For anyone who has ever had a mammogram, reminded someone to have a mammogram or sported anything pink for breast cancer awareness month, the New York Times has a thought-provoking article well worth reading. The author battled breast cancer twice and raises the interesting and controversial question of whether the uber-awareness campaign about breast cancer led to more mammograms than were necessary. The author argues that mammograms can result in early treatment—which comes with its own risks—but ultimately doesn’t save many lives. Studies cited show many women died despite early detection and many others, who underwent years of treatment for breast cancer, might never have been bothered by their breast tumors at all.  

The article arrives on the heels of a study in the journal Cancer that found that the proportion of women undergoing screening for breast cancer every year did not change after the U.S. Preventive Services Task Force advised that there was not enough evidence to support routine mammograms for women in their 40s.

Otis Brawley, chief medical officer of the American Cancer Society, weighed in on the Times article on the ACS Press room Blog and agreed that it is recommended reading: “This is a powerful and important article, one I believe every breast cancer advocate, and frankly even advocates for prostate and other cancers, should read,” wrote Brawley. “ It lays out the challenge that lies before us in reducing death and suffering from breast cancer, while demonstrating the challenge that we in public health face in how to accurately and truthfully administer information.”

>>Read the article.

Mammography Rates Remained Steady After Change in Guidelines
The proportion of women undergoing screening for breast cancer every year did not change after U.S. Preventive Services Task Force released recommendations saying there wasn't enough evidence to support routine mammograms for women in their 40s, according to a new study published in the journal Cancer. In 2009, the Task Force changed their recommendations to state that women aged 50 to 74 should have a mammogram every other year, and screenings for women under age 50 should be evaluated by each woman with her doctor, according to individual risk factors. "When there are conflicting versions of guidelines, providers may err on the side of screening," said David Howard, a health policy researcher from Emory University in Atlanta, in an interview with Reuters. Read more on cancer.

Latest HIV Vaccine Study Halted
The National Institutes of Health halted a study testing an experimental HIV vaccine after an independent review board found the vaccine did not prevent HIV infection and did not reduce the amount of HIV in the blood. The trial, started in 2009, is the latest in a series of failed HIV vaccine trials, according to Reuters. The halted study included more than 2,500 volunteers in 19 U.S. cities. Study populations included men who have sex with men and transgender people who have sex with men. Read more on HIV.

CDC's Food Safety Report Card: Some Foodborne Illnesses Spiked in 2012
The Centers for Disease Control and Prevention (CDC) recently released the "nation’s annual food safety report card," and it shows that 2012 rates of infections from two types of foodborne bacteria—campylobacter and Vibrio—have increased significantly when compared to a baseline period of 2006-2008, while rates of most others have not changed during the same period. The data are part of the Foodborne Diseases Active Surveillance Network report. Campylobacter infections have been linked to tranmission in many foods, including poultry, raw milk and produce. These infections were at their highest level since 2000, up 14 percent since 2006-2008. Vibrio infections, often associated with raw shellfish, were up 43 percent.

“The U.S. food supply remains one of the safest in the world,” said CDC Director Tom Frieden, MD, MPH. “However, some foodborne diseases continue to pose a challenge. We have the ability, through investments in emerging technologies, to identify outbreaks even more quickly and implement interventions even faster to protect people from the dangers posed by contaminated food.” Read more on food safety.

Experts Debate Expected Changes to ADHD Diagnosis
Medical experts are at odds as to what to ultimately expect from the predicted changes to the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The DSM-5 will be released in May by the American Psychiatric Association. The broadened criteria should increase the number of people diagnosed with ADHD in part by expanding the age time frame for the onset of symptoms. "In the current version, it's seven years,” James Norcross, MD, a child and adolescent psychiatrist at the University of Texas Southwestern Medical Center at Dallas. “That will be changed to 12 years in the DSM-5, which may make things easier for adults and adolescents, because they'll be able to better recall some of the challenges that may have occurred." Norcross said the changes are positive overall. However, Allen Frances, MD, chair of the task force for the DSM-4 and former chair of psychiatry at Duke University School of Medicine in Durham, N.C., worries the new criteria will serve to increase the unnecessary use of stimulant medications. "We're already overdiagnosing ADHD,” he said. “Almost 20 percent of teen boys get the diagnosis of ADHD, and about 10 percent of boys are on stimulant drugs. We don't need to make it easier to diagnose ADHD.” Read more on mental health.

FDA Releases Violations on Several Dozen Compounding Pharmacies
Yesterday the U.S. Food and Drug Administration (FDA) released a list of violation reports for 28 of the 31 drug compounding pharmacies it’s inspected since April. The safety of drugs produced at compounding pharmacies came into question last year after the Framingham, Massachusetts-based New England Compounding Center was linked to a meningitis outbreak that caused 39 deaths and 656 cases of illness in 19 states. Found violations range from “inappropriate clothing for sterile drug processing to insufficient testing for contaminants,” according to Reuters. Still, FDA reiterated its stance that it needs more increased regulatory authority when it comes to compounding facilities. Last month Commissioner Margaret A. Hamburg, MD, proposed the FDA be given greater authority to oversee high-risk sterile compounding facilities that distribute drug products in advance of or without receiving a prescription. Read more on prescription drugs.

USPSTF: Limit Oral Cancer Screenings to Patients with Signs, Symptoms
Primary care physicians should limit oral cancer screenings to adult patients who actually show signs or symptoms of the condition, according to new draft recommendations from the U.S. Preventive Services Task Force (USPSTF). "The evidence shows that it is difficult to detect oral cancer and that the evidence is not clear whether oral cancer screening improves long-term health outcomes among the general adult population or among high-risk groups," said Jessica Herzstein, MD. "We need more high-quality research on whether screening tests can accurately detect oral cancer and if screening adults for oral cancer in primary care settings improves health outcomes." Tobacco and alcohol are both major risk factors for oral cancer. The task force also recommended physicians take into account patient wishes, medical histories and other expert opinions when making decisions. Read more on cancer.

FDA Budget Includes Funds for Food, Medical Product Safety Improvements
The U.S. Food and Drug Administration’s (FDA) requested $4.7 billion budget will include funds to support the Food Safety Modernization Act and to help ensure the safety of medical products. However, the budget will also include a $15 million cut related to human drug, biologics and medical device programs. “Our budget increases are targeted to strategic areas that will benefit patients and consumers and overall strengthen our economy,” said Margaret A. Hamburg, M.D., Commissioner of Food and Drugs. “Through the good work of the FDA, Americans will receive life-saving medicines approved as fast as or faster than anywhere in the world, confidence in the medical products they rely on daily, and a food supply that is among the safest in the world.” Read more on food safety.

Study: No Link Between Fertility Drugs, Increased Ovarian Cancer Risk
There is no link between fertility drugs and an increased risk of ovarian cancer, according to a new study in the journal Fertility and Sterility. While previous studies have suggested a connection, Albert Asante, MD, lead author of the study and a clinical fellow in the division of reproductive endocrinology at the Mayo Clinic, said the results show that “women who need to use fertility drugs to get pregnant should not worry about using these fertility drugs." The study looked at the medical information of approximately 1,900 women who participated in an ovarian cancer study at the Mayo Clinic. Approximately 13 out of every 100,000 women will develop ovarian cancer in their lives. Read more on cancer.

Unemployment Stress Can Lead to Severe Cardiovascular Troubles
The stress and anxiety of unemployment can cause both immediate and long-lasting cardiovascular problems. There’s even a possibility of something called “broken heart syndrome.” "In a very stressful situation, you can actually get a severe release of adrenaline and sympathetic nerve discharges that cause the heart to beat irregularly," said John Higgins, MD, a sports cardiologist at the University of Texas Health Science Center in Houston, according to HealthDay. In the most severe cases this can lead to heart attack. However, Kavitha Chinnaiyan, MD, director of cardiac imaging at Beaumont Hospital in Royal Oak, Mich., said steps can be taken to reduce the damage. "We know from studies that behaviors such as meditation, yoga and tai chi work specifically to reduce our response to stress," she said, noting that meditation in particular “helps you see your choices and have a clearer perspective of what to do next. Stress may still be around us, but meditation gives us a better ability to cope with it." Learn more on the connection between stable employment and health in an INFOGRAPHIC.

Smaller, Frequent Meals Help Kids Keep Weight Off
Smaller, more frequent meals can help kids ward of overeating and obesity, according to several new studies in the journal Pediatrics. One study found that simply using smaller dishware—thus forcing smaller portions—meant kids ate less; they found that adult-sized dishware led first-graders to take 90 calories more of food. Researchers also found kids who ate more often were 22 less likely to be overweight. "The results are very interesting and confirm our expectations that the impact of plate size on adults in the laboratory also apply to children," said Thomas Robinson, MD, a childhood obesity researcher at Stanford University, according to Reuters. "This study provides very important preliminary evidence that using smaller dishware may help reduce children's energy intakes." Read more on obesity.

Low-calorie Drinks Increasingly Popular for Kids
While sugary drinks remain popular, low-calories drinks are also gaining more and more consumers, according to a new study in the journal Pediatric Obesity. Researchers at the University of North Caroline (UNC) found both that consumption of calories from sweetened drinks was down and consumer of low-calorie drinks was up over a 10-year period. The findings were especially significant for kids. "The food industry is trying many ways to reduce the caloric content of foods and beverages," said Barry M. Popkin, PhD, W.R. Kenan Jr. Distinguished Professor of Nutrition at UNC's Gillings School of Global Public Health. "We are increasingly seeing them replace caloric sweeteners with low-calorie sweeteners. This trend has particularly emerged in the last three to four years as U.S. concern about obesity, diabetes and other complications of consuming excessive sugary high-calorie beverages has increased." Read more on nutrition.

Missed, Delayed Mammograms Increase Death Risk for Older Women
Older women with misses or delayed mammograms are significantly more likely to die from breast cancer, according to new research to be presented at the annual meeting of the American Association for Cancer Research. Researchers found “that 23 percent of women who had their last mammogram five or more years before being diagnosed with breast cancer had advanced cancer, compared with 20 percent of those who had a mammogram six months to a year before their diagnosis,” according to HealthDay. Increased time between mammograms also significantly increased the risk of death from cancer for women age 75 and older. Researchers said more study is needed to examine the connection. "It is possible that the differences in the relationship between screening interval and [death] in older versus younger women may be related to the more aggressive nature of the tumors in younger women, which might obliterate the effects of more screening,” said Michael Simon, MD, leader of the breast multidisciplinary team at the Barbara Ann Karmanos Cancer Institute in Detroit. “Other reasons may include differences in cancer treatment, information that was not available for this [group] of women.” Read more on cancer.

CDC: Distracted Driving a Major Danger in U.S., Younger Populations
About 69 percent of U.S. drivers talk on their phone while behind the wheel and approximately one in three use text messaging or email, according to a new study from the U.S. Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. The rates were higher than those seen in several European countries. The study also found that younger men and women were, on average, more likely to engage in the risky behavior. No significant difference in behavior between men and women was found. “Everyone, of every age and generation, has the ability to make a decision to drive distraction-free,” said Linda C. Degutis, DrPH, MSN, director of CDC’s National Center for Injury Prevention and Control. “It’s especially risky for young, inexperienced drivers—who are already extremely vulnerable to crashes—to be distracted when they are behind the wheel. Answering a call or reading a text is never worth a loss of life.” Read more on safety.

High-fat Dairy Foods Increase Breast Cancer Survivors Change of Death
Breast cancer survivors who consume high-fat dairy foods are at higher risk of dying of cancer than those who consumer little or none of the food type, according to a new study in the Journal of the National Cancer Institute. Researchers found that they were at a 49 percent higher risk of death. High-fat dairy foods include ice cream, butter and certain kinds of cheeses. While the risk in absolute terms is a 12 percent risk of dying of breast cancer, researchers said this “modest” increase justifies the relatively easy lifestyle change of cutting out high-fat dairy foods. Read more on cancer.

National Salmonella Outbreak in Kids Linked to Type of Frog
A 2008-2011 outbreak of Salmonella Typhimurium in kids has been linked to African dwarf frogs kept as pets, according to a new study in the journal Pediatrics. There were 376 cases in 44 states and 29 percent of the cases led to hospitalizations, though no one died. Most victims were less than 10 years old. The researchers said too few parents are aware of the salmonella risk from reptiles and amphibians, which require diligent handwashing and careful maintenance of their habitats. Children under age 5 are at especially high risk and should have no contact with African dwarf frogs or their environments. Read more on infectious disease.

Judge Strikes Down N.Y. City’s Sugary Drink Limit; Bloomberg to Appeal
“The loopholes in this rule effectively defeat the stated purpose of this rule,” wrote State Supreme Court Justice Milton Tingling when striking down New York City’s 16-ounce limit on sodas and other sugary drinks just hours before it was set to go into effect. He also called the law “arbitrary and capricious.” Still, Mayor Michael Bloomberg says he expects to win on appeal. “As far as we have come, there is one public health crisis that has grown worse and worse over the years, and that is obesity," he said at a news confernce. "Five thousand people will die of obesity this year in New York. The best science tells us that sugary drinks are a cause of obesity." Read more on obesity.

NFL, GE Partner in $60M Effort to Study and Prevent Brain Injuries
The National Football League and General Electric Co have announced a $60 million partnership to advance research into brain injuries while also developing new technologies to help limit injuries to athletes. It includes $40 million for research into imaging technologies and $20 million for researchers and businesses working on injury prevention, identification and management. The NFL has faced multiple lawsuits related to concussions, including a class action on behalf of 4,000 former players. "We're trying to do this with the best minds anywhere in the world," said GE Chairman and CEO Jeff Immelt at a news conference. Each year, U.S. emergency rooms see about 173,000 temporary brain injuries related to sports and recreation in people age 19 and under, according to the U.S. Centers for Disease Control and Prevention. Read more on injury prevention.

Ovarian Cancer Patients Who Don’t Receive Recommended Treatment More Likely to Die in 5 Years
Ovarian cancer patients who do not received the treatment recommended by the National Comprehensive Cancer Network (NCCN) clinical practice guidelines—or as many as two-thirds of patients—have a 30 percent greater risk of dying within five years, according to new findings to be presented at the annual meeting of the Society of Gynecologic Oncology. The study found that low-volume hospitals that treat fewer ovarian cancer patients are less likely to follow the treatment guidelines. "The high-volume hospitals, which did 20 or more cases a year, and high-volume physicians, which did 10 or more a year, were significantly more likely to administer treatment that was adherent to NCCN guidelines," said Robert Bristow, MD, director of gynecologic oncology at the School of Medicine of the University of California, Irvine. According to the American Cancer Society, in the United States, approximately 22,000 new cases of ovarian cancer are diagnosed each year and 15,000 women die from the disease. Read more on cancer.

Breast Cancer in Young Women May Be Up Slightly in Past Several Decades
Advanced breast cancer in women ages 25 to 39 may have increased since 1976, according to a new report in The Journal of the American Medical Association. In 2009 there were about 2.9 advanced cased per 100,000 younger women, up from 1.53 per 100,000 in 1976. The researchers say further study is needed to verify the numbers. In the mean time, they recommend that young women see a doctor if the notice lumps or other early indicators, and not simply assume they are too young to develop breast cancer. Read more on cancer.

Cohabitating Same-sex Couples Report Worse Health than Married Heterosexuals, Possibly Tied to Discrimination
Stress and discrimination may be the reason that cohabitating same-sex couples report generally worse health than do married heterosexuals, according to a new report in the Journal of Health and Social Behavior. The study looked at how the individuals describe their health, not at their health records. The same-sex male couples were 61 percent more likely to report poor or fair health and same-sex female couple were 46 percent more likely. "Research consistently suggests that 'out' sexual minorities experience heightened levels of stress and higher levels of discrimination, and these experiences may adversely affect the health of this population," said Hui Liu, lead author and an assistant professor of sociology at Michigan State University. "It may also be that same-sex cohabitation does not provide the same psychosocial, socioeconomic and institutional resources that come with legal marriage, factors that are theorized to be responsible for many of the health benefits of marriage." Read more on LGBT issues.

Poll: 1 in 5 Americans Know a Victim of Gun Violence
One in five Americans—and 4 in 10 black Americans—know a victim of gun violence, according to the latest Kaiser Health Tracking Survey. The poll measured personal experience and concerns about firearms. About 42 percent of Americans are worried about being the victim of gun violence, with racial and ethnic minority groups more likely to be concerned. About 75 percent of Hispanics, 62 percent of black Americans and 30 percent of white Americans say they are worried. Read more on violence.

Excess Weight More Harmful to Minority Children with Asthma
Excess weight has a greater negative impact on Hispanic and African-American children with asthma than it does on Caucasian children with asthma, according to a new report in the Journal of Asthma. The added weight impedes lung function. Hispanic and African-American children also experience higher rates of asthma than do Caucasian children. Deepa Rastogi, MD, MS, senior author and attending physician in the Division of Respiratory and Sleep Medicine, The Children's Hospital at Montefiore, said this information can help physicians identify and treat asthma early. “Physicians might want to measure the degree of airway obstruction in Hispanic and African-American children who are both overweight or obese and asthmatic. Early identification of a drop in lung function can assist in better patient management.” Read more on obesity.

Study: 30 Percent of Chemo Drugs Used Off-label
Approximately one-third of chemotherapy drugs are used to combat cancers for which they were not approved, according to a new study in the Journal of Clinical Oncology. "The main criticism of off-label prescribing has been the concern that it jeopardizes patient safety because the full risk-benefit ratio is often not completely understood," said Monika Krzyzanowska, MD, MPH, of the University of Toronto. Still, lead researcher Rena Conti, an assistant professor of health policy and economics at the University of Chicago, said they cannot determine the effectiveness of the off-label treatments, according to Reuters. "We don't know what the outcomes are. We can't make a judgment of whether the off-label use we document… is appropriate or inappropriate." Read more on cancer.

Poll: One in Eight American Adults has Type 2 Diabetes
One in eight American adults—or 29 million people—suffer from type 2 diabetes, according to a Harris Interactive/HealthDay poll. The poll also found that one in three have a parent, sibling, spouse or child with diabetes. Despite those high numbers, only 21 percent of the people polled think of themselves as “well-versed” on the chronic condition, according to HealthDay. "Diabetes is very insidious,” said Ronald Tamler, MD, clinical director of the Mount Sinai Diabetes Center in New York City. “You don't know you're in trouble until the complications hit or until it's so out of control you have uncontrolled urination and thirst." Read more on diabetes.

Study: IVF Does Not Affect Risk of Breast, Gynecological Cancers
In vitro fertilization (IVF) does not increase a woman’s risk of breast and gynecological cancers, according to a new study in the journal Fertility & Sterility. Researchers looked at the medical records of 67,608 women who underwent IVF between 1994 and 2011 and 19,795 women who sought treatment, did not receive it. They found no increase in the chance of being diagnosed with breast or endometrial cancer and only a slight increase in ovarian cancer depending on the times treated, which might have been the result of chance. Previous studies had linked IVF to increased risk of breast cancer and borderline ovarian tumors. Read more on cancer.

Studies Link Excessive Television as Kids, Violence as Adults
Reducing the amount of violent television programming a child watches may also reduce their aggression levels, according to two new studies in the journal Pediatrics. A New Zealand study found higher rates of criminal convictions in people who had watched more television as children, while a U.S. study found kids who watched “pro-social” programming were better behaved than their peers who watched regular programming. "It's not just the bad behaviors that they get from TV. They can get good behaviors, too," said the U.S. study's lead author, Dimitri Christakis, MD, MPH, director of the Center for Child Health, Behavior and Development at Seattle Children's Research Institute. The link between television and violence has been difficult for researchers to study because of the presence of so many other factors, but the findings do support previous research showing a link between watching too much television early in life and antisocial problems, according to study co-author Bob Hancox, MD, an associate professor in the department of preventive and social medicine at the University of Otago in Dunedin. Read more on violence.

NIH: Diabetes Control Much Improved in Past Two Decades
People are increasingly meeting the recommended goals for the top markers of diabetes control, according to a new study in the journal Diabetes Care. The "ABC's" of diabetes control include A1C (which assesses blood sugar levels), blood pressure and cholesterol. About 19 percent of people with diabetes met all three of the goals in 2010, up from only 2 percent in 1988. The National Institutes of Health and the U.S. Centers for Disease Control and Prevention conducted and funded the study. Still, the researchers say continued improvement is needed, especially for younger people and certain minority groups. Read more on diabetes.