Tag Archives: cancer screening

Adjusted risk pool has some rethinking cervical cancer rates

What if experts wanted to figure out the rate of tonsil cancer, but forgot to exclude all the people who’d had their tonsils removed?

Those people are no longer at risk for tonsil cancer, and since there are more than half a million tonsillectomies performed each year in the U.S., counting them in the risk pool would dramatically dilute the true rate of the disease.

That’s what seems to have happened with cervical cancer, according to a thought-provoking new study published in the journal Cancer.

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Navratilova, GMA uncritically push screening

In February, Martina Navratilova was diagnosed with ductal carcinoma in situ, the most common form of breast cancer. She has since had a lumpectomy and says she’s doing well and doesn’t expect the cancer to return. But in an interview with Good Morning America during which she announced her diagnosis and surgery, the tennis star stepped beyond the world of sport and into the world of medicine. And there she made the sort of missteps she’s known for avoiding on the court.

“The reason I wanted to speak about this is to encourage these woman to have mammograms,” (Navratilova) said. “I just want to encourage women to have that yearly check-up.”

Navratilova said she doesn’t agree with recent recommendations that women between the ages of 40 and 49 should not necessarily get regular breast cancer screenings.

“The cancer knows that you’re not 50 yet?” she said. “I can’t speak for the doctors, but in my personal case I’m so glad that I did it.”

In her blog “A Healthy Piece of My Mind,” writer and PR rep Eve Harris pointed out the fallacies lurking in the tennis star’s screening recommendations, beyond the obvious age-related concerns.

First, Harris said, Navratilova exhorts women to scrape together the money to pay for screenings, yet doesn’t mention the many programs available to help uninsured and underinsured women pay for mammograms.

Second, Navratilova claims that she was lucky, and would have been in serious trouble had she not detected the cancer when she did. In fact, Harris writes, there is not enough information about the natural progression of such cancers to make that declaration.

GMA correspondent Robin Roberts, who also has battled breast cancer, failed to point out any of that and, in fact, offered a very simplified interpretation of what the new breast cancer screening recommendations say.

(Hat tip to @lauranewmanny)

Rounding up some of the latest health coverage

With good topics for the blog flooding in and a short holiday week to get them all posted, I’m taking a shortcut to point you toward some interesting stories:

ProPublica: What Health Care Reform Means for the underinsured

Rapidly rising premiums have forced them to increase their deductible every year, and now they have a policy with a $5,000 deductible per illness per year.

Steve Lopez in the Los Angeles Times: A doctor is flummoxed by the costs when he becomes the patient

As a physician, he’s well aware that emergency room treatment is very expensive. But knowing the true cost of the limited supplies and labor required to treat such a minor wound, he found the experience more than a little disturbing.

Trevor Butterworth in Forbes.com: Why mall Santas do need the H1N1 vaccine, featuring AHCJ board member Maryn McKenna’s take on how well the media has covered H1N1.

McKenna gives the media a “gentleman’s C” for its coverage of swine flu, but believes it has been getting better in the past few months.

AHCJ member Elaine Schattner, M.D., in the Huffington Post: Mammography: A Not-So-Fatalistic View

I’m a medical oncologist and breast cancer survivor who holds a highly informed and intensely personal perspective on the subject. In my view, the press is getting and giving the wrong message on mammography. There are significant flaws in recent analyses that have escaped most headlines.

Times crafts strong reminder of screening’s dangers

Sarah-Kate Templeton, in The Times of London, tells the story of one victim of medical screening and overtreatment, wrapping that story in the larger debate about unnecessary medical screening and finally caps it all off with the news of a “Making Sense of Screening” guide, produced for the charity Sense About Science by a group of British scientists and doctors.

Templeton’s story provides a forceful reminder of the dangers of some early screening and aggressive treatment, all in the words of a 56-year-old math teacher who was diagnosed with a dormant form of breast cancer, and whose doctors recommended radical treatment.

The National Health Service has had to rewrite its advice to include warnings about potential harm caused by the screening process “after research showed that thousands of women have been misled into having unnecessary surgery.”

(Hat tip to Gary Schwitzer)

Scans at LA hospital spewed 8x normal radiation

On Oct. 8, the FDA issued an alert recommending hospitals review CT scan radiation levels after dangerous doses were detected at an unnamed hospital. The Los Angeles Times‘ Alan Zarembo took over from there, finding that serious radiation overdoses at Los Angeles’ Cedars-Sinai hospital had prompted the warning.

Zarembo followed up with a series of stories on the radiation and its aftermath:

Heading into the CT scanner, photo by grewlike via Flickr.

Cedars-Sinai investigated for significant radiation overdoses of 206 patients

Zarembo leads with a summary of what exactly went down at Cedars-Sinai:

More than 200 patients at Cedars-Sinai Medical Center were inappropriately exposed to high doses of radiation from CT brain scans used to diagnose strokes, hospital officials told The Times on Friday.

About 40% of the patients lost patches of hair as a result of the overdoses, a hospital spokesman said.

Even so, the overdoses went undetected for 18 months as patients received eight times the dose normally delivered in the procedure, raising questions about why it took Cedars-Sinai so long to notice that something was wrong.

Class action filed for Cedars radiation patients

Zarembo checks with experts who say the class-action suit filed on behalf of victims has little chance of success because it’s difficult to prove damages, especially since they may not develop for years.

Cedars-Sinai head expresses regret for radiation overdoses

A quick-hit story in which the hospital details exactly what they’ve done to ensure it doesn’t happen again.

4 patients say Cedars-Sinai did not tell them they had received a radiation overdose

Zarembo tracked down patients who said that, while they were contacted by the hospital concerning hair loss, they weren’t informed of radiation overdose or potential cancer risk.

Hospital error leads to radiation overdoses

Zarembo writes that the problem has been traced to a CT scanner reset in early 2008.

Cedars-Sinai radiation overdoses went unseen at several points

In one of the most remarkable moments, Zarembo writes that, before every single scan, technicians were shown a screen indicating, among many other things, the unusually high radiation level. The error was in plain sight the entire time.

Beginning in February 2008, each time a patient at Cedars-Sinai Medical Center received a CT brain perfusion scan– a state-of-the-art procedure used to diagnose strokes – the dose displayed would have been eight times higher than normal. No standard medical imaging procedure would use so much radiation, which one expert said is on par with the levels used to blast tumors.

Somebody should have noticed. But nobody did – everybody trusted the machines.


The New York Times‘ Walt Bogdanich added a broader perspective on the story, adding an additional case and subtly weaving it into the debate about the dangers of medical screening.