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Lung Cancer Rates on the Decline

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The rates of new lung cancer cases in the United States dropped among men in 35 states and among women in 6 states between 1999 and 2008 Among women, lung cancer incidence decreased nationwide between 2006 and 2008, after increasing steadily for decades.

The decrease in lung cancer cases corresponds closely with smoking patterns across the nation. In the West, where smoking prevalence is lower among men and women than in other regions, lung cancer incidence is decreasing faster. Studies show declines in lung cancer rates can be seen as soon as five years after smoking rates decline.

The report also noted that states that make greater investments in effective tobacco control strategies see larger reductions in smoking; and the longer they invest, the greater the savings in smoking–related health care costs. Such strategies include higher tobacco prices, hard–hitting media campaigns, 100 percent smoke-free policies, and easily accessible quitting treatments and services for those who want to quit.

“Although lung cancer among men and women has decreased over the past few years,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “too many people continue to get sick and die from lung cancers, most of which are caused by smoking.  The more we invest in proven tobacco control efforts, the fewer people will die from lung cancer.”

Lung cancer is the most commonly diagnosed cancer that affects both men and women, and is the leading cause of cancer death in the United States. Cigarette smoking and exposure to secondhand smoke cause most lung cancer deaths in the United States. To further reduce lung cancer incidence, intensified efforts to reduce smoking are needed.

For this report, researchers analyzed lung cancer data from CDC′s National Program of Cancer Registries and the National Cancer Institute′s Surveillance, Epidemiology, and End Results Program. They estimated smoking behavior by state using the CDC′s Behavioral Risk Factor Surveillance System.

Study findings include:

  • Among men, lung cancer rates continued to decrease nationwide.
  • From 1999 to 2008 lung cancer rates among men decreased in 35 states and remained stable in nine states (change could not be assessed in six states and the District of Columbia).
  • States with the lowest lung cancer incidence among men were clustered in the West.
  • After increasing for years, lung cancer rates among women decreased nationwide between 2006 and 2008.
  • Lung cancer rates decreased between 1999 and 2008 among women in California, Florida, Nevada, Oregon, Texas, and Washington.
  • Lung cancer rates among women remained stable in 24 states, and increased slightly in 14 states (change could not be assessed in six states and the District of Columbia).

Source: CDC

Two Doses of HPV Vaccine May Protect as Much as Standard 3-dose Course

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Two doses of the human papillomavirus (HPV) vaccine Cervarix were as effective as the current standard three-dose regimen after four years of follow-up, according to researchers from the National Cancer Institute (NCI), part of the National Institutes of Health, and their colleagues. The results of the study, based on data from a community-based clinical trial of Cervarix in Costa Rica, appeared online Sept.9, 2011, in the Journal of the National Cancer Institute.

Worldwide, approximately 500,000 new cases of cervical cancer are diagnosed every year, and about 250,000 women die from the disease. An overwhelming majority of these new cases and deaths occur in low-resource countries. Virtually all cases of cervical cancer are caused by persistent infection with HPV. Cervarix is one of two vaccines approved by the U.S. Food and Drug Administration to protect against persistent infection with two carcinogenic HPV types, 16 and 18, which together account for 70 percent of all cervical cancer cases. The vaccine is intended to be administered in three doses given over the course of six months. To date, investigators have observed up to eight years of protection from persistent HPV infection with the vaccine. Studies are ongoing to determine the maximum length of protection.

The cost of the vaccine as well as the logistical difficulties of administering three doses to an adolescent population in resource-poor countries is greater than administering two doses. Even in wealthier countries such as the United States, few adolescent females complete the entire course of three vaccinations. According the Centers for Disease Control and Prevention, although approximately 49 percent of American girls ages 13 to 17 received one dose of the vaccine in 2010, only 32 percent received all three doses. In the United States, the predominately used HPV vaccine is Gardasil, which has a different formulation than Cervarix. Gardasil also protects against up to 90 percent of genital warts because it targets HPV strains 6 and 11 as well as 16 and 18.

The NCI-sponsored Costa Rica Vaccine Trial was designed to assess the efficacy of Cervarix in a community-based setting. Women ages 18 to 25 years were randomly assigned to receive the HPV vaccine or a Hepatitis A vaccine as the control treatment. Although the investigators intended to administer all three doses of the assigned vaccine to all 7,466 women in the study, about 20 percent of the participants received only one or two doses of the HPV or control vaccine. A third of women did not complete the vaccine series because they became pregnant or were found to have possible cervical abnormalities, reasons that would not likely bias the findings.

The investigators found that, after four years of follow up, two doses of the vaccine conferred the same strong protection against persistent infection with HPV 16 and 18 as did the full three-dose regimen. From just a single dose, they also observed a high level of protection, but they are cautious about the long-term efficacy of a single dose because other vaccines of this type usually require a booster dose. Additional studies are needed to evaluate the efficacy of a single dose, as well as the duration of protection for both one and two doses.

“Our study provides evidence that an HPV vaccine program using two doses will work. It may be that vaccinating more women, with fewer doses for each, will reduce cervical cancer incidence more than a standard three-dose program that vaccinates fewer women,” said Aimée R. Kreimer, Ph.D., lead author and investigator in NCI’s Division of Cancer Epidemiology and Genetics. “The main question will be whether the duration of protection from fewer doses is adequate.”

Kreimer emphasized that findings from this study of the Cervarix vaccine in women in Costa Rica may not be relevant for all populations, such as those in which HIV infection, malnutrition, or endemic diseases may influence the immune response. In addition, it is not known whether the same results would be obtained with the other FDA-approved HPV vaccine, Gardasil, because the vaccine formulations are different.

“Further studies are needed to confirm our findings in other populations as well as to quantify the duration of protection for fewer than three doses,” said Kreimer. “If other studies confirm that fewer than three doses provide adequate protection against persistent cervical HPV 16 and 18 infection, we may be one step closer to prevention of cervical cancer, especially for women in resource-poor settings, where the need is greatest.”

It is important to note that regulatory agencies have approved the HPV vaccine based on prevention of cervical precancers, not persistent infections. From studying the natural history of HPV and cervical cancer, experts know that persistent infections are first steps toward precancer. Furthermore, vaccine recommendations take into consideration many factors and studies. In the United States, the CDC’s Advisory Committee on Immunization Practices determines federal recommendations regarding vaccination.

This study was carried out by an international team of experts from the NCI, the Costa Rica HPV Vaccine Trial, and colleagues at DDL Diagnostic Laboratory in the Netherlands.


Source: NIH

Violence During Pregnancy Can Lead to Reduced Infant Birth Weight

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Pregnant women who are assaulted by an intimate partner are at increased risk of giving birth to infants of reduced weight, according to a population-level analysis of domestic violence supported by the National Institutes of Health.

The study analyzed medical records of more than 5 million pregnant women in California over a 10-year period. Although the results showed a pattern of low-weight births among women who experienced an assault, the study was not designed to establish cause and effect, and so could not prove that violence caused the reduced birth weights. Similarly, the study was not designed to provide a biological explanation for how violence against an expectant mother might cause her child to be of lower birth weight.

Infants born to women who were hospitalized for injuries received from an assault during their pregnancies weighed, on average, 163 grams, or one-third pound, less than did infants born to women who were not hospitalized, the study found. Assaults in the first trimester were associated with the largest decrease in birth weight.

Infants born weighing less than 2,500 grams, or 5.5 pounds, are considered low birth weight and have an increased risk of death or of developing several health and developmental disorders. Low birth weight infants also are at greater risk for sudden infant death syndrome (SIDS) as well as breathing problems, cerebral palsy, heart disorders and learning disabilities. The study found that among infants born to mothers who had experienced an assault, about 15 percent weighed less than 2,500 grams at birth. This rate was higher than the rate of low birth weight infants among pregnant women who were hospitalized after a car crash or for other injuries (8 to 10 percent) and more than double the rate among women who were not hospitalized while pregnant (6 percent).

Although women’s education level, rates of smoking, and nutritional habits are known to affect birth weight, the study concluded that the lower birth weights seen in the study could not be accounted for by these factors and were most strongly linked to the violence itself.

“These findings suggest that violence experienced by pregnant women could put their infants at increased risk for low birth weight and its subsequent health problems,” said Rosalind B. King, Ph.D., of the Demographic and Behavioral Sciences Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that funded the study. “It follows that programs to reduce violence against women might have the added benefit of reducing the number of low birth weight infants.”

The study was conducted by Anna Aizer, Ph.D., of Brown University, Providence, R.I. Her findings were published online in the Journal of Human Resources.

Using data collected between 1991 and 2002, Dr. Aizer compared the birth records in California to the records of pregnant women hospitalized in California as a result of injuries from assault.

She found that for every 100,000 women who gave birth in that period, 31 had been hospitalized for an injury from an assault while they were pregnant. Although these data did not distinguish between domestic violence and violence from other types of assault, previous research has shown that 87 percent of pregnant women with injuries were injured by an intimate partner.

The overall rate of assaults was 31 per 100,000 women. The study documented higher rates of assault among the poor (49.5 per 100,000), black women (157 per 100,000), and those without a high school education (39 per 100,000).

Dr. Aizer theorized that higher rates of violence among poor women might be a root cause of poor health and poverty that persists in some families from one generation to the next. A connection between violence during pregnancy, adult health, and future earnings is possible because all three factors are linked to low birth weight. Poor women are at greater risk for having low birth weight infants than are other women. In turn, when they reach adulthood, individuals born at low birth weight are at increased risk for such adult health problems as diabetes and heart disease. Also, when they reach adulthood, individuals born at low birth weight infants also earn less than their counterparts who were born at normal birth weight.

“The costs of violence against women may be borne not just by the victims but by the next generation as well,” said Dr. Aizer. “Given the importance of birth weight in determining adult education and income, these results suggest that the higher levels of violence experienced by poor women may also contribute to the intergenerational persistence of poverty.”

The American College of Obstetricians and Gynecologists has developed a slide presentation for physicians, advising them on how to screen patients for intimate partner violence, how to assess patients’ safety, and where to refer patients for additional help.

via Violence during pregnancy linked to reduced birth weight, September 8, 2011 News Release – National Institutes of Health (NIH).

Asthma Rates in U.S. Rising

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People diagnosed with asthma in the United States grew by 4.3 million between 2001 and 2009, with nearly 1 in 12 Americans diagnosed with asthma. In addition to increased diagnoses, asthma costs grew from about $53 billion in 2002 to about $56 billion in 2007, about a 6 percent increase. The explanation for the growth in asthma rates is unknown.

Asthma is a lifelong disease that causes wheezing, breathlessness, chest tightness, and coughing, though people with asthma can control symptoms and prevent asthma attacks by avoiding things that can set off an asthma attacks, and correctly using prescribed medicine, like inhaled corticosteroids. The report highlights the benefits of essential asthma education and services that reduce the impact of these triggers, but most often these benefits are not covered by health insurers.

“Despite the fact that outdoor air quality has improved, we’ve reduced two common asthma triggers—secondhand smoke and smoking in general—asthma is increasing,” said Paul Garbe, D.V.M., M.P.H, chief of CDC’s Air Pollution and Respiratory Health Branch. “While we don’t know the cause of the increase, our top priority is getting people to manage their symptoms better.”

Asthma triggers are usually environmental and can be found at school, work, home, outdoors, and elsewhere and can include tobacco smoke, mold, outdoor air pollution, and infections linked to influenza, cold-like symptoms, and other viruses.

Asthma diagnoses increased among all demographic groups between 2001 and 2009, though a higher percentage of children reported having asthma than adults (9.6 percent compared to 7.7 percent in 2009), Diagnoses were especially high among boys (11.3 percent). The greatest rise in asthma rates was among black children (almost a 50 percent increase) from 2001 through 2009. Seventeen percent of non-Hispanic black children had asthma in 2009, the highest rate among racial/ethnic groups.

Annual asthma costs in the United States were $3,300 per person with asthma from 2002 to 2007 in medical expenses. About 2 in 5 uninsured and 1 in 9 insured people with asthma could not afford their prescription medication.

“Asthma is a serious, lifelong disease that unfortunately kills thousands of people each year and adds billions to our nation’s health care costs,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “We have to do a better job educating people about managing their symptoms and how to correctly use medicines to control asthma so they can live longer more productive lives while saving health care costs.”

This report coincides with World Asthma Day, an annual event sponsored by the Global Initiative for Asthma. This year’s theme is “You Can Control Your Asthma.” Reducing asthma attacks and the human and economic costs of asthma are key priorities for the U.S. Department of Health and Human Services and the focus of a collaborative effort involving many parts of HHS. In support of this effort CDC recommends:

  • Improving indoor air quality for people with asthma through measures such as smoke-free air laws and policies, healthy schools and workplaces.
  • Teach patients how to avoid asthma triggers such as tobacco smoke, mold, pet dander, and outdoor air pollution.
  • Encouraging clinicians to prescribe inhaled corticosteroids for all patients with persistent asthma and to use a written asthma action plan to teach patients how manage their symptoms.
  • Promoting measures that prevent asthma attacks such as increasing access to corticosteroids and other prescribed medicines.
  • Encourage home environmental assessments and educational sessions conducted by clinicians, health educators, and other health professionals both within and outside of the clinical setting.

The figures were reported in Vital Signs, released today by the Centers for Disease Control and Prevention.

Source: CDC

Medical Costs for Youth With Diabetes 6x Higher

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Young people with diabetes face substantially higher medical costs than children and teens without the disease, according to a recent article in the May issue of the journal Diabetes Care. The study found annual medical expenses for youth with diabetes are $9,061, compared to $1,468 for youth without the disease.

Much of the extra medical costs come from prescription drugs and outpatient care. Young people with the highest medical costs were treated with insulin, and included all those with type 1 diabetes and some with type 2 diabetes. People with type 1 diabetes cannot make insulin anymore and must receive insulin treatment. Some people with type 2 diabetes also are treated with insulin, because their bodies do not produce enough to control blood glucose (sugar).

Children and adolescents who received insulin treatment had annual medical costs of $9,333, compared to $5,683 for those who did not receive insulin, but did take oral medications to control blood glucose.

“Young people with diabetes face medical costs that are six times higher than their peers without diabetes,” said Ann Albright, Ph.D., R.D., director of CDC’s Division of Diabetes Translation. “Most youth with diabetes need insulin to survive and the medical costs for young people on insulin were almost 65 percent higher than for those who did not require insulin to treat their diabetes.”

The study examined medical costs for children and teens aged 19 years or younger who were covered by employer-sponsored private health insurance plans in 2007, using the MarketScan Commercial Claims and Encounters Database. The estimates were based on administrative claim data from nearly 50,000 youth, including 8,226 with diabetes.

Medical costs for people with diabetes, the vast majority of whom are adults, are 2.3 times higher than costs for those without diabetes, according to CDC’s National Diabetes Fact Sheet, 2011. Authors of the Diabetes Care study suggest that the difference in medical costs associated with diabetes may be greater for youth than for adults because of higher medication expenses, visits to specialists and medical supplies such as insulin syringes and glucose testing strips.

Among youth with diabetes, 92 percent were on insulin, compared to 26 percent of adults with diabetes. Insulin is a hormone produced by the pancreas that helps convert blood glucose into energy. Without adequate insulin, blood glucose levels rise and can eventually lead to serious health complications, including heart disease, kidney failure, blindness, nerve damage and amputation of feet and legs.

Type 1 diabetes develops when the body’s immune system destroys insulin-producing beta cells in the pancreas. Risk factors may be genetic or environmental. There is no known way to prevent type 1 diabetes.

In type 2 diabetes, the body no longer handles insulin properly and gradually loses the ability to produce it. Risk factors include obesity, older age, family history, physical inactivity, history of diabetes while pregnant, and race/ethnicity. Type 2 diabetes is extremely rare in children younger than 10 years. Although type 2 diabetes is infrequent in children and teens aged 10 to 19 years, rates are higher in this group compared to younger children, with higher rates among minorities.

Source: CDC; Diabetes Care, May 2011

Alzheimer’s Diagnostic Guidelines Updated for First Time in 27 Years

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For the first time in 27 years, clinical diagnostic criteria for Alzheimer’s disease dementia have been revised, and research guidelines for earlier stages of the disease have been characterized to reflect a deeper understanding of the disorder.

The National Institute on Aging/Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s Disease outline some new approaches for clinicians and provides scientists with more advanced guidelines for moving forward with research on diagnosis and treatments. They mark a major change in how experts think about and study Alzheimer’s disease. Development of the new guidelines was led by the National Institutes of Health and the Alzheimer’s Association.

The original criteria were the first to address the disease and described only later stages, when symptoms of dementia are already evident. The updated guidelines announced today cover the full spectrum of the disease as it gradually changes over many years. They describe the earliest preclinical stages of the disease, mild cognitive impairment, and dementia due to Alzheimer’s pathology. Importantly, the guidelines now address the use of imaging and biomarkers in blood and spinal fluid that may help determine whether changes in the brain and those in body fluids are due to Alzheimer’s disease. Biomarkers are increasingly employed in the research setting to detect onset of the disease and to track progression, but cannot yet be used routinely in clinical diagnosis without further testing and validation.

“Alzheimer’s research has greatly evolved over the past quarter of a century. Bringing the diagnostic guidelines up to speed with those advances is both a necessary and rewarding effort that will benefit patients and accelerate the pace of research,” said National Institute on Aging Director Richard J. Hodes, M.D.

“We believe that the publication of these articles is a major milestone for the field,” said William Thies, Ph.D., chief medical and scientific officer at the Alzheimer’s Association. “Our vision is that this process will result in improved diagnosis and treatment of Alzheimer’s, and will drive research that ultimately will enable us to detect and treat the disease earlier and more effectively. This would allow more people to live full, rich lives without — or with a minimum of — Alzheimer’s symptoms.”

The new guidelines appear online April 19, 2011 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. They were developed by expert panels convened last year by the National Institute on Aging (NIA), part of the NIH, and the Alzheimer’s Association. Preliminary recommendations were announced at the Association’s International Conference on Alzheimer’s Disease in July 2010, followed by a comment period.

Guy M. McKhann, M.D., Johns Hopkins University School of Medicine, Baltimore, and David S. Knopman, M.D., Mayo Clinic, Rochester, Minn., co-chaired the panel that revised the 1984 clinical Alzheimer’s dementia criteria. Marilyn Albert, Ph.D., Johns Hopkins University School of Medicine, headed the panel refining the MCI criteria. Reisa A. Sperling, M.D, Brigham and Women’s Hospital, Harvard Medical School, Boston, led the panel tasked with defining the preclinical stage. The journal also includes a paper by Clifford Jack, M.D., Mayo Clinic, Rochester, Minn., as senior author, on the need for and concept behind the new guidelines.

The original 1984 clinical criteria for Alzheimer’s disease, reflecting the limited knowledge of the day, defined Alzheimer’s as having a single stage, dementia, and based diagnosis solely on clinical symptoms. It assumed that people free of dementia symptoms were disease-free. Diagnosis was confirmed only at autopsy, when the hallmarks of the disease, abnormal amounts of amyloid proteins forming plaques and tau proteins forming tangles, were found in the brain.

Since then, research has determined that Alzheimer’s may cause changes in the brain a decade or more before symptoms appear and that symptoms do not always directly relate to abnormal changes in the brain caused by Alzheimer’s. For example, some older people are found to have abnormal levels of amyloid plaques in the brain at autopsy yet never showed signs of dementia during life. It also appears that amyloid deposits begin early in the disease process but that tangle formation and loss of neurons occur later and may accelerate just before clinical symptoms appear.

To reflect what has been learned, the National Institute on Aging/Alzheimer’s Association Diagnostic Guidelines for Alzheimer’s Disease cover three distinct stages of Alzheimer’s disease:

  • Preclinical — The preclinical stage, for which the guidelines only apply in a research setting, describes a phase in which brain changes, including amyloid buildup and other early nerve cell changes, may already be in process. At this point, significant clinical symptoms are not yet evident. In some people, amyloid buildup can be detected with positron emission tomography (PET) scans and cerebrospinal fluid (CSF) analysis, but it is unknown what the risk for progression to Alzheimer’s dementia is for these individuals. However, use of these imaging and biomarker tests at this stage are recommended only for research. These biomarkers are still being developed and standardized and are not ready for use by clinicians in general practice.
  • Mild Cognitive Impairment (MCI) — The guidelines for the MCI stage are also largely for research, although they clarify existing guidelines for MCI for use in a clinical setting. The MCI stage is marked by symptoms of memory problems, enough to be noticed and measured, but not compromising a person’s independence. People with MCI may or may not progress to Alzheimer’s dementia. Researchers will particularly focus on standardizing biomarkers for amyloid and for other possible signs of injury to the brain. Currently, biomarkers include elevated levels of tau or decreased levels of beta-amyloid in the CSF, reduced glucose uptake in the brain as determined by PET, and atrophy of certain areas of the brain as seen with structural magnetic resonance imaging (MRI). These tests will be used primarily by researchers, but may be applied in specialized clinical settings to supplement standard clinical tests to help determine possible causes of MCI symptoms.
  • Alzheimer’s Dementia — These criteria apply to the final stage of the disease, and are most relevant for doctors and patients. They outline ways clinicians should approach evaluating causes and progression of cognitive decline. The guidelines also expand the concept of Alzheimer’s dementia beyond memory loss as its most central characteristic. A decline in other aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment may be the first symptom to be noticed. At this stage, biomarker test results may be used in some cases to increase or decrease the level of certainty about a diagnosis of Alzheimer’s dementia and to distinguish Alzheimer’s dementia from other dementias, even as the validity of such tests is still under study for application and value in everyday clinical practice.

The panels purposefully left the guidelines flexible to allow for changes that could come from emerging technologies and advances in understanding of biomarkers and the disease process itself.

“The guidelines discuss biomarkers currently known, and mention others that may have future applications,” said Creighton H. Phelps, Ph.D., of the NIA Alzheimer’s Disease Centers Program. “With researchers worldwide striving to develop, validate and standardize the application of biomarkers at every stage of Alzheimer’s disease, we devised a framework flexible enough to incorporate new findings.”

Source: NIH

Scientists ID Gene that May Hold Key to Muscle Repair

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Researchers have long questioned why patients with Duchenne muscular dystrophy (DMD) tend to manage well through childhood and adolescence, yet succumb to their disease in early adulthood, or why elderly people who lose muscle strength following bed rest find it difficult or impossible to regain.

Now, researchers are beginning to find answers in a specialized population of cells called satellite cells. Their findings, reported in the journal Genes & Development, suggest a potential therapeutic target for conditions where muscle deterioration threatens life or quality of life.

Key to the development of skeletal muscle of the embryo and fetus, satellite cells continue to actively increase muscle mass through infancy. After that, they decrease in number and become quiescent, or inactive, until they are activated by injury or degeneration to proliferate. The process, which enables the body to repair damaged muscle, works quite well — to a point, says Vittorio Sartorelli, M.D., senior investigator in the NIAMS Laboratory of Muscle Stem Cells and Gene Regulation and lead author of the study.

For example, when a young person experiences muscle loss after a period of inactivity, muscle rebuilds as soon as activity is resumed. However, in the elderly, muscles lose that capacity. Similarly, in patients with DMD, the initial phases of muscle degeneration are effectively counteracted by the ability of satellite cells to regenerate.

“That is why people can survive until they are 20 years old without much of a problem, but, at a certain point, satellite cells stop proliferating,” said Dr. Sartorelli. “That is the point at which the patient will start developing weakness and problems that will ultimately lead to death.”

Suspecting a genetic switch that might turn off satellite cell proliferation in these circumstances, the scientists looked to a gene called Ezh2, known to keep the activity of other genes in check. When they genetically inactivated Ezh2 in satellite cells of laboratory mice, the mice failed to repair muscle damage caused by traumatic injury — satellite cells could not proliferate.

Ezh2 expression is known to decline during aging, and the new research in mice suggests that therapies to activate Ezh2 and promote satellite cell proliferation might eventually play a role in treating degenerative muscle diseases.

“We will not be able to cure the muscular dystrophies with this approach because the mutation in the gene that causes the diseases would remain. But certainly, if we can extend the period in which the satellite cells proliferate and compensate for the underlying defect, we might increase the lifespan of people with muscular dystrophy. We could certainly increase their quality of life,” said Dr. Sartorelli.

Likewise, in the elderly, tweaking the gene in satellite cells would not increase their lifespan, but could increase their quality of life by helping to prevent falls and enabling them to move and walk better and go about their daily activities.

Dr. Sartorelli cautions that while the identification of Ezh2’s role is a crucial step, any therapies are still many years away.

Source: NIH

Complementary and Alternative Medicine: Patients Don’t Tell Their Doc’s

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Despite their high use of complementary and alternative medicine (CAM), Americans over the age of 50 often do not discuss CAM use with their health care providers, a survey indicates.

The results, from AARP and the National Center for Complementary and Alternative Medicine (NCCAM) at the National Institutes of Health were released today.

Overall, 53 percent of respondents reported that they had used CAM at some point in their lives. Among those, 58 percent said they had discussed CAM with a health care provider.

This dialogue is important because, while CAM is a part of health and wellness for many Americans, some CAM products can interact with conventional medicine.

CAM is a group of diverse medical and health care interventions, practices, products, or disciplines that are not generally considered part of conventional medicine. CAM includes natural products such as herbal supplements, and manual therapies and mind/body practices such as chiropractic care, massage, acupuncture, and meditation.

Use of CAM among the 50 and older population is widespread. The 2007 National Health Interview Survey found that 44 percent of people aged 50-59 use some form of CAM, compared to the average adult use rate of 38 percent.

“Older Americans want to lead healthy, active lives, and that means using health care safely,” said AARP Vice President Elinor Ginzler. “For many people, CAM is an important part of staying healthy, but some CAM products may make conventional medicines less effective or lead to potentially dangerous interactions. Health care providers and patients need to start talking together to ensure you get the full benefit of both CAM and your medications.”

Other findings from the AARP/NCCAM survey suggest that if CAM is discussed at a medical appointment, it is most likely to be brought up by the patient. Respondents were twice as likely to say they raised the topic rather than their health care provider. According to the survey, the two main reasons that the patients gave for a lack of discussion with their health care providers are that the provider never asks (42 percent) and the patients did not know they should bring it up (30 percent).

In the survey, the most frequently cited reasons for using CAM are for general wellness (77 percent), to help reduce pain or treat a painful condition (73 percent), to treat a specific health condition (59 percent), and to supplement conventional medicine (53 percent). Those surveyed could provide more than one reason for using CAM.

“In this survey, we found that 37 percent of respondents have used an herbal product or dietary supplement in the past 12 months. Some of these natural products can interact with conventional treatments,” said Josephine P. Briggs, M.D., director of NCCAM. “As we’ve learned from NCCAM-funded research into herbal and dietary supplements, natural does not always mean safe. Thus, an open dialogue about CAM use, particularly herbals and dietary supplements, is vital to ensuring safe and coordinated care.”

The AARP/NCCAM survey was conducted by telephone interview in October 2010, with a random sample of 1,013 people aged 50 and older.

Source: NIH

Antimicrobial Resistance a Growing Health Threat, Says CDC

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Millions of Americans take antimicrobial drugs each year to fight illness, trusting they will work. However, the bacteria, viruses and other pathogens are fighting back.

Within the past couple of years alone, new drug-resistant patterns have emerged and resistance has increased – a trend that demands urgent action to preserve the last lines of defense against many of these germs.

Today, the Centers for Disease Control (CDC) joined the World Health Organization and other health partners in recognizing World Health Day, which this year spotlights antimicrobial resistance. [Read more…]

U.S. Cancer Rates Decline

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Rates of death in the United States from all cancers for men and women continued to decline between 2003 and 2007, the most recent reporting period available, according to the latest Annual Report to the Nation on the Status of Cancer. The report also finds that the overall rate of new cancer diagnoses for men and women combined decreased an average of slightly less than 1 percent per year for the same period.

The drop in cancer death rates continues a trend that began in the early 1990s. The report finds, for the first time, lung cancer death rates decreased in women, more than a decade after rates began dropping in men. [Read more…]