Category Archives: Cancer
Malpractice Worries Mean More Tests, Higher Costs for Patients
Concern over malpractice suits increases the number of diagnostic tests ordered by physicians and referrals to emergency rooms, which in turns adds significantly to the costs of health care, according to a new study in the journal Health Affairs. This problem of “defensive medicine” cost the nation approximately $55.6 billion in 2008, or 2.4 percent of all U.S. health care spending. "It's an area where we can chip away at healthcare costs without causing pain to the patient, since these are services ordered not primarily because doctors think they're medically necessary," said Michelle Mello, senior author and professor of law and public health at the Harvard School of Public Health in Boston. Researchers examined the records of approximately 29,000 people who experienced chest pain, lower back pain or headache, but were not later diagnosed with a serious illness related to the complaint. The found that physicians with high levels of concern over malpractice suits ordered additional testing for people with headaches about 11 percent of the time (compared to 6 percent for doctors with low levels of concern) and for patients with lower back pain ordered additional tests about 30 percent of the time (compared to 18 percent). Read more on access to health care.
Poll: 10% of Americans Take Drugs Prescribed for Someone Else
Approximately 1 in 10 Americans has taken prescription drugs prescribed to somebody else, according to a new Reuters/Ipsos poll. About 6 in 10 say they did it for pain relief, while 1 in 5 said it was to sleep or manage stress and anxiety. The poll also found that it was generally not difficult to for people to get their hands on non-prescribed medications, with two-thirds of users saying they were given the drugs by a family member, friend or acquaintance. With prescription drug misuse already the second most abused category of drugs in the United States, this ease of access and casual approach to taking major narcotics is a serious public health issue with severe potential problems. Wilson Compton, MD, a division director at the National Institute on Drug Abuse, said that because prescription drugs are tailored to a person’s particular needs, it can be dangerous for someone else to take them. "Simply because it's a medicine that comes from a pharmacy does not mean it is without risk," he said. "There's a reason they require a prescription." Read more on prescription drugs.
Drug for Enlarged Prostate, Baldness Improves Ability to Identify Prostate Cancer Early
A recently completed study on the effects of a drug used to treat enlarged prostates and male pattern baldness also reduces the risk of prostate cancer by making it easier to identify and treat early, according to a new study in the New England Journal of Medicine. It also refutes concerns that finasteride, found in the prostate drug Proscar and the hair-loss drug Propecia, promotes more virulent prostate cancers."You take Proscar for six months to a year and it halves the size of your prostate, but the cancer inside your prostate does not shrink," said Otis Brawley, MD, chief medical officer for the American Cancer Society. "If I'm performing a biopsy on a smaller prostate, I'm more likely to hit that cancer than if I am sticking into a larger prostate. This drug wasn't causing more prostate cancer. It's causing more prostate cancer to be diagnosed." Approximately 1 in 6 men will be diagnosed with prostate cancer in their lifetime, with 3 to 5 percent dying from the disease. Read more on cancer.
CDC: Excessive Alcohol Consumption Costs States Billions
Excessive alcohol use cost states and the District of Columbia a median of $2.9 billion in 2006. On a state by state basis, those costs range from a low of $420 million in North Dakota to a high of $32 billion in California, according to the U.S. Centers for Disease Control and Prevention (CDC). Binge drinking—five or more drinks for men or four or more drinks for women—was responsible for about 70 percent of that; an estimated 18 percent of U.S. adults report binge drinking. “Excessive alcohol use has devastating impacts on individuals, families, communities, and the economy,” said CDC Director Tom Frieden, MD, MPH. “In addition to injury, illness, disease, and death, it costs our society billions of dollars through reduced work productivity, increased criminal justice expenses, and higher healthcare costs. Effective prevention programs can support people in making wise choices about drinking alcohol.” Read more on alcohol.
Poll: After Jolie’s Mastectomy, More Women Inclined to Discuss Issue with Doctors
In the wake of actress Angelina Jolie’s announcement that she underwent a preventative double mastectomy, more women have decided to seek medical advice on that procedure or ovary removal, according to a new poll from HealthDay. The survey found that 86 percent of women knew about Jolie’s decision and 5 percent would speak with their own doctors about the issue. That translates to about 6 million U.S. women. Jolie’s decision was made because she carries a mutation in a gene called BRCA1, which increases her risk of developing breast cancer to about 60 percent and her risk of developing ovarian cancer to as much as 40 percent. The U.S. averages are 12 percent for breast cancer and 1.4 percent for ovarian cancer. Still, doctors stress that genetic testing is only recommended for women deemed at “high risk,” which includes those with a personal history or a strong family history of breast or ovarian cancers. The American Cancer Society (ACS) Board of Directors has stated that "only very strong clinical and/or pathologic indications warrant doing this type of preventive operation," and ACS says the procedure is not 100 percent effective. Read more on cancer.
Stimulant-related ER Visits Up 300 Percent for Younger Adults
Emergency department visits due to central nervous system (CNS) stimulants rose by about 300 percent for younger adults from 2005 to 2011, according to a new report from the Substance Abuse and Mental Health Services Administration (SAMHSA). There were 22,949 such visits in 2011, with about 30 percent of the visits also involving alcohol. There were also about 1.24 million visits related to the nonmedical use of pharmaceuticals. “Nonmedical use of any drug, even an over-the-counter drug, can be dangerous, but these CNS stimulants can potentially cause significant and lasting harm, including heart problems and addiction,” said SAMHSA Chief Medical Officer Elinore F. McCance-Katz, MD, PhD. “We must raise awareness of this public health risk and do everything possible to prevent it.” Nonmedical use of CNS prescription drugs—which include those used to treat attention deficit/hyperactivity disorder—is linked to heart and blood vessel problems, as well as drug abuse or dependence. When paired with alcohol they can increase the risk of alcohol poisoning or alcohol-related injuries. Read more on substance abuse.
Who better to offer up advice on summer sun protection than the Los Angeles County Health Department? Recently the department warned its residents to “practice summer sun smarts” to protect themselves from skin cancer, which, at 1 million diagnoses per year according to the Environmental Protection Agency, is now the most common form of cancer among Americans.
July is recognized as "UV Safety Month" to encourage everyone—not just those in Los Angeles—to protect themselves from ultraviolet (UV) rays, a major risk factor for most skin cancers, by using sunscreen and avoiding prolonged sun exposure during peak hours. “Simple sun safeguards can go a long way in protecting the health of you and your family this summer,” says Jonathan E. Fielding, MD, MPH, the departments’ director of public health.
In other summer sun safety news, this week the National Highway Traffic Safety Administration (NHTSA) and SAFE KIDS Worldwide partnered up to promote National Heatstroke Prevention Day this past Wednesday, July 31. NHTSA and their partners used this opportunity to educate parents on the dangers of leaving children in unattended vehicles in the summer heat, as there have already been over 20 heat-related deaths of children in cars this summer. Children’s body temperatures can spike three to five times faster than an adult’s, and even cool temperatures in the 60s can cause the temperature in the car to rise well above 110 degrees Fahrenheit—so safety steps are critical at all times.
Task Force Calls for Regular Lung Cancer Screening for Older, High-risk Patients
New recommendations from the U.S. Preventive Services Task Force call for annual lung cancer screenings for people ages 55-79 who smoked at least a pack of cigarettes a day for 30 years, or the equivalent (e.g., two packs a day for 15 years). Low-dose computed tomography (CT) scans utilize an X-ray machine to take a series of detailed pictures that can help identify smaller tumors earlier, allowing for earlier treatment and improved health outcomes. “Lung cancer is the leading cause of cancer death in the United States and a devastating diagnosis for more than two hundred thousand people each year,” says Task Force chair Virginia Moyer, MD, MPH. “Sadly, nearly 90 percent of people who develop lung cancer die from the disease, in part because it often is not found until it is at an advanced stage. By screening those at high risk, we can find lung cancer at earlier stages when it is more likely to be treatable.” Lung cancer kills about 160,000 Americans each year. Read more on tobacco.
Study Links Breastfeeding, Higher Intelligence in Kids
Children who breastfeed score higher on intelligence tests later in life, according to a new study in JAMA Pediatrics. Researchers found that for each month spent breastfeeding there were slightly higher results on the intelligence tests at ages three and seven, though not on tests of motor skills or memory. Mandy Belfort, MD, who led the study at Boston Children's Hospital, said the study accounted for parental intelligence and other home factors and provides parents with one more piece of important information when making a decision on the complex question of whether to breastfeed. "Given the size of the benefit, I think this should be helpful for women who are trying to make decisions about how long to breastfeed… because there are many factors that go into that decision," said Belfort. "You have to weigh that against the time that it takes, maybe the time that it takes away from work and your other family duties." Previous studies have linked breastfeeding to lower risk of ear and stomach infections, as well as eczema. Read more on infant and maternal health.
NCI: ‘Cancer’ May Need to Be Redefined
The dramatic increase in cancer screenings over the past few decades has resulted in overdiagnosis and overtreatment, in part because of confusion—by both patients and physicians—over which types of cancer are actually lethal and require immediate treatment. As a result, a panel of experts commissioned by the U.S. National Cancer Institute has recommended that the word “cancer” may need to be redefined to differentiate between lethal and indolent cancers. The recommendations were published in the Journal of the American Medical Association. "We're still having trouble convincing people that the things that get found as a consequence of mammography and PSA testing and other screening devices are not always malignancies in the classical sense that will kill you," said Harold Varmus, MD, director of the National Cancer Institute, to The New York Times. "Just as the general public is catching up to this idea, there are scientists who are catching up, too." Over the past several years the U.S. Preventive Services Task Force has also called for an end to regular mammography screening for women under 50, as well as the widespread use of PSA tests to identify prostate cancer. Read more on cancer.
MERS Unlikely to Cause Pandemic; Global Cooperation Still Needed
Middle East respiratory syndrome (MERS), which emerged last year in Saudi Arabia, was compared to severe acute respiratory syndrome (SARS) and found to be less infectious, in a new study published in The Lancet Infectious Diseases. The study examined the question of whether MERS has the potential to cause a pandemic, and how quickly. The study authors concluded that MERS does not yet have pandemic potential, and in fact appears to be less infectious than SARS. There have been 81 laboratory-confirmed cases of MERS infections, 45 of which were fatal. MERS is more likely to affect older men with chronic disease, and were most often transmitted in health care settings—but unlike SARS, the virus was less likely to also infect healthy health care workers. Researchers call for healthcare facilities to prepare to provide safe care for patients with acute respiratory infections, and take measures to help prevent the spread of the disease. Read more on infectious disease.
CDC: HPV Vaccination Rates for Adolescent Girls Remain Stagnant
Just over half (53.8%) of girls age 13-17 years old received the human papilloma virus (HPV) vaccine in 2012, with no increase over the rate in 2011. Since 2006, the Advisory Committee on Immunization Practices has recommended routine vaccination of adolescent girls at ages 11 or 12 years with 3 doses of HPV vaccine. HPV causes 70 percent of cervical cancers. If HPV vaccine had been offered during healthcare visits when girls were already in the office to get a different vaccine, HPV vaccination coverage could have reached 90 percent. Approximately 79 million persons in the United States are infected with HPV, and approximately 14 million will become newly infected each year. Each year, 26,000 new cases of cancer are diagnosed that can be traced back to HPV infection. Read more on vaccines.
New Breathalyzer-like Device Tells You If Your Workout is Working
New technology being prototyped in Japan measures how well you're burning body fat and help you gauge the success of your diet and exercise program, using a smartphone and pocket-sized, bluetooth enabled device. The device measures exhaled breath for acetone, a metabolite produced from fat burning. The researchers tested the device in 17 healthy men and women, reporting their findings online July 25 in the Journal of Breath Research, and finding that the device was as effective as more established "gold standard" measures. Further research is needed on larger, more diverse populations, but if it pans out, "Enabling users to monitor the state of fat burning could play a pivotal role in daily diet management," Hiyama said in a journal news release. Read more on technology.
Smoking During Pregnancy, Kids Behavioral Problems Linked
Women who smoked during pregnancy are more likely to have children with behavioral disorders, according to a new study in the journal JAMA Psychiatry. Researchers analyzed data from three separate studies, findings that the kids of smokers exhibited a noticeable increase in negative behaviors such as getting in fights or having difficulty paying attention. Possible explanations include being born smaller or experiencing impaired brain development. "It's illuminating the prenatal period as having an ongoing influence on outcomes," said Gordon Harold, the study's senior author from the University of Leicester in the U.K. "We're not saying life after birth is no longer relevant… Rather, both influences are clearly important." Read more on tobacco.
Study: Family History of One Cancer Type Can Also Raise the Risk of Other Tumor Types
Health care professionals already knew that people are at increased risk for developing the same type of cancer as a close relative. A new study in the journal Annals of Oncology shows that they are also at increased risk for developing cancer in general, including types of tumors dramatically different than those developed by relatives, which could provide physicians with new ways to identify cancers earlier. Previous genetic studies have shown that certain gene mutations can increase the risk of multiple types of cancer. The new findings include:
- A 1.5-fold increased risk of breast cancer in women with a history of colorectal cancer in the family.
- A 3.3-fold increased risk of oral and pharyngeal cancer among people who had a first-degree relative with cancer of the larynx.
- A four-fold increased risk of cancer of the esophagus among people with a first-degree relative who had oral or pharyngeal cancer.
- A 2.3-fold increased risk of ovarian cancer among those with a first-degree relative who had breast cancer.
- A 3.4-fold increased risk of prostate cancer if a first-degree relative had bladder cancer.
"These findings may help researchers and clinicians to focus on the identification of additional genetic causes of selected cancers and on optimizing screening and diagnosis, particularly in people with a family history of cancer at a young age," said study co-author Eva Negri, MD, head of the laboratory of epidemiologic methods at the Mario Negri Institute for Pharmacological Research in Milan, Italy. Read more on cancer.
Weight Discrimination Increases the Likelihood of Obesity
People who face discrimination for being overweight may be as much as two and a half times more likely to become or stay obese, according to a new study in the journal PLoS One. "Discrimination is hurtful and demeaning, and has real implications for physical health," said lead researcher Angelina Sutin, an assistant professor of psychology at Florida State University. "In the case of weight discrimination, people often rationalize that it is OK to do because it will motivate the victim to lose weight. Our findings suggest the opposite." The experience of “weightism” damages self-esteem and undermines efforts to maintain a healthy weight. Researchers said the observed increase in the likelihood of obesity was independent of factors such as age, sex, ethnicity and education. Experts say that approaches to improving the treatment of obesity could include working with patients to develop adaptive ways to cope with discrimination, public messaging campaigns to raise awareness of the negative effects of “weightism” and even working with health care professionals to ensure they are not exhibiting discriminatory behaviors which could actually damage their patients’ health. Read more on obesity.
Study: Pertussis Booster Only ‘Moderately’ Effective
The “booster” vaccine for pertussis—or whooping cough—is only “moderately” effective in preventing the disease in adolescents and adults, according to a new study in the journal BMJ. The Kaiser Permanente-backed study, which is the first to look at the effectiveness of the Tdap booster shot in the new generation that has only received acellular vaccines, found the effectiveness to be between 53 and 64 percent. This indicates that additional vaccinations may be required to adequately prevent outbreaks according to lead author Roger Baxter, MD, co-director of the Kaiser Permanente Vaccine Study Center. The state of California saw its highest number of cases of pertussis in more than 60 years in 2010, when it had more than 9,000 cases that led to 809 hospitalizations and 10 deaths, according to the National Center for Biotechnology Information. Read more on vaccines.
NYC Hospitals Prescribing Fruits, Vegetables to At-risk Youth
An apple a day to keep the doctor away? At two New York City hospitals, you can get a prescription for just that. Under a four-month pilot program, doctors at Lincoln Medical Center in the Bronx and Harlem Hospital are giving prescriptions for fruits and vegetables to at-risk youths. The kids and their families receive coupons which can be redeemed for product at local farmers markets and city green carts. “This is probably going to prevent an awful lot more disease over the long-term than a lot of the medicines we tend to write for,” said New York City Health Commissioner Thomas Farley, MD, said Tuesday in the green market outside Lincoln Medical Center. Read more on nutrition.
Breast Cancer Survival Times Shorter for Black Women
The fact that black women receive less health care overall than their white counterparts, combined with the lack of early screening and detection programs in many black communities, means they live an average of three fewer years with a breast cancer diagnosis, according to a new study in The Journal of the American Medical Association. Researchers at the University of Pennsylvania found that black women were less likely to receive an early diagnosis when the cancer was more treatable; they also found that quality of care was in general lower, though not enough to explain the survival gap. Data showed that 70 percent of white women lived at least five years after a breast cancer diagnosis, compared to 56 percent of black women. “Something is going wrong,” said Jeffrey H. Silber, MD, a professor at the University of Pennsylvania and the director of the Center for Outcomes Research at the Children’s Hospital of Philadelphia, which studies disparities in health care. “These are huge differences. We are getting there too late. That’s why we are seeing these differences in survival.” Read more on cancer.
>>NewPublicHealth is kicking off a new series to highlight some of the best public health education and outreach campaigns every month. Submit your ideas for Public Health Campaign of the Month to info@newPublichealth.org.
Why limit your good ideas for improving population health to just one country when all the world can be your stage—to share and learn?
That’s the thinking behind Creative for Good, a new website developed by the Ad Council, a non-profit developer of public service advertisements (PSA) in the United States, Ketchum Public Relations and the World Economic Forum. The new site offers more than 60 U.S. and international case studies and well as a primer to help organizations plan and execute their own PSAs.
Creative for Good grew out of the World Economic Forum Summit in Dubai two years ago, with the goal of helping countries around the world increase the quantity and effectiveness of social cause marketing.
PSA examples on the site include:
NCI Releases Massive Data Set to Help Cancer Researchers
The National Cancer Institute (NCI) has released a massive data set of cancer-specific genetic variations to help the cancer research community gain a better understanding or both drug response and drug resistance to cancer treatments. The data set was published in Cancer Research, a journal of the American Association for Cancer Research. The database—the largest worldwide—includes 6 billion data points connecting “drugs with genomic variants for the whole human genome across cell lines from nine tissues of origin, including breast, ovary, prostate, colon, lung, kidney, brain, blood, and skin,” said Yves Pommier, MD, PhD, NCI’s chief of the Laboratory of Molecular Pharmacology. “Opening this extensive data set to researchers will expand our knowledge and understanding of tumorigenesis [the process by which normal cells are transformed into cancer], as more and more cancer-related gene aberrations are discovered,” he said. “This comes at a great time, because genomic medicine is becoming a reality, and I am very hopeful this valuable information will change the way we use drugs for precision medicine.” Read more on cancer.
FDA Approves Device that Uses the Brain’s Electrical Impulses to Diagnose ADHD
The U.S. Food and Drug Administration (FDA) has approved the marketing of the first medical device that will look at a brain’s electrical impulses to help determine whether children and adolescents have attention-deficit/hyperactivity disorder (ADHD). The 15-20 minute test for people ages 6 to 17, which utilizes electroencephalogram technology, can be used to confirm an ADHD diagnosis or help health professionals decide whether further testing should focus on ADHD. “Diagnosing ADHD is a multistep process based on a complete medical and psychiatric exam,” said Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health. “The NEBA System along with other clinical information may help health care providers more accurately determine if ADHD is the cause of a behavioral problem.” Read more on technology.
Study: Divorce When a Child is Young Negatively Impacts Later Parental Relationship Security
Young children whose parents divorce may have more difficult and less secure relationships with their parents later in life, according to a new study in the journal Personality and Social Psychology Bulletin. Researchers looked at date from 7,335 men and women with the average age of 24, finding those whose parents divorced when they were age 5 or younger had less secure parental relationships as adults. A secure relationship means that the child feels “they can trust them and depend on them and that the parent will be available psychologically,” according to HealthDay. The negative effect was especially true for relationships with the father. The study found that participants were more likely to have a “strained” relationship with the parent they did not live with after the divorce; about 74 percent of the participants lived with their mothers and only 11 percent lived with their fathers. Omri Gillath, an associate professor of social psychology at the University of Kansas, said the results demonstrate the need for divorcing parents to be as civilized as possible. Read more on pediatrics.
CDC Foundation Releases Website, App to Help Prevent Concussions in Kids
The CDC Foundation and the U.S. Centers for Disease Control and Prevention (CDC) have released a “Heads Up to Parents” website and mobile app that provide resources for parents and coaches to protect kids against brain injuries, such as concussions. The website includes customizable fact sheets, videos, tools, tips and online training courses, while the app includes basics on brain injuries, safety tips and a helmet selector. Emergency rooms treat about 170,000 young athletes for suspected traumatic brain injuries each year. Read more on safety.
Soy Does Not Reduce Recurrence of Prostate Cancer
Soy supplements do not reduce the risk of recurrence of prostate cancer, according to a new study in the Journal of the American Medical Association. Prostate cancer is the second most common type of cancer for men. While some doctors have believed that the isoflavones found in soy could help prevent prostate cancer, the study involving men who’d had their prostates surgically removed was stopped early because no benefit was seen. "When we did the analysis and there was an absolute absence of the effect, I was a little surprised. But in a way, it was good because the outcome was clear," said Maarten Bosland, the lead author from the University of Illinois at Chicago, to Reuters. Read more on cancer.
Five Things for Kids to Tell their Asthma Doctor
The key to making sure a child’s asthma is being treated properly is to make sure the child is fully involved when meeting with an allergist, according to a study in the journal Annals of Allergy, Asthma & Immunology. "Our research shows that physicians should ask parents and children about the effects asthma is having on the child's daily life," said lead author Margaret Burks, of the pediatrics department of the University of Texas Health Science Center at San Antonio, in a release. "Parents can often think symptoms are better or worse than what the child is really experiencing, especially if they are not with their children all day.” With that in mind, the study identified five things kids should make sure to tell their asthma doctor:
- If they can't play sports or participate in gym class and recess activities
- When symptoms get worse outside or at home
- If they often feel sad or different from other kids because of asthma
- If they miss school because of asthma
- When the asthma appears to have gone away
Read more on pediatrics.