June 10th, 2011 by Peggy Polaneczky, M.D. in Health Tips
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In a large multicenter study enrolling over 70,000 women, annual screening with transvaginal pelvic ultrasound and ca125 blood testing did not reduce deaths from ovarian cancer, and in fact led to an increase in complications due to screening.
Investigators in the NCI-sponsored Prostate, Lung and Ovarian Cancer (PLCO) Screening trial randomly assigned over 78,000 women age 55-64 years of age to either annual screening with transvaginal pelvic sonograms for 4 years plus CA125 testing for 6 years or usual care at 10 study sites across the US., and followed the groups for up to 13 years. Over that time period, ovarian cancer rates in the screened group were 5.7 per 10,000 person-years vs 4.7 per 10,000 persons-years in the usual care group, with 3.1 deaths vs 2.6 deaths per 10,000 person years, respectively. Over 3000 women had false positive screening results, a third of whom had surgery and 15% of those operated on had a complications from their surgery. Deaths from other causes did not differ between the groups.
The investigators concluded that annual screening for ovarian cancer does not reduce mortality, and in fact caused harms among women with fals positive abnormal results.
This is not the first study that failed to find efficacy for ultrasound and ca125 in reducing mortality from ovarian cancer, but Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
May 15th, 2011 by GarySchwitzer in News
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A new analysis in the American Journal of Preventive Medicine, “The Public’s Response to the U.S. Preventive Services Task Force’s 2009 Recommendations on Mammography Screening,” included a content analysis of news stories and social media posts around the time of the USPSTF announcement. The authors report:
“Of the 233 newspaper articles, blog posts, and tweets coded, 51.9% were unsupportive, and only 17.6% were supportive. Most newspaper articles and blog posts expressed negative sentiment (55.0% and 66.2%, respectively)….The most common reasons mentioned for being unsupportive of the new recommendations were the belief that delaying screening would lead to later detection of more advanced breast cancer and subsequently more breast cancer-related deaths (22.5%) and the belief that the recommendations reflected government rationing of health care (21.9%).
…
These results are consistent with previous studies that suggest a media bias in favor of mammography screening.”
Also see an accompanying editorial by Task Force members Diana Petitti and Ned Calonge.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
May 8th, 2011 by GarySchwitzer in Health Tips
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All over the country in May, hospitals are offering “Free Throat Cancer Screening.” A Google search turned up dozens of results for that specific term or the related “oral, head and neck cancer screening.”
Here’s one example, promoting “Oral, Head and Neck Cancer Awareness Week, May 8-14.”
This promotion uses ominous warnings:
Can you live without your voice?
What about your jaw?
Would you miss it if you couldn’t swallow food?
Throat cancer can take all of those things away, along with your ability to eat, talk and breathe normally. These debilitating problems can be prevented, but you have to catch cancer early.
Some promotions – such as this one – use celebrity pitches such as “If it happened to Michael Douglas, it can happen to you.”
Here’s one that states, “A 10-minute, painless screening could save your life.”
But where’s the evidence for that? Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
April 24th, 2011 by GarySchwitzer in Health Policy, Opinion
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On the US News & World report website, Dr. Kenny Lin writes as a physician and a concerned observer about “Dangers of Incidentaloma: Why To Think Twice Before Getting a CT Scan.”
It’s an important issue. Give it a look.
Lin’s blog, “The Common Sense Family Doctor,” is also worth visiting. Recently he cited one of my alltime favorite essays, “The Last Well Person,” by Dr. Clifton Meador, who wrote in 1994:
“The demands of the public for definitive wellness are colliding with the public’s belief in a diagnostic system that can find only disease. A public in dogged pursuit of the unobtainable, combined with clinicians whose tools are powerful enough to find very small lesions, is a setup for diagnostic excess. And false positives are the arithmetically certain result of applying a disease-defining system to a population that is mostly well. … If the behavior of doctors and the public continues unabated, eventually every well person will be labeled sick. Like the invalids, we will all be assigned to one diagnosis-related group or another. How long will it take to find every single lesion in every person? Who will be the last well person?”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
April 6th, 2011 by GarySchwitzer in Health Policy, News
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A study in the Journal of Clinical Oncology found that “that men in their seventies had prostate cancer screening nearly twice as often as men in their early fifties, who are more likely to benefit from prostate cancer detection and treatment.” An American Society for Clinical Oncology news release includes this quote:
“Our findings show a high rate of elderly and sometimes ill men being inappropriately screened for prostate cancer. We’re concerned these screenings may prompt cancer treatment among elderly men who ultimately have a very low likelihood of benefitting the patient and paradoxically can cause more harm than good,” said senior author Scott Eggener, MD, assistant professor of surgery at the University of Chicago. “We were also surprised to find that nearly three-quarters of men in their fifties were not screened within the past year. These results emphasize the need for greater physician interaction and conversations about the merits and limitations of prostate cancer screening for men of all ages.”
The US Preventive Services Task Force states that the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years, and it recommends against screening for prostate cancer in men age 75 years or older.
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
In a large multicenter study enrolling over 70,000 women, annual screening with transvaginal pelvic ultrasound and ca125 blood testing did not reduce deaths from ovarian cancer, and in fact led to an increase in complications due to screening.
