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Aug 19 2014
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Public Health News Roundup: August 19

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EBOLA UPDATE: Death Toll Passes 1,200; Improvement Seen in Three African Doctors Who Received Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
The death toll in the ongoing Ebola outbreak in West Africa has passed 1,200, according to the World Health Organization, with infection rates continuing to outpace containment efforts. Concerns over the disease also continue to spread, with a 30-year-old woman in Germany isolated and then taken to a specialist medical unit after being found with a high fever. However, the Liberian information minister was also recently quoted as saying that three African doctors treated with the experimental ZMapp treatment are showing “remarkable signs of improvement.” The drug was used to treat two Americans who are now also showing signs of improvement. Read more on Ebola.

Study: Older Americans Receiving Cancer Screenings Against Recommendations
As many as half of older Americans continue to receive cancer screenings despite the recommendation by several professional societies that certain cancers not be screening for in people who aren’t expected to live for another 10 years, according to a new study in JAMA Internal Medicine. “There is general agreement that routine cancer screening has little likelihood to result in a net benefit for individuals with limited life expectancy,” wrote Trevor Royce, MD, in the study. Keith Bellizzi of the University of Connecticut‘s Center for Public Health and Health Policy in Storrs added that "Each screening test carries different risks and benefits ... Individuals should be counseled about these risks in order to make an informed decision (sometimes involving caregivers or family members)." Read more on cancer.

Study: Dramatic Drop in Deaths, Hospitalization for Heart Disease and Stroke
Lifestyle changes, better treatment and effective preventive measures have caused a dramatic drop in deaths and hospitalizations for heart disease over the past decade, according to a new study in the journal Circulation. In a review of data on nearly 34 million Americans covered by Medicare, researchers found that from 1999 to 2011 hospitalizations rates for heart attacks dropped by 38 percent; rates of unstable angina dropped by almost 85 percent; and hospitalizations for both heart failure and stroke dropped by approximately one-third. "The findings are jaw-dropping," said lead researcher Harlan Krumholz, MD, a professor of cardiology at the Yale School of Medicine in New Haven, Conn, according to HealthDay. "They really show that we have begun to reverse this epidemic of heart disease and stroke." Read more on heart and vascular health.

Aug 15 2014
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Public Health News Roundup: August 15

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HHS: $250M to Expand Access to High-Quality Preschools
The U.S. Department of Health and Human Services (HHS) has announced that applications are now available for the $250 million Preschool Development Grants competition, which was established to build, develop and expand voluntary, high-quality preschool programs in high-need communities for children from low- and moderate-income families. “When we invest in early education, the benefits can last a lifetime,” said HHS Secretary Sylvia M. Burwell, in a release. “Children who attend high-quality early learning and preschool programs are more likely to do well in school and secure good jobs down the road. We all gain when our country has a stronger, more productive workforce, lower crime rates, and less need for public assistance. These Preschool Development Grants will help put more children on the path to opportunity.” Read more on education.

Study: Three Common Respiratory Illnesses Linked to Higher Risk of Lung Cancer
Chronic bronchitis, emphysema and pneumonia are all tied to an increased risk of lung cancer, according to a new study in the American Journal of Respiratory and Critical Care Medicine. Researchers analyzed data on more than 250,000 people, concluding that the reason for the increased risk could relate to underlying disease mechanisms. They also said that a better understanding of the respiratory diseases could affect how doctors monitor and help patients. Read more on prevention.

FDA: More Data Needed on Painkiller’s Abuse-Deterrent Capability
The U.S. Food and Drug Administration (FDA) has requested additional study and information to determine the effectiveness of an abuse-deterrent capability in an experimental painkiller. Acura Pharmaceuticals states that its drug, which contains the common painkillers hydrocodone bitartrate and acetaminophen, cannot be abused by snorting. The drug is designed to cause a burning sensation when snorted or form a gelatinous mixture when prepared for injection. However, the drug failed in a mid-stage trial to show a statistically significant likelihood of reducing abuse. Read more on substance abuse.

Aug 12 2014
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Public Health News Roundup: August 12

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EBOLA UPDATE: Death Toll at 1,013 as Two More Doctors are Set to Receive an Experimental Treatment
(NewPublicHealth is monitoring the public health crisis in West Africa.)
Two more Ebola-infected doctors are set to receive the experimental ZMapp drug that was given to two American health workers and a Spanish priest. The Americans continue to receive treatment in an Atlanta hospital, while the 75-year-old missionary died early this morning. The death toll of the West African outbreak—the largest Ebola outbreak in history—now stands at 1,013, according to the World Health Organization. Read more on Ebola.

FDA Approves New Colorectal Screening Test
The U.S. Food and Drug Administration (FDA) has approved the first stool-based colorectal screening test to identify cancers such as colon cancer or precursors to cancer. The test can detect red blood cells and DNA mutations that can indicate certain types of abnormal growths. Colorectal cancer is the third most common cancer among those that affect both men and women, and regular screening tests for all people ages 50 and older could reduce related deaths by at least 60 percent, according to the U.S. Centers for Disease Control and Prevention. “This approval offers patients and physicians another option to screen for colorectal cancer,” said Alberto Gutierrez, PhD, director of the Office of In Vitro Diagnostics and Radiological Health at the FDA’s Center for Devices and Radiological Health, in a release. “Fecal blood testing is a well-established screening tool and the clinical data showed that the test detected more cancers than a commonly used fecal occult test.” Read more on cancer.

Study: Women, Blacks Affected Most by Heart Disease and Stroke
Women and African-Americans are affected the most by chronic diseases linked to increased risk of heart attack or stroke, according to a new population-based study in the journal Circulation. Researchers analyzed the five major risk factors for heart disease—high cholesterol, smoking, high blood pressure, obesity and diabetes—in more than 13,500 Americans from 1987 to 1998, finding that while the combined risk for women dropped from 68 percent to 58 percent, it was still higher than the risk for men, which dropped from 51 percent to 48 percent. The study also found that diabetes more than doubled the risk of heart disease for African-Americans when compared to whites—28 percent versus 13 percent. Researchers said the difference could be because heart disease has been traditionally viewed as a disease of white men, affecting how it is treated. Read more on health disparities.

Aug 6 2014
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Public Health News Roundup: August 6

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EBOLA UPDATE: African Death Toll Hits 932 as Liberia Shuts Down a Major Hospital Over Continued Infections
(NewPublicHealth is monitoring the public health crisis in West Africa.)
St. Joseph's Catholic hospital in the Liberia capital of Monrovia has been shut down after the death of its hospital director from Ebola and the subsequent infections of six staff members, including two nuns and a priest. The World Health Organization reports that there were 45 deaths in the three days leading to August 4—bringing the death toll so far to 932—and is calling for an emergency meeting to determine whether the outbreak constitutes a "Public Health Emergency of International Concern" and to discuss what additional public health measures can be taken. Read more on infectious diseases.

‘Gluten-free’ Labels Must Now Fully Meet FDA Standards
What does a “gluten-free” food label actually mean? Exactly what it says, as of yesterday. August 5 was the deadline for all U.S. foods bearing a gluten-free label claim to meet the U.S. Food and Drug Administration’s (FDA) final rule covering the issue. The rule sets a gluten limit of less than 20 ppm (parts per million) in foods that carry the label, which is the lowest level that can be detected. The agency issued the rule last August, giving manufacturers one year to bring their product lines into compliance. “Gluten-free” labeling is critical to people with celiac disease, which has no cure and can only be treated through diet. "This standard ’gluten-free’ definition eliminates uncertainty about how food producers label their products. People with celiac disease can rest assured that foods labeled 'gluten-free' meet a clear standard established and enforced by FDA," said Felicia Billingslea, director of FDA's division of food labeling and standards, in a release. Read more on food safety.

Study: Daily Aspirin Linked to Reduction in Risk for Some Cancers
A daily dose of aspirin is linked to a reduction in the risk of developing and dying from colon, stomach and esophageal cancers, according to a new study in the Annals of Oncology. Researchers analyzed the results of available studies, determining “that most people between the ages of 50 and 65 would benefit from a daily aspirin," said lead researcher Jack Cuzick, head of the Center for Cancer Prevention at Queen Mary, University of London, adding, “It looks like if everyone took a daily aspirin, there would be less cancer, and that would far outweigh any side effects.” The most serious side effect associated with aspirin is gastrointestinal bleeding. According to HealthDay, Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society, said that while the study does not mean that everyone should be taking aspirin as a cancer-prevention measure, if does mean they should discuss the possibility with their doctors. Read more on cancer.

Jul 30 2014
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Helping the Homeless Quit Smoking: Q&A with Michael Businelle and Darla Kendzor, The University of Texas School of Public Health

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Not surprisingly, a recent study in the American Journal of Public Health found that homeless smokers struggle with quitting more than economically disadvantaged smokers who have their own housing. The study compared homeless smokers receiving treatment at a shelter-based smoking cessation clinic to people enrolled in a smoking cessation program at a Dallas, Texas, safety-net hospital.

“On average, homeless people reported that they found themselves around about 40 smokers every day, while the group getting cessation care at the hospital reported that they were more likely to be around three to four smokers every day,” said Michael S. Businelle, PhD, assistant professor of health promotion and behavioral sciences at The University of Texas School of Public Health Dallas Regional Campus, and the lead author of the study. “Imagine if you had an alcohol problem and were trying to quit drinking—it would be almost impossible to quit if you were surrounded by 40 people drinking every day. That is the situation homeless folks have to overcome when they try to quit smoking.”

Businelle said research shows that about 75 percent of homeless people smoke and that smoking is a leading cause of death in this population. And although homeless smokers are just as likely to try to quit smoking as are other smokers, they are far less successful at quitting, according to Businelle’s work. He said tailored smoking cessation programs are needed for homeless people, including smoke-free zones in shelters.

NewPublicHealth recently spoke with Businelle and his wife, Darla Kendzor, PhD, who is a co-author of the recent study on smoking and the homeless, as well as an assistant professor at The University of Texas.

NPH: Why did you embark on the study?

Michael Businelle: The smoking prevalence in this population is so high and homeless people are not enrolled in clinical trials so we don’t know what will work best for them. We’ve developed, over the last 50 years, really good treatments for the general population of smokers, but there are very few treatments that have been tested in homeless populations.

Darla Kendzor: And cancer and cardiovascular disease, which are in large part due to tobacco smoking, are the leading causes of death among homeless adults. So quitting smoking would make a big difference for them. 

Read more

Jul 30 2014
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Public Health News Roundup: July 30

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U.S. Surgeon General Issues ‘Call to Action’ Warning on Tanning and Skin Cancer
The U.S. Surgeon General has released the office’s first Call to Action on the dangers of tanning as it relates to skin cancer, which the Surgeon General called a “major public health problem.” The Call to Action is designed to increase awareness of skin cancer and presents five strategic goals to support its prevention:

  • Increase opportunities for sun protection in outdoor settings
  • Provide individuals with the information they need to make informed, healthy choices about ultraviolet (UV) radiation exposure
  • Promote policies that advance the national goal of preventing skin cancer
  • Reduce harms from indoor tanning
  • Strengthen research, surveillance, monitoring, and evaluation related to skin cancer prevention

Skin cancer is the most common type of cancer in the United States, with nearly 5 million people treated for all types combined annually at a cost of $8.1 billion. Melanoma is responsible for the most deaths and 90 percent of melanomas are estimated to be the result of UV exposure. Read more on cancer.

NIH, 23andMe Partner to Expand Researcher Access to Genetic Disease Data
The National Institutes of Health (NIH) has entered into a $1.4 million, two-year deal with home genetics startup 23andMe to open up the company’s stores of genetic data to external researchers. The grant will enable the creation of survey tools and other methods to help researchers access information on thousands of diseases and traits for more than 400,000 people who have use 23andMe’s services. “23andMe is building a platform to connect researchers and consumers that will enable discoveries to happen faster,” said Anne Wojcicki, co-founder and CEO of 23andMe, in a release. “This grant from the NIH recognizes the ability of 23andMe to create a unique, web-based platform that engages consumers and enables researchers from around the world to make genetic discoveries.” Read more on research.

Study: Students Increasingly Accepting Healthier School Lunches
Despite initial pushback from students wary of revised school lunch policies implemented to provide heathier meals in 2012, a nationally representative sample of 557 U.S. public elementary schools found that approximately 70 percent of respondents said that students liked the new lunches by the second half of the school year. Researchers also found that school meal sales were up for disadvantaged students, who are more likely than their peers to experience a lack of proper nutrition. Read more on school health.

Jul 28 2014
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Public Health News Roundup: July 28

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Study: EHRs Don’t Increase the Risk for Medicare Fraud
The use of electronic health records (EHRs) does not increase the risk of Medicare fraud, according to a new study from the University of Michigan Schools of Information and Public Health and the Harvard School of Public Health. In the study, scheduled to be published in the journal Health Affairs, researchers analyzed longitudinal data to determine whether U.S. hospitals that recently adopted EHRs also saw increases in the severity of patients’ conditions and payments from Medicare; they determined that adopters and non-adopters saw rates increase approximately equally. "There have been a lot of anecdotes and individual cases of hospitals using electronic health records in fraudulent ways. Therefore there was an assumption that this was happening systematically, but we find that it isn't," said Julia Adler-Milstein, U-M assistant professor of information, as well as an assistant professor of health management and policy in the U-M School of Public Health. Read more on technology.

Fist Bumps May Be the Best Greeting for Reducing Germ Transmission
Want to meet society’s hand-to-hand greeting expectation while also reducing the transmission of germs? Try a fist bump. Researchers from the Institute of Biological, Environmental, and Rural Sciences at Aberystwyth University in the United Kingdom used a germ-covered glove test to determine that handshakes transmit nearly twice as many bacteria as high-fives, which in turn transmit more bacteria than fist bumps. The study in the American Journal of Infection Control determined that duration and grip of a physical greeting also increased the number of bacteria transmitted. “Adoption of the fist bump as a greeting could substantially reduce the transmission of infectious diseases between individuals,” said author, David Whitworth, PhD. “It is unlikely that a no-contact greeting could supplant the handshake; however, for the sake of improving public health we encourage further adoption of the fist bump as a simple, free, and more hygienic alternative to the handshake.” Read more on infectious disease.

Fear a Greater Motivator than Data When it Comes to Using Sunscreen
Fear over developing skin cancer is a larger motivator for people’s usesof sunscreen than actual data that quantifies their risk, according to a new study in the Journal of Behavioral Medicine. Researchers analyzed data on approximately 1,500 people with no history of skin cancer, finding that for people who reported “never” using it and those who reported “always” using it, worry was a greater factor than education about risk, and the greater the worry, the more likely the use. “Most health behavior studies don’t account for the more visceral, emotional reactions that lead people to do risky behaviors, like eat junk food or ignore the protective benefits of sunscreen,” says Marc Kiviniemi, MD, lead researcher and assistant professor of community health and health behavior in the UB School of Public Health and Health Professions. “This study is important because most of what we do in public health communications focuses on spreading knowledge and information. By not addressing emotions, we are potentially missing a rich influence on behavior when interventions do not address feelings.” Read more on cancer.

Jul 14 2014
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Recommended Reading: Health Affairs and RWJF Primer on E-Cigarettes

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The public comment period for rules regulating the sale and use of e-cigarettes proposed in April by the U.S. Food and Drug Administration (FDA) ends on August 8, after which the agency is expected to release final rules governing the products. Experts say the timing is critical because sales of the products—which weren’t even on the market a decade ago—are heating up, with revenues approaching $1 billion a year, according to Forbes Magazine.

Last week, Health Affairs and the Robert Wood Johnson Foundation (RWJF) released a health policy brief about e-cigarettes that sets out key issues concerning the products and provides important background, particularly for people poised to comment on the FDA’s proposed rules.

Among the issues the policy brief addresses are e-cigarette safety; whether the devices ought to be regulated as a medical (smoking cessation) device or as a cigarette; and whether e-cigarettes pose a risk as a “gateway” drug to tobacco products. It notes that the FDA is currently funding close to 40 studies on e-cigarettes.

The issue is especially critical because sales to kids and teens are increasing, and there is still insufficient information on whether the vapor emitted by the devices pose a cancer risk. A 2013 study of 40,000 middle and high school students around the country by researchers at UC San Francisco found that e-cigarette use in that group doubled between 2011 and 2012, from 3.1 percent to 6.5 percent.

Read the policy brief from Health Affairs and RWJF.

>>Bonus Link: Read a NewPublicHealth post on initiatives by major cities to regulate the sale and use of e-cigarettes. 

Jul 9 2014
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Public Health News Roundup: July 9

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Study: Global Child TB Rates 25 Percent Higher than Previously Realized
The true number of children who develop tuberculosis (TB) each year in the 22 countries with the worst TB rates is nearly 25 percent higher than the World Health Organization (WHO) estimated as recently as 2012, according to a new study in The Lancet Global Health. Researchers used mathematical modeling to determine that approximately 650,000 children in these countries develop TB each year; the WHO estimate was 530,000. The study also determined that approximately 15 million children are exposed to TB every year and 53 million are living with latent TB infections which can become infectious active TB. While the findings are troubling, they also indicate promising ways to reduce the risk. "Our findings highlight an enormous opportunity for preventive antibiotic treatment among the 15 million children younger than 15 years of age who are living in the same household as an adult with infectious TB,” said lead author Peter Dodd, MD, from the University of Sheffield in the United Kingdom, in a release. "Wider use of isoniazid therapy for these children as a preventative measure would probably substantially reduce the numbers of children who go on to develop the disease." Read more on global health.

Severe Obesity Can Cut a Person’s Lifespan by Nearly 14 Years
Severe obesity can take nearly 14 years off a person’s life, according to a new study in the journal PLOS Medicine. Using data from 20 previous studies, researchers determined that severe obesity—defined as a body mass index (BMI) greater than 40—can cut lives short by anywhere from 6.5 to 13.7 years, due to increased risk of health problems such as heart disease, cancer and diabetes. "We found that the death rates in severely obese adults were about 2.5 times higher than in adults in the normal weight range," said lead investigator Cari Kitahara, a research fellow at the U.S. National Cancer Institute, according to HealthDay. Approximately 6 percent of U.S. adults are severely obese; severe obesity accounts for approximately 509 deaths per 100,000 men annually and 382 deaths per 100,000 women annually. Read more on obesity.

HHS: $100M for 150 New Community Health Centers
The U.S. Department of Health and Human Services (HHS) has announced approximately $100 million in available funds for communities to expand access to affordable, high-quality primary care through an estimated 150 new community health centers in 2015. Currently there are approximately 1,300 health centers with more than 9,200 service sites providing care to more than 21 million people in the United States and its territories. The centers, made possible under the Affordable Care Act (ACA), have also helped approximately 4.7 million people enroll for ACA coverage. Read more on community health.

Jul 1 2014
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Public Health News Roundup: July 1

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Study: New Requirements Needed for Hand Hygiene for Anesthesia Providers
Anesthesia providers frequently miss identified opportunities to clean their hands during surgical procedures, with the points immediately before patient contact and immediately after contact with the patient’s environment the times when they are least likely to practice proper hand hygiene, according to a new study in the American Journal of Infection Control. However, the findings also point to a larger problem: Complete compliance with all hand hygiene guidelines would take so much time that there would be no time to actually perform any procedures. The findings indicate “a need to create more practical—but still effective—methods of controlling bacterial transmission in anesthesia work environments.” Read more on prevention.

HHS: $840M to Help State, Local Agencies Improve Disaster Preparedness
The U.S. Department of Health and Human Services (HHS) has awarded approximately $840 million in grants to help state and local public health and health care systems improve their emergency response preparedness. Distributed through the Hospital Preparedness Program (HPP) and the Public Health Emergency Preparedness (PHEP) program, the funds will ensure that communities are prepared to respond to an array of emergencies, including infectious disease outbreaks, natural disasters, or chemical, biological, or radiological nuclear events. “Community and state preparedness is essential to the health security of all Americans,” said Nicole Lurie, MD, assistant secretary for preparedness and response (ASPR), in a release. “Events in the last few years have demonstrated how critical it is for health systems across the country to be ready and able to respond quickly and effectively.” Read more on disasters.

ACP: Annual Pelvic Exams Not Needed for Asymptomatic Women
Annual pelvic exams for women do more harm than good and should not be a routine part of health care for women who are not pregnant or who show no other signs of pelvic problems, according to new guidelines from the American College of Physicians (ACP). In a review, researchers found no studies on the effectiveness of pelvic exams in identifying cancers, infections and other health issues that they are commonly used to find. Researchers stressed that their findings only apply to pelvic exams and that women should still undergo recommended cervical cancer screening. Read more on prevention.