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New studies show effects of mammography guideline changesPublic release date: 27-Nov-2012 [ | E-mail | Share ]
Contact: Linda Brooks lbrooks@rsna.org 630-590-7762 Radiological Society of North America
CHICAGO Researchers assessing the impact of revised guidelines for screening mammography issued by the U.S. Preventive Services Task Force (USPSTF) found evidence that the new recommendations may lead to missed cancers and a decline in screening, according to two studies presented today at the annual meeting of the Radiological Society of North America (RSNA).
Routine screening mammography has traditionally been recommended by both the USPSTF and the American Cancer Society for all women over the age of 40. In 2009, the USPSTF issued controversial new guidelines recommending routine screening with mammography every two years for women 50 to 74 years old. In the studies being presented at RSNA 2012, researchers analyzed the impact of the new guidelines on women between the ages of 40 and 49 and the Medicare population.
"Recommendations on screening mammography are extremely important public policy and we wanted to contribute to that dialogue," said Elizabeth Arleo, M.D., assistant professor of radiology at New York Presbyterian Hospital Weill Cornell Medical College in New York City. "We get questions all day long from patients and referring physicians on the appropriateness of screening mammography. The inconsistent information is very confusing for everyone."
For her study, Dr. Arleo and a team of researchers analyzed data on screening mammography at New York Presbyterian Hospital Weill Cornell Medical College between 2007 and 2010. Over the four years, 43,351 screening exams were performed, which led to the detection of 205 breast cancers.
"Nearly 20 percent of cancers detected with screening mammography were found among women in their 40s, Dr. Arleo said. "It seems unacceptable to potentially miss nearly 20 percent of the breast cancers we are identifying. This, in our view, would represent a substantial degree of under-diagnosis."
Of the women screened in the study, 14,528, or 33.5 percent, were between the ages of 40 and 49. Of the 205 breast cancers detected, 39 (19 percent) were found in the 40-49 age group. Of those cancers, more than 50 percent (21 of 39) were invasive. Only three of the women between the ages of 40 and 49 diagnosed with cancer had a first-degree relative with pre-menopausal cancer.
"Our data favor the American Cancer Society recommendations of annual mammograms starting at age 40," Dr. Arleo said.
In the second study, a team of researchers analyzed data from The Medicare Part B Physician/Supplier Procedure Summary Master Files for 2005-2010. They calculated the following annual utilization rates for screening mammography per 1,000 female Medicare beneficiaries: 2005, 311.6; 2006, 312.4; 2007, 316.2; 2008, 320.1; 2009, 322.9; and 2010, 309.1.
From 2005 to 2009, the compound annual growth rate for screening mammography utilization was 0.9 percent, compared to a 4.3 percent decline in the utilization rate from 2009 to 2010.
"There was considerable controversy over the task force guidelines, but it was unclear how much they would influence women's choices about screening," said David C. Levin, M.D., professor and chairman emeritus of the Department of Radiology at Thomas Jefferson University Hospital in Philadelphia. "We're not able to tell from the data whether this significant drop in utilization was a result of women deciding to wait another year to have their mammogram, or women over the age of 74 not having the exam. But, clearly, the new USPSTF guidelines have had an effect."
Dr. Levin said the drop in the mammography utilization rate is especially concerning, given that the 2009 rate of 322.9 per 1,000 women wasn't particularly high.
"We'll never see 1,000 out of 1,000 women getting a screening mammogram, but you'd like to see that number closer to 1,000, and certainly higher than 322," he said. "We need to continue to follow these numbers and to watch the breast cancer mortality statistics."
###
Coauthors of Dr. Arleo's research are Melissa B. Reichman, M.D., Ruth Rosenblatt, M.D., Kemi T. Babagbemi, M.D., and Brittany Zadek Dashevsky, M.D., Ph.D.
Coauthors of Dr. Levin's research are Andrea J. Frangos, M.P.H., Vijay M. Rao, M.D., Laurence Parker, Ph.D., and Richard Sharpe, M.D., M.B.A.
Note: Copies of RSNA 2012 news releases and electronic images will be available online at RSNA.org/press12 beginning Monday, Nov. 26.
RSNA is an association of more than 50,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill.
Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-949-3233.
For patient-friendly information on mammography, visit RadiologyInfo.org.
[ | E-mail | Share ]
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
New studies show effects of mammography guideline changesPublic release date: 27-Nov-2012 [ | E-mail | Share ]
Contact: Linda Brooks lbrooks@rsna.org 630-590-7762 Radiological Society of North America
CHICAGO Researchers assessing the impact of revised guidelines for screening mammography issued by the U.S. Preventive Services Task Force (USPSTF) found evidence that the new recommendations may lead to missed cancers and a decline in screening, according to two studies presented today at the annual meeting of the Radiological Society of North America (RSNA).
Routine screening mammography has traditionally been recommended by both the USPSTF and the American Cancer Society for all women over the age of 40. In 2009, the USPSTF issued controversial new guidelines recommending routine screening with mammography every two years for women 50 to 74 years old. In the studies being presented at RSNA 2012, researchers analyzed the impact of the new guidelines on women between the ages of 40 and 49 and the Medicare population.
"Recommendations on screening mammography are extremely important public policy and we wanted to contribute to that dialogue," said Elizabeth Arleo, M.D., assistant professor of radiology at New York Presbyterian Hospital Weill Cornell Medical College in New York City. "We get questions all day long from patients and referring physicians on the appropriateness of screening mammography. The inconsistent information is very confusing for everyone."
For her study, Dr. Arleo and a team of researchers analyzed data on screening mammography at New York Presbyterian Hospital Weill Cornell Medical College between 2007 and 2010. Over the four years, 43,351 screening exams were performed, which led to the detection of 205 breast cancers.
"Nearly 20 percent of cancers detected with screening mammography were found among women in their 40s, Dr. Arleo said. "It seems unacceptable to potentially miss nearly 20 percent of the breast cancers we are identifying. This, in our view, would represent a substantial degree of under-diagnosis."
Of the women screened in the study, 14,528, or 33.5 percent, were between the ages of 40 and 49. Of the 205 breast cancers detected, 39 (19 percent) were found in the 40-49 age group. Of those cancers, more than 50 percent (21 of 39) were invasive. Only three of the women between the ages of 40 and 49 diagnosed with cancer had a first-degree relative with pre-menopausal cancer.
"Our data favor the American Cancer Society recommendations of annual mammograms starting at age 40," Dr. Arleo said.
In the second study, a team of researchers analyzed data from The Medicare Part B Physician/Supplier Procedure Summary Master Files for 2005-2010. They calculated the following annual utilization rates for screening mammography per 1,000 female Medicare beneficiaries: 2005, 311.6; 2006, 312.4; 2007, 316.2; 2008, 320.1; 2009, 322.9; and 2010, 309.1.
From 2005 to 2009, the compound annual growth rate for screening mammography utilization was 0.9 percent, compared to a 4.3 percent decline in the utilization rate from 2009 to 2010.
"There was considerable controversy over the task force guidelines, but it was unclear how much they would influence women's choices about screening," said David C. Levin, M.D., professor and chairman emeritus of the Department of Radiology at Thomas Jefferson University Hospital in Philadelphia. "We're not able to tell from the data whether this significant drop in utilization was a result of women deciding to wait another year to have their mammogram, or women over the age of 74 not having the exam. But, clearly, the new USPSTF guidelines have had an effect."
Dr. Levin said the drop in the mammography utilization rate is especially concerning, given that the 2009 rate of 322.9 per 1,000 women wasn't particularly high.
"We'll never see 1,000 out of 1,000 women getting a screening mammogram, but you'd like to see that number closer to 1,000, and certainly higher than 322," he said. "We need to continue to follow these numbers and to watch the breast cancer mortality statistics."
###
Coauthors of Dr. Arleo's research are Melissa B. Reichman, M.D., Ruth Rosenblatt, M.D., Kemi T. Babagbemi, M.D., and Brittany Zadek Dashevsky, M.D., Ph.D.
Coauthors of Dr. Levin's research are Andrea J. Frangos, M.P.H., Vijay M. Rao, M.D., Laurence Parker, Ph.D., and Richard Sharpe, M.D., M.B.A.
Note: Copies of RSNA 2012 news releases and electronic images will be available online at RSNA.org/press12 beginning Monday, Nov. 26.
RSNA is an association of more than 50,000 radiologists, radiation oncologists, medical physicists and related scientists, promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill.
Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-949-3233.
For patient-friendly information on mammography, visit RadiologyInfo.org.
[ | E-mail | Share ]
?
AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
ScienceDaily (Nov. 5, 2012) ? Autosomal-dominant polycystic kidney disease (ADPKD) is one of the most common genetic disorders, affecting one in every 1,000 people and responsible for up to ten percent of patients on dialysis worldwide. The disease is characterized by the development of cysts that lead to progressive kidney failure and necessitate dialysis or a kidney transplant in most patients aged around fifty. Moreover, the persistent cyst growth causes high blood pressure and painful complications. Although we have known about the disease for over a century and its genetic basis for almost 20 years, there was no effective treatment until now.
Kidneys stopped growing
"Our study highlights a potential treatment that reduces kidney growth and the associated symptoms and slows the decline in kidney function," explains Professor Olivier Devuyst from the Institute of Physiology at the University of Zurich -- one of the chief researchers in the phase-three clinical trial just published in the New England Journal of Medicine.
Over 1,400 patients were given tolvaptan over a three-year period at 129 centers worldwide. The drug is a selective V2 vasopressin receptor antagonist that lessens the effect of the antidiuretic (urine-concentrating) vasopressin hormone and increases urination.
The researchers studied whether tolvaptan slows the progression of the kidney disease by slowing the cyst growth. "The study achieved its goal," explains Professor Devuyst. In patients who received tolvaptan for three years instead of the placebo, the entire kidney volume decreased with fewer complications resulting from the disease, the pain eased off and the decline in kidney function was slowed. Adverse events such as increased urination and thirst as well as increased liver enzymes and blood sodium level were apparent.
15-year research project
The study is the culmination of 15 years of research done by several research groups including that of Olivier Devuyst. They began by examining transport mechanisms in cells that coat the cysts and, in particular, identified the pathway of the V2 vasopressin receptor as a potential trigger for cystic kidney disease. The demonstration that blocking this receptor slows the disease and improves the kidney function in various animal models provided the rationale for the intervention study with tolvaptan.
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The above story is reprinted from materials provided by University of Zurich.
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Journal Reference:
Vicente E. Torres, Arlene B. Chapman, Olivier Devuyst, Ron T. Gansevoort, Jared J. Grantham, Eiji Higashihara, Ronald D. Perrone, Holly B. Krasa, John Ouyang, Frank S. Czerwiec. Tolvaptan in Patients with Autosomal Dominant Polycystic Kidney Disease. New England Journal of Medicine, 2012; : 121103123025000 DOI: 10.1056/NEJMoa1205511
Note: If no author is given, the source is cited instead.
Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.
JERUSALEM (AP) ? Israel's military chief of staff has toured the Golan Heights a day after three Syrian tanks entered a demilitarized zone set up in a 1974 disengagement treaty between the sides.
Israel complained to U.N. peacekeepers over the incursion.
Lt. Gen. Benny Gantz told Israeli soldiers there Sunday to be on high alert, warning that violence from Syria's civil war might reach Israel.
Several Syrian shells, apparently misfired, have exploded inside Israel.
Israel captured the Golan Heights from Syria in the 1967 Mideast war. Before that, Syria used the highlands to shell Israeli villages below.
Israel annexed the strategic territory in 1981 in a move that is not recognized internationally.
The demilitarized zone was created after the 1973 Mideast war, when Syria tried to retake the plateau.
New York, NY -- (SBWIRE) -- 10/30/2012 -- In recent years, internet has grabbed attention of a tremendous number of people residing in six out of seven continents. Internet clientele has become the basis of income for millions of individuals and firms. Numerous commercial websites are coming into light day by day with the motive of earning profits, increasing revenue or serving its customers.
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Public release date: 27-Nov-2012
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