist to protect cigarette company interests.