The U.S. Preventive Services Task Force just released a recommendation that pregnant women be screened for gestational diabetes, even if they have not been previously diagnosed with type 1 or 2 diabetes.
The task force often finds itself in the news when determining what works and doesn’t work in screenings and preventive care.
Previously, it told healthy women not to bother with calcium and vitamin D pills, said many women could wait on mammograms until age 50 and recently clarified who might benefit from regular lung cancer screening tests. The task force’s work lies in translating medical evidence into clinical practice, which can be a difficult and contentious task. Its recommendations are often nuanced and misunderstood.
How does the group come to these determinations and how can you report on the science and not just the heat a recommendation generates? What is evidence-based medicine and how does the USPSTF use it to make recommendations on health care services?
In a Jan. 28 webcast, USPSTF chair Dr. Virginia Moyer and co-vice chair Dr. Michael LeFevre will explain how the task force works in an effort to deepen our reporting of upcoming task force recommendations. A Q&A with the doctors, moderated by AHCJ medical studies topic leader Brenda Goodman, will follow. Continue reading
With mammograms in the news lately, it’s worth noting that the U.S. Preventive Services Task Force has posted its plan for reviewing and updating its recommendations for screening for breast cancer. The draft research plan lays out the “strategy the Task Force will use to collect and examine research and is the first step in updating the 2009 recommendation,” according to Ana Fullmer at USPTF. Recommendations are updated every five to seven years, so she says a new recommendation probably won’t be finished for a few years.
The panel is seeking answers about the specific benefits and harms of screening mammography for women over 40, they’re asking if benefits and risks vary by imaging technique – digital mammograms, ultrasound or MRIs; and importantly, they’re trying to find out how common ductal carcinoma in situ (DCIS) is in the U.S. and what benefits and harms are involved in treating it.
Experts recently recommended renaming DCIS to exclude the word “carcinoma” so the finding wouldn’t be so frightening to patients. DCIS is an abnormal pattern of cell growth in the milk ducts of the breast. In many cases, it doesn’t progress to cancer. Yet a growing number of women have decided to remove both breasts rather than take their chances that it isn’t dangerous.
Interested parties who want to weigh in on the draft plan are encouraged to submit comments and questions to the Task Force by Dec. 11.
Image by themozhi’s pixel displays via flickr.
It’s a jaw-dropper of a story. A reluctant television reporter is persuaded by her producers to have a mammogram in front of the cameras. A few weeks later, she reveals the results on air: The test she initially didn’t want found cancer.
In an essay for ABC News, her employer, Amy Robach wrote:
The doctors told me bluntly: “That mammogram just saved your life.”
If you’re a woman, this is the kind of news that sends a cold stab of fear through you. Here’s a professional in the prime of her life with no family history and, by her own estimation, very little in the way of personal risk. And she’s young — just 40 years old.
The problem with Robach’s story is that it is too scary. It seems to be a play for ratings in November, a month when television stations rely on viewership numbers to set advertising rates. Continue reading
Eva Grayzel’s symptoms started with a sore on her tongue.
“It felt like a canker sore,” she recalled.
Her dentist referred her to an oral surgeon who did a biopsy. It came back negative.
A pathologist diagnosed it as moderate dysplasia. Two years passed before another oral surgeon saw the lesion for what it was: oral cancer.
When she finally got the bad news, her life was on the line.
Grayzel related her story at the recent fall meeting of the California Dental Association.
Donna Domino of DrBicuspid.com reported on her nightmarish journey back from the brink of death:
After having a third of her tongue removed and enduring six weeks of daily radiation to her head and neck to treat her stage IV oral squamous cell carcinoma, Eva Grayzel had had enough.
The vivacious 31-year-old mother of two young children could only eat a spoonful of food a day because it was too painful to swallow. She developed painful blisters in her mouth and throat that would open and bleed during severe coughing fits. She lost her voice and would wake in a panic gasping for breath when thick saliva pooled in her throat. Given only a 15 percent chance of survival, she wrote a farewell note to her husband and children.
“I felt myself begin to wither away in fear, devastation, and loneliness,” she told a large and rapt group of dentists and hygienists during a session at the recent California Dental Association’s (CDA) fall meeting in San Francisco.
The Institute of Medicine’s newly-released report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,updates its recommendations on the looming “crisis” in cancer care. Adults over age 65 comprise the majority of cancer patients and the majority of cancer deaths. Their care needs are complex, yet the nation is faced with a shrinking health care workforce, providing fragmented care, at the time when the population of older adults is set to double in less than two decades.
Additionally, care and treatment costs are rising faster than many other areas of medicine — from $72 billion in 2004 to $125 billion in 2010. It’s projected to climb another $50 billion by the start of the next decade. This places an extraordinary burden on Medicare, as the primary insurer, on patients, and on families. The IOM also points out growing disparities in care – in access to care, affordable treatment options and in finding knowledgeable providers, particularly among those caring for seniors. The report also describes the complexity of caring for older adults with cancer, who may have multiple chronic conditions, decrease in cognition, require assistance with ADLs or IADLs, depend on family or friends for caregiving help, and who may be more vulnerable to side effects. Continue reading
Image by Gage Skidmore via flickr.
“The ability to talk to a lot of people is freakish,” said Chris Rock in a conversation with Jerry Seinfeld for his new online show “Comedians in Cars Getting Coffee.”
“It’s more freakish than being able to run fast or dunk a basketball or any of those things.”
It’s freakish and powerful, maybe too powerful when it comes to celebrity endorsements of medical tests.
Dubbed “The Katie Couric Effect” for the 20 percent boost to colonoscopies after the popular anchor televised her own screening in March 2000, it’s also been demonstrated in cervical cancer and myriad other kinds of cancer screening tests.
No doubt it is happening again in the wake of Angelina Jolie’s May announcement of her BRCA testing for breast and ovarian cancer. The stock market has bet on it. And some doctors saw spikes in calls from patients after her New York Times op-ed was published. Continue reading
Image by Sweet One via flickr.
It can be tough to find a medical study that is both important and compelling. But that was the opportunity presented to health reporters this week in the shape of a big study on a humble condiment, vinegar.
What makes this study even more wonderful, in a way, is that it was presented at the American Society of Clinical Oncology, a medical meeting that’s awash in high-stakes, big money, endlessly pitched and spun drug research.
In the midst of that madding crowd was Dr. Surendra Shastri, a preventive oncologist at Tata Memorial Hospital in Mumbai who needed an inexpensive, low-tech way to screen for cervical cancer – the leading cancer killer of women in India.
He found it in the form of sterile vinegar which bleaches suspect cells white when it’s swabbed on the cervix. Continue reading
You don’t need a background in epidemiology to get great information and story ideas from state and national cancer registries.
Those databases full of hospital/clinic-reported patient information and outcomes for cancer victims from the census tract to national level are valuable tools for researchers studying health trends, but also can be a trove of information for reporters. With about 1.3 million American adults and 12,000 children dying of cancer every year, it’s easy to see the value of these resources as reporting tools.
Each state and a number of organizations run registries. The National Cancer Institute runs a large registry, called SEER, that reporters can use to compare cancer trends across time, ethnicity, gender and ages. The Commission on Cancer, run by the American College of Surgeons, operates another good resource for national cancer statistics called the National Cancer Database. And while each state operates its own registry, the usefulness and usability will vary by state to state. Continue reading
Pamela Fayerman of The Vancouver Sun has been writing about a genetic counselor who has been “relieved of her duties” at the BC Cancer Agency, part of the Provincial Health Services Authority, for allegedly failing to document cases.
Part of the counselor’s duties included making arrangements for genetic testing for people who fit the criteria for having a predisposition to cancer. But patients told Fayerman that “tardiness and lack of communication was part of a disturbing pattern” that led to the personnel action.
Fayerman, through one woman’s story, explains how the delays and lack of communication have affected patients and their families and the decisions they have made while waiting for testing. In the case of one patient:
If she had received results of genetic testing right after being diagnosed, she said, she would have been in a better position to make a decision about having her breasts removed or whether a lumpectomy (which she had) was sufficient. And her other organs might have been spared from damage due to chemotherapy treatment, she says. In addition, she would know sooner about whether her daughter faces an increased risk of breast cancer.
In a blog post, Fayerman says the stories wouldn’t have happened if patients had not called her to tell her their stories. She discusses the “leap of faith” such sources must make and how she handles patients who decide to step forward and share their stories publicly.
Amid the controversy over the Susan G. Komen for the Cure foundation’s changes in funding for Planned Parenthood, Reuters’ reporters Sharon Begley and Janet Roberts took a look at the organization’s financial statements.
Their analysis shows that the charity has “cut by nearly half the proportion of fund-raising dollars it spends on grants to scientists working to understand the causes and develop effective new treatments for the disease.”
In 2008, it spent 29 percent of its donations on research awards. In 2011, that number was down to 15 percent.
Reuters reports that, according to the 2011 financial statement, “43 percent of donations were spent on education, 18 percent on fund-raising and administration, 15 percent on research awards and grants, 12 percent on screening and 5 percent on treatment.”
Meanwhile, AHCJ member and independent journalist Christie Aschwanden writes that the real scandal lies with the organization’s “science denialism.” She says it has perpetuated the “notion that breast cancer is a uniformly progressive disease that starts small and only grows and spreads if you don’t stop it in time” – breast cancer’s false narrative.
Aschwanden points out that Komen’s insistence that women be “screened now” and that early detection saves lives, as proclaimed in its ads, “flies in the face of basic cancer biology” as well as places blame on people who have metastatic breast cancer. The piece is well worth a read, especially to find out what Komen’s own chief scientific adviser says about the organization’s message.
And, for a re-cap of the Komen saga, ProPublica has put together a handy timeline of Komen’s “Shifting Story on Planned Parenthood.”