Health and Medical News and Resources

General interest items edited by Janice Flahiff

[Reblog] False Positives and Real Dollars: Why $88 won’t effectively screen for lung cancer

 

On a related note, during Peace Corps training in Nashville (1979) I came down with a bad cough, often coughing for 5-10 minutes at a time. Don’t think the rainy weather and me going around with an umbrella or raincoat helped. Anyways, was sent to an area doctor and after a few tests, told me and the Peace Corps staff not to be concerned. Just a dormant fungus (and I do live a bit north of the Ohio River Valley). Anyways, after a few days in Monrovia, Liberia (6 am temps of about 85), I stopped coughing.

PS We were boarded in motels. One late night was awakened by a few young men  in the group coughing loudly and giggling outside my window. Chalk it up now to some late night drinking and the men still being, well, young.

On another note, my husband quit smoking back in the 80’s after about 25 years of smoking. He had a lung X-ray and a dark spot on the lungs was noticed. He had quit smoking the month before. So now I’m wondering…cancer or fungus? He has not had any firm diagnosis of cancer since.

Beschreibung: Konventionelles Röntgenbild des ...

Beschreibung: Konventionelles Röntgenbild des Thorax (der Lunge) mit rundlicher Verdichtung in der linken Lunge Quelle: selbst erstellt –Benutzer:Lange123 17:18, 11. Nov. 2004 (CEST) (Photo credit: Wikipedia)

From the 9 February 2015 article By MATT HAWKINS, MD at The Health Care Blog

…Histoplasma capsulatum is a fungus endemic to the Ohio and Mississippi River Valleys.  It is everywhere.  You get it by breathing.  Prior studies suggest that >80% of those living in these regions have contracted the fungus.  The majority of people with histo don’t get sick.  But – they get lung nodules.  Lots of them.  The nodules are benign but often indistinguishable on imaging from “early” lung cancer.

The entrepreneurial owners of the pictured urgent care center likely know this.  They also know that Medicare and other carriers have limited coverage (reasonably so) to patients between the ages of 55 and 74 with at least a 30 pack year history of smoking.  If patients have quit smoking, they must have quit within 15 years to be eligible for coverage.  At first glance, it may seem like offering cheap, $88 screening for Americans ineligible for lung cancer screening coverage, or those eligible citizens too busy to get a physician order for a screening exam, is a good deed.  But, $88 is just the tip of the iceberg.  Additional screening exams and subsequent procedures/biopsies will all incur additional costs.

Our collective fear of malignancy, the unfortunately high frequency of lung cancer, and the promise of low dose CT screening for this disease will drive people outside of the NLST’s strict inclusion criteria into these low-cost, high-volume CT-scanning conveyor belts to “catch the cancer early.”

And what will they find in the Ohio River Valley?

Lots and lots of lung nodules.

The markedly increased propensity of patients in this region to have pulmonary nodules is likely to lead to an increased number of image-guided and open surgical biopsies (when the image-guided biopsy provides insufficient tissue for analysis).  More invasive procedures will naturally lead to more cost-inducing complications (such as pneumothorax and pulmonary hemorrhage) and, in some instances, death.

….

 

 

 

February 10, 2015 Posted by | health care | , , , , | Leave a comment

[UK Physician Authored Blog]: Private Health Screening- What to Think About When You’re Thinking About Screening Tests

Fr0m the blog

We are a group of doctors who are concerned about the safety and the ethics of private screening tests. We are worried that the companies who charge you for these tests are not giving consumers full and fair information about them. You can read more about this here. You can see some examples of misleading advertising here. You can see our critique of two of these adverts here. You can see what other doctors and patients think, and add your comments here. You can read about us here..

..

it’s important to balance the pros and cons of tests with reliable information so that you can decide whether you want to have them done or not. Many screening tests are done within the NHS and have been approved by the UK National Screening Committee. This organisation examines the balance of risk and benefit and makes recommendations about what the NHS should provide…

..

Click on the links below to see some of the reasons we are worried about private health screening tests:

October 16, 2012 Posted by | Health Education (General Public) | , , , | Leave a comment

Highest-Value Preventive Services Save Billions if Applied to 90 Percent of U.S. Population

From the 12 June 2012 article at the Robert Woods Foundation Web site

Identifying the highest-value clinical and community preventive services

Published: Jun 12, 2012

Dates of Project: 2006–2012

Field of Work: Identifying high-value evidence-based clinical and community preventive services.

Problem Synopsis: The health impact and cost-effectiveness of clinical preventive services such as smoking cessation or breast cancer screening needs to be examined and re-examined as more and better data becomes available, and as analytical tools improve. Disparities in the use of services also need to be examined and documented.

Similarly, preventive interventions to improve health at the community level such as seat belt laws, need to be examined for their health and economic impact.

Synopsis of the Work: A research team at the Partnership for Prevention:

  • Updated rankings of clinical preventive services recommended by the U.S. Preventive Services Task Force
  • Estimated the health and economic benefits for the U.S. population and selected subpopulations of increasing their use
  • Quantified disparities in their provision
  • Developed and tested methods for estimating the health and economic impact of interventions to improve health at the community level that were recommended by the Centers for Disease Control and Prevention

Key Results and Findings:

  • The research team updated the rankings of clinical preventive services recommended by the CDC. When published in 2012, the analysis will show that highly rated services—including childhood immunizations, tobacco cessation counseling, and discussing daily aspirin use to prevent heart disease—continue to be a good value because of their health impact and cost-effectiveness.
  • The team found that providing 90 percent of the U.S. population with three clinical preventive services—tobacco cessation screening and assistance; discussing daily aspirin use; and alcohol screening with brief counseling—would generate an estimated net savings of more than $1 billion each, per year. In addition, these three services plus colorectal cancer screening each would prevent the loss of more than 100,000 years of life, a year.
  • The team found troubling disparities, and specific opportunities for improvement, in the use of clinical preventive services among racial and ethnic populations.
  • The team created analytic tools to assess the health and economic benefits of interventions to improve health and prevent disease at the community level, and used them to assess interventions to reduce tobacco use and increase physical activity.

June 22, 2012 Posted by | Public Health | , , , , | Leave a comment

   

%d bloggers like this: