Tag Archives: medical diagnostics

Health

Infant screen time could impact academic success, study says

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CNN
 — 

Letting infants watch tablets and TV may be impairing their academic achievement and emotional well-being later on, according to a new study.

Researchers found that increased use of screen time during infancy was associated with poorer executive functioning once the child was 9 years old, according to the study published Monday in the journal JAMA Pediatrics.

Executive functioning skills are mental processes that “enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully,” according to the Harvard University Center on the Developing Child.

Those executive functioning skills are important for higher-level cognition, such as emotional regulation, learning, academic achievement and mental health, according to the study. They influence our success socially, academically, professionally and in how we care for ourselves, said Dr. Erika Chiappini, assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine in Baltimore.

“Though these cognitive processes naturally develop from infancy through adulthood, they are also impacted by the experiences that we have and when we have them in our development,” said Chiappini, who was not involved in the study, in an email.

The results support recommendations from the American Academy of Pediatrics, which discourages all screen time before 18 months old, with the exception of video chatting, said Dr. Joyce Harrison, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. Harrison was not involved in the research.

The study looked at data from Growing Up in Singapore Towards healthy Outcomes, or GUSTO, which surveyed women from all socioeconomic backgrounds during their first trimester of pregnancy. The sample was made up of 437 children who underwent electroencephalography (EEG) scans, which are used to look at the neural pathways of cognitive functions in the brain, at age 1, 18 months and 9 years old.

The parents reported each child’s screen time, and researchers found there was an association between screen time in infancy and attention and executive function at 9 years old, according to the study.

Further research needs to be done, however, to determine if the screen time caused the impairments in executive function or if there are other factors in the child’s environment that predispose them to both more screen time and poorer executive functioning, the study noted.

In a learning-packed time like infancy, one of the big problems with screen use is that young children aren’t learning much from them, according to AAP.

“There is no substitute for adult interaction, modeling and teaching,” Harrison said.

Babies have a hard time interpreting information presented in two dimensions, such as on screens, and have trouble distinguishing fantasy from reality, Chiappini said.

“Babies and kids are also social learners and very much benefit from the back-and-forth interaction with others (adults and kids) which is hard to achieve with screens,” Chiappini said via email.

When it comes to emotional regulation, infants and toddlers can learn from their caregivers when they model self-control or help to label emotions and appropriate expressions, she added.

For example, you can give a young child options for what they can do when they are mad, like taking a break or breathing deeply instead of inappropriate behaviors like hitting, Harrison said.

Talking about emotions can be too abstract for preschool-age kids, and in those cases using color zones to talk about emotions can be helpful, said Dr. Jenny Radesky, a developmental behavioral pediatrician and associate professor of pediatrics at Michigan Medicine C.S. Mott Children’s Hospital. Radesky was not involved in the research.

Calm and content can be green; worried or agitated can be yellow; and upset or angry can be red, using graphics or images of faces to help kids match what they’re feeling with their color zone. To reinforce it, adults can talk about their own emotions in terms of colors in front of their kids, Radesky said in a CNN previous article.

Parents and children can go through the colors together and come up with calming tools for the different zones, she added.

To strengthen those executive function skills, Harrison says it’s important to provide structured engagement where a child can work through solving problems to the extent that they can at their developmental level — instead of having problems solved for them.

And yet, sometimes parents just need to get the laundry done or attend a work meeting, and screens can feel like an effective distraction.

For very young children, it’s probably still best to avoid screen time, Harrison emphasized.

Instead, try to involve the child in house chores, she said.

“Give your toddler some clothes to fold alongside you while you are trying to get laundry done or keep your infant safely in a position where you can make frequent eye contact while you are engaged your chore,” Harrison said via email.

For older preschoolers, save up your screen time to use strategically, she said.

“For example, their one hour of screen time can be reserved for a time when you have an important video meeting to attend,” Harrison said.

And there is some content that can help teach emotional regulation when your tank is empty. Finding media that is aimed at speaking to children directly about emotions — like Daniel Tiger or Elmo Belly Breathing — can be like a meditation instead of distraction, Radesky previously told CNN.

And you can make screen time works better by engaging your child while they watch, Chiappini said. Ask questions like “what is that character feeling?” and “what could they do to help their friend?” she added.

Raising children is a complex and sometimes overwhelming task, and no caregiver can give their child everything they want to all the time, Radesky said.

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Health

Many women underestimate breast density as a risk factor for breast cancer, study shows

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CNN
 — 

Dense breast tissue has been associated with up to a four times higher risk of breast cancer. However, a new study suggests few women view breast density as a significant risk factor.

The study, published in JAMA Network Open, surveyed 1,858 women ages 40 to 76 years from 2019 to 2020 who reported having recently undergone mammography, had no history of breast cancer and had heard of breast density.

Women were asked to compare the risk of breast density to five other breast cancer risk factors: having a first-degree relative with breast cancer, being overweight or obese, drinking more than one alcoholic beverage per day, never having children and having a prior breast biopsy.

“When compared to other known and perhaps more well-known breast cancer risks, women did not perceive breast density as significant of a risk,” said Laura Beidler, an author of the study and researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For example, the authors report that dense breast tissue is associated with a 1.2 to four times higher risk of breast cancer compared with a two times higher risk associated with having a first-degree relative with breast cancer – but 93% of women said breast density was a lesser risk.

Dense breasts tissue refers to breasts that are composed of more glandular and fibrous tissue than fatty tissue. It is a normal and common finding present in about half of women undergoing mammograms.

The researchers also interviewed 61 participants who reported being notified of their breast density and asked what they thought contributes to breast cancer and how they could reduce their risk. While most women correctly noted that breast density could mask tumors on mammograms, few women felt that breast density could be a risk factor for breast cancer.

Roughly one-third of women thought there was nothing they could do to reduce their breast cancer risk, although there are several ways to reduce risk, including maintaining a healthy, active lifestyle and minimizing alcohol consumption.

Breast density changes over a woman’s lifetime, and is generally higher in women who are younger, have a lower body weight, are pregnant or breastfeeding, or are taking hormone replacement therapy.

The level of breast cancer risk increases with the degree of breast density; however, experts aren’t certain why this is true.

“One hypothesis has been that women who have more dense breast tissue also have higher, greater levels of estrogen, circulating estrogen, which contributes to both the breast density and to the risk of developing breast cancer,” said Dr. Harold Burstein, a breast oncologist at the Dana-Farber Cancer Institute who was not involved in the study. “Another hypothesis is that there’s something about the tissue itself, making it more dense, that somehow predisposes to the development of breast cancer. We don’t really know which one explains the observation.”

Thirty-eight states currently mandate that women receive written notification about their breast density and its potential breast cancer risk following mammography; however, studies have shown that many women find this information confusing.

“Even though women are notified usually in writing when they get a report after a mammogram that says, ‘You have increased breast density,’ it’s kind of just tucked in there at the bottom of the report. I’m not sure that anyone is explaining to them, certainly in person or verbally, what that means,” said Dr. Ruth Oratz, a breast oncologist at NYU Langone’s Perlmutter Cancer Center who was not involved in the study.

“I think what we’ve learned from this study is that we have to do a better job of educating not only the general public of women, but the general public of health care providers who are doing the primary care, who are ordering those screening mammograms,” she added.

Current screening guidelines recommend women of average risk of breast cancer undergo breast cancer screening every one to two years between ages 50 to 74 with the option of beginning at age 40.

Because women with dense breast tissue are considered to have higher than average cancer risks, the authors of the study suggest women with high breast density may benefit from supplemental screening like breast MRI or breast ultrasound, which may detect cancers that are missed on mammograms. Currently, coverage of supplemental screening after the initial mammogram varies, depending on the state and insurance policy.

The authors warn that “supplemental screening not only can lead to increased rates of cancer detection but also may result in more false-positive results and recall appointments.” They say clinicians should use risk assessment tools when discussing tradeoffs associated with supplemental screening.

“Usually, it’s a discussion between the patient, the clinical team, and the radiologist. And it’ll be affected by prior history, by whether there’s anything else of concern on the mammogram, by the patient’s family history. So those are the kinds of things we discuss frequently with patients who are in such situations,” Burstein said.

Breast cancer screening recommendations differ between medical organizations, and experts say women at higher risk due to breast density should discuss with their doctor what screening method and frequency are most appropriate.

“I think it’s really, really important that everyone understands – and this is the doctors, the nurses, the women themselves – that screening is not a one size fits all recommendation. We cannot just make one general recommendation to the entire population because individual women have different levels of risks of developing breast cancer,” Oratz said.

For the nearly one-third of women with dense breast tissue that reported there was nothing they could do to prevent breast cancer, experts say there are some steps you can take to reduce your risk.

“Maintaining an active, healthy lifestyle and minimizing alcohol consumption address several modifiable factors. Breastfeeding can decrease the risk. On the other hand, use of hormone replacement therapy increases breast cancer risk,” said Dr. Puneet Singh, a breast surgical oncologist at the MD Anderson Cancer Center who was not involved in the study.

The researchers add that there are approved medications, such as tamoxifen, that can be given for those at significantly increased risk that may reduce the chances of breast cancer by about half.

Finally, breast cancer doctors say that in addition to appropriate screening, knowing your risk factors and advocating for yourself can be powerful tools in preventing and detecting breast cancer.

“At any age, if any woman feels uncomfortable about something that’s going on in her breast, if she has discomfort, notices a change in the breast, bring that to the attention of your doctor and make sure it gets evaluated and don’t let somebody just brush you off,” Oratz said.

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Health

Only 14% of diagnosed cancers in the US are detected by screening, report says

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CNN
 — 

A small proportion – 14.1% – of all diagnosed cancers in the United States are detected by screening with a recommended screening test, according to a new report.

The remaining diagnosed cancers tend to be found when someone has symptoms or seeks imaging or medical care for other reasons, suggests the report, posted online Wednesday by researchers at the nonprofit research organization NORC at the University of Chicago.

“I was shocked that only 14% of cancers were detected by screening. I think, for many people, we talk so much about cancer screening that we imagine that that’s how all cancers are diagnosed. We talk about mammograms and colonoscopies all the time,” said Caroline Pearson, an author of the report and senior vice president at the organization.

Yet “the vast majority of cancer types don’t have screening tests available,” Pearson said.

The technical report notes that just four types of cancer – breast, cervical, colorectal and lung – have screening tests recommended for use by the US Preventive Services Task Force, and the percent of cancers detected by screening varies across those types: 61% of breast, 52% of cervical, 45% of colorectal and 3% of lung cancers. The report also includes data on prostate cancer, even though screening for prostate cancer is not broadly recommended, and the data suggests that 77% of prostate cancers are detected by screening.

The report, which has not been published in a peer-reviewed journal, is based on data from 2017. But Pearson said that since then, studies have shown that the rates of cancer screenings declined during the early days of the Covid-19 pandemic. She suspects that the percentage of cancers detected by screening could now be even lower than what was found in the new report.

“I definitely think that the percent of cancers detected by screening would have been lower as a result of the pandemic. We know that people missed a tremendous number of recommended screenings, and we are seeing those cancers showing up at later stages in clinical settings,” Pearson said. “So with the reduction in screenings, we get fewer cancers diagnosed that way, and that is certainly something that we would pick up in the data.”

For the new report, Pearson and her colleagues developed a model to calculate the percentage of cancers detected by screening, using data from the National Cancer Institute on the incidence of diagnosed cancers, national screening rates from the National Health Interview Survey, testing rates from the US Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, and several studies on the rate at which cancers are detected.

There has not been much data in the medical literature on cancers that are detected by screening, she said, adding that she hopes the report draws attention to the importance of cancer screening, the need for more tests and the need for more data on how cancers are diagnosed, including the important role that screening tests play in catching cancers early.

“We would benefit from much more robust data and analysis to really understand how cancer is affecting different populations and how we can improve equity,” Pearson said. “For the researchers of the world, I would love for people to dig into some of these estimates and some of the geographic variations that we’re seeing to understand how we can begin to shape the public policy environment to improve treatment across the country and improve screening across the country.”

Dr. Otis Brawley, an oncology professor at Johns Hopkins University, said he was not surprised by the findings in the new report – especially because some cancer screening tests can be improved in their performance.

“Everyone has been led to believe that screening is better than it actually is,” said Brawley, who was not involved in the new report. “We need to invest in research to try to find better tests.”

In the case of breast cancer, for instance, “clinical trials tell us screening prevents 25% of those destined to die of breast cancer from dying of breast cancer,” he said. “In the US, about 60% of women aged 50 to 70 get screened. That means we can only prevent about 15% of the deaths destined to occur. It also means a lot of patients are diagnosed with cancer after a negative screening test.”

People in the United States could benefit from following cancer prevention measures – such as getting screened and maintaining a healthy lifestyle – but the public can also benefit from better screening tests themselves, Brawley said.

“We spend so much time pushing screening and pushing screening tests – yes, they do save lives, but we need to be able to save more lives,” he said. “We need better.”

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Business

Elizabeth Holmes sentenced to more than 11 years in prison for fraud

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CNN
 — 

Elizabeth Holmes was sentenced to more than 11 years in prison on Friday following her conviction in January for defrauding investors while running the failed blood testing startup Theranos.

Judge Edward Davila imposed a sentence of 11 years and three months in prison, with another three years of supervision after Holmes is released. The sentence also includes a fine of $400, or $100 for each count of fraud. Restitution will be set at a later date. Holmes was ordered to turn herself into custody on April 27, 2023.

Holmes, who was found guilty in January on four charges of defrauding investors, faced up to 20 years in prison as well as a fine of $250,000 plus restitution for each count.

Lawyers for the government asked for a 15-year prison term, as well as probation and restitution, while Holmes’ probation officer pushed for a nine-year term. Holmes’ defense team asked Davila, who presided over her case, to sentence her to up to 18 months of incarceration followed by probation and community service.

Before the sentencing was announced, a tearful Holmes spoke to the court in San Jose, California. “I loved Theranos. It was my life’s work,” she said. “The people I tried to get involved with Theranos were the people I loved and respected the most. I am devastated by my failings.”

She also apologized to the employees, investors and patients of Theranos. “I’m so, so sorry. I gave everything I had to build our company and to save our company,” she said. “I regret my failings with every cell in my body.”

In arguments before the judge on Friday over her sentence, Kevin Downey, one of Holmes’ lawyers, said that unlike other defendants in corporate fraud cases, the Theranos founder did not express greed by cashing out shares or spending money on “yachts and planes.” Instead, the money was “used to build medical technology.”

Federal prosecutor Jeffrey Schenk pointed out that Holmes did gain fame, admiration, and a lifestyle from the fraud, even if she did not make financial gains. “These still are benefits she’s receiving,” he said.

Friday’s sentencing hearing caps off Holmes’ stunning downfall. Once hailed as a tech industry icon for her company’s promises to test for a range of conditions with just a few drops of blood, she is now the rare tech founder to be convicted and face prison time for her company’s missteps.

Holmes, now 38, started Theranos in 2003 at the age of 19 and soon thereafter dropped out of Stanford University to pursue the company full-time. After a decade under the radar, Holmes began courting the press with claims that Theranos had invented technology that could accurately and reliably test for a range of conditions using just a few drops of blood taken from a finger prick.

Theranos raised $945 million from an impressive list of investors, including media mogul Rupert Murdoch, Oracle founder Larry Ellison, Walmart’s Walton family and the billionaire family of former Secretary of Education Betsy DeVos. At its peak, Theranos was valued at $9 billion, making Holmes a billionaire on paper. She was lauded on magazine covers, frequently wearing a signature black turtleneck that invited comparisons to late Apple CEO Steve Jobs. (She has not worn that look in the courtroom.)

The company began to unravel after a Wall Street Journal investigation in 2015 found the company had only ever performed roughly a dozen of the hundreds of tests it offered using its proprietary blood testing device, and with questionable accuracy. Instead, Theranos was relying on third-party manufactured devices from traditional blood testing companies.

In 2016, Theranos voided two years of blood test results. In 2018, Holmes and Theranos settled “massive fraud” charges with the Securities and Exchange Commission, but did not admit to or deny any of the allegations as part of the deal. Theranos dissolved soon after.

In her trial, Holmes alleged she was in the midst of a decade-long abusive relationship with her then-boyfriend and Theranos COO Ramesh “Sunny” Balwani while running the company. Balwani, she alleged, tried to control nearly every aspect of her life, including disciplining her eating, her voice and her image, and isolating her from others. (Balwani’s attorneys denied her claims.)

In July, Balwani was found guilty on all 12 charges in a separate trial and faces the same potential maximum prison time as her. Balwani is scheduled to be sentenced on December 7.

“The effects of Holmes and Balwani’s fraudulent conduct were far-reaching and severe,” federal prosecutors wrote in a November court filing regarding Holmes’ sentencing. “Dozens of investors lost over $700 million and numerous patients received unreliable or wholly inaccurate medical information from Theranos’ flawed tests, placing those patients’ health at serious risk.”

More than 100 people wrote letters in support of Holmes to Davila, asking for leniency in her sentencing. The list includes Holmes’ partner, Billy Evans, many members of Holmes’ and Evans’ families, early Theranos investor Tim Draper, and Sen. Cory Booker. Booker described meeting her at a dinner years before she was charged and bonding over the fact that they were both vegans with nothing to eat but a bag of almonds, which they shared.

“I still believe that she holds onto the hope that she can make contributions to the lives of others, and that she can, despite mistakes, make the world a better place,” Booker wrote, noting that he continues to consider her a friend.

Ahead of the hearing, there were also questions over how Holmes’ sentencing could be complicated by developments in her life after stepping down from Theranos. Holmes and her partner, Evans, who met in 2017, have a young son. Holmes is also pregnant, as confirmed by recent court filings and her most recent court appearance in mid-October.

Mark MacDougall, a white-collar defense lawyer and former federal prosecutor, told CNN Business before the hearing that the fact that Holmes has a young child could impact how she is sentenced.

“I don’t know how it can’t, just because judges are human,” he said.

MacDougall also said he doesn’t see what a long prison sentence accomplishes. “Elizabeth Holmes is never going to run a big company again,” he said. “She’s never going to be in a position to have something like this happen again.”

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Health

Lab-made blood could have enormous potential for people with rare blood conditions

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CNN
 — 

Scientists have transfused lab-made red blood cells into a human volunteer in a world-first trial that experts say has major potential for people with hard-to-match blood types or conditions such as sickle cell disease. The research could someday mean an end to long searches for compatible donors or dangerous transfusion reactions.

The experimental transfusion was done at Addenbrooke’s Hospital in Cambridge, England, as part of a collaborative effort among UK scientists to understand how lab-made blood transfusions could work.

The scientists took whole blood from donors in a UK database and separated out the stem cells. These are the body’s raw materials – the cells from which all specialized cells, like a red blood cell, can generate.

The researchers grew red blood cells from those stem cells and transfused them into two healthy volunteers.

The transfusions involved only a tiny amount of blood: the equivalent of one or two teaspoons. A standard blood transfusion would involve many hundred times that amount.

This stage of the trial involves two mini transfusions at least four months apart, one with a standard donation of red cells and the other with lab-made cells from the same donor.

The researchers are closely monitoring the volunteers to determine whether the process was safe. They say there have been with “no untoward side effects” so far.

They’re also watching how long the lab-grown cells last compared with an infusion of standard red blood cells. Red blood cells typically last about 120 days, but a transfusion from a standard donation contains cells that are a variety of ages because the bone marrow continuously makes these cells.

Previous tests have shown that manufactured cells function like normal cells and that these lab-made cells are likely to survive longer overall while in circulation. This study will determine for the first time whether that’s true.

Further trials will be necessary to determine whether there could be a clinical use of this lab-grown product.

The research could eventually make a difference for people with sickle cell disease, those who develop antibodies against most donor blood types, or those with genetic disorders in which their body can’t make red blood cells or the blood cells they make don’t work well.

Red blood cells are the helper cells that carry oxygen from the lungs to the body’s tissues, which use this oxygen to produce energy. The process also generates waste in the form of carbon dioxide that the red blood cells take to the lungs to be exhaled out.

With sickle cell disease – also called sickle cell anemia – red blood cells take on a folded shape that can clog tiny blood vessels and cause organ damage and pain. People with sickle cell often need multiple transfusions over the course of their lives.

“This world leading research lays the groundwork for the manufacture of red blood cells that can safely be used to transfuse people with disorders like sickle cell,” Dr. Farrukh Shah, a researcher on the study and medical director of transfusion for NHS Blood and Transplant, said in a news release. “The need for normal blood donations to provide the vast majority of blood will remain. But the potential for this work to benefit hard to transfuse patients is very significant.”

Dr. Glenn Ramsey, medical director of the blood bank at Northwestern Memorial Hospital and a professor of pathology at Northwestern University Feinberg School of Medicine, said he has had many patients over the years who are extremely difficult to transfuse and would have benefited from a therapy like the one in this study.

Often, if there is not a local blood match, he has to turn to the American Rare Blood Donor Program – and even then won’t always find an appropriate donor. In one case a few Thanksgivings ago, it was so difficult to find a match for one patient that they had to turn to a world database and bring in blood from Canada.

“This doesn’t come up very often, and it’s an extreme example, but this would be the kind of problem that these kinds of cells could try to solve,” said Ramsey, who was not involved in the new research.

He found the work “quite exciting” and its potential enormous.

Scientists have been working on this issue for many years, he said.

“Down the road in years to come, this might be a way to replace transfusions as we know it,” Ramsey said. “It’s still a long way from getting to that point, but it certainly starts us down the road to see if this will even be feasible.”

Dr. Cheryl Maier, an assistant professor of pathology and laboratory medicine and a medical director at the Emory Center for Transfusion and Cellular Therapies, said the experiment is a “really exciting advancement.”

She is particularly interested in the possibilities of lab-made red blood cell for people with sickle cell.

“There hasn’t been a lot of attention on some of these diseases, especially sickle cell, which mostly affects African American patients, and it can be really frustrating and disheartening that there isn’t more attention to it,” said Maier, who wasn’t involved in this study.

“For certain patients, especially patients with sickle cell disease or other patients that need some kind of chronic transfusion therapy, if you gave them incompatible blood, they would have oftentimes a very strong bad transfusion reaction,” she said.

The research could lay the groundwork for studies of things like platelets, which are often in critically short supply, she said. If scientists find that lab-made red blood cell products last longer, it may also improve the quality of life for people who wouldn’t have to be transfused as regularly.

“Even in 2022, there are patients that we almost can’t find units for, and they get a delay in their treatment because we can’t find matching units for them,” Maier said. “I think it definitely has the ability to revolutionize how we support some patients that are really difficult to support with blood products currently.”

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Health

Skipped cancer screenings this past year? It’s time to restart

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CNN
 — 

Many people postponed routine medical care because of disruptions related to the Covid-19 pandemic. That includes a decline in cancer screenings, such as mammograms and colonoscopies. In the meantime, cancer remains one of the major causes of death in the United States, second only to heart disease.

Why is cancer screening so important, and who should be screened for what types of cancer? How can people find out when their last exam was and what they are due for now? What if someone has fallen behind on their cancer screenings? And what should people do if they remain very concerned about their risk of contracting the coronavirus?

To help us with these questions, I spoke with CNN Medical Analyst Dr. Leana Wen, an emergency physician and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also author of “Lifelines: A Doctor’s Journey in the Fight for Public Health.”

CNN: Why is getting screened for cancer so important?

Dr. Leana Wen: Regular cancer screening is key to detecting cancer early. That allows for cancers to be found before someone has symptoms. In general, early detection of cancer results in better outcomes. A small, localized tumor may be removed before it has spread to other parts of the body, for example. Screening can also find abnormal cells that could become cancer, and prompt treatment could prevent that cancer from developing and spreading.

CNN: Who should be screened for which cancers, and when?

Wen: The three primary types of cancer screenings supported by the US Centers for Disease Control and Prevention are for breast, cervical and colorectal cancer. The US Preventive Services Taskforce (USPSTF), an influential national organization that makes disease prevention recommendations, advises mammograms every two years for women who are between 50 and 74 years old, who are at average risk for breast cancer.

A mammogram is a type of X-ray and available at most hospitals and outpatient radiology centers. According to the USPSTF, those at higher risk within this age group, and those under 50, should speak with their physician to determine the frequency of screenings. Some other medical organizations, including the American Cancer Society, recommend more frequent annual screening mammograms.

Cervical cancer screening is done through a Pap test, in which a health-care provider does a gynecological exam to collect a few cells and mucus from the patient’s cervix. The USPSTF recommends that for women and other people who have a cervix to receive a Pap test every three years starting at age 21, until age 65. Some individuals may receive more frequent screenings, depending on their risk factors.

The USPSTF also recommends that for all adults ages 45 to 75 to be screened for colorectal cancer. There are several screening tools involved. One is a stool-based test that detects the presence of certain markers in your stool. Another is the colonoscopy, which involves a procedure that uses a long flexible scope to look into your rectum and colon. The colonoscopy is generally recommended every 10 years. Which tests, and how often, will also depend on the individual’s medical history and family history.

CNN: What about lung cancer, which is another leading cause of death?

Wen: Lung cancer screening is also supported by the CDC, specifically for individuals between 50 and 80 years old with a history of heavy smoking, who smoke now, or who have quit within the past 15 years. The USPSTF recommends annual low-dose computed tomography screening, which is a type of CT scan that can be done in many hospitals and radiology facilities.

CNN: Are there other cancers people should screen for — for example, what about ovarian cancer or pancreatic cancer?

Wen: There are a lot of cancers, including ovarian, pancreatic, thyroid and skin cancer, for which there isn’t sufficient evidence to justify regular, ongoing screening tests in individuals with average risk factors. If there is a particular type of cancer that runs in your family, you should ask your physician about the benefits of screening. Of course, if you develop symptoms — for example, you discover a new growth on your neck or there is a discoloration of your skin that’s changing in appearance — you should definitely consult your healthcare provider.

CNN: A lot of people may not recall when they had their last screening test, especially if they moved or changed healthcare providers. How should they find out if they’re due?

Wen: If you’ve had the same doctor throughout, you could call your physician’s office and find out the dates of your last screening tests. If you changed physicians but they are in the same hospital network, your healthcare system should have these records — and you might be able to access them if your provider offers an electronic patient portal.

Another possibility is to contact your insurance company, if you’ve had the same insurance company over the last several years. They should also have records of your last preventive tests. And you can always contact previous providers. In general, it’s a good idea to have copies of your old medical records so they can be compared with new test results.

CNN: What if you missed several screening tests? Would you recommend that people catch up with them as soon as possible?

Wen: Yes. A lot of patients missed screening tests for all kinds of reasons. Perhaps fear of Covid-19 resulted in delays. Perhaps they moved or changed jobs. Perhaps they had kids or grandkids or other new caregiving responsibilities, and life got busy. Find out which tests you are due for and start scheduling them now.

I’d add that this goes for other preventive services too. Make sure you are also on track with screenings for high blood pressure, diabetes, high cholesterol and other chronic conditions. The sooner these conditions are detected and flagged as potential problems, the sooner you can know and begin to address them.

CNN: There are some people who remain very concerned about their risk of contracting Covid-19 while undergoing screenings. What’s your advice for them?

Wen: Healthcare settings tend to be very cautious and have been taking many steps to reduce Covid-19 risk. People who are concerned about contracting Covid-19 should ask the facility where they’d get the tests what type of mitigation measures are being used. Are all staff masked while seeing patients, for example? Remember that one-way masking with a high-quality mask works very well. For mammograms and Pap tests, and for visits with your doctor, you can wear an N95 or equivalent throughout the exam. For colonoscopies, this might not be possible during the whole procedure, but almost certainly the colonoscopy will be done in a room where others are masked the entire time.

You can also reduce your risk of severe illness further by making sure you are up-to-date on your coronavirus boosters. If you are eligible for the preventive antibody Evusheld, that’s something you should take advantage of too.

Finally, it’s important to put the risk of Covid-19 into context. Absence of the coronavirus is not the only marker of good health, and we need to consider good health, both physical and mental health, in a holistic way, which includes keeping on track with preventive healthcare like cancer screenings.

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Health

Cancer death rates fall steadily in the US, with more survivors than ever

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CNN
 — 

More people are surviving cancer than ever before in the United States, according to a new report from the American Association for Cancer Research.

In the past three years, the number of cancer survivors in the US – defined as living people who have had a cancer diagnosis – increased by more than a million. There are 18 million survivors in the US as of January, with that number expected to increase to 26 million by 2040, the association said. The report notes that there were only 3 million US cancer survivors in 1971.

For all cancers combined, the five-year overall survival rate has increased from 49% in the mid-1970s to nearly 70% from 2011 to 2017, the most recent years for which data is available.

The overall cancer death rate, adjusted for age, continues to drop, with reductions between 1991 and 2019 translating into nearly 3.5 million deaths avoided, the association said.

Declines in smoking and improvements in catching and treating cancer early are driving the change, according to the AACR Cancer Progress Report 2022, released Wednesday.

Dr. Lisa Coussens, president of the association, said in a statement that part of the credit goes to an investment in research – both for treatments and for understanding the disease.

“Targeted therapies, immunotherapy, and other new therapeutic approaches being applied clinically all stem from fundamental discoveries in basic science,” she said. “Investment in cancer science, as well as support for science education at all levels, is absolutely essential to drive the next wave of discoveries and accelerate progress.”

For example, between August 1 and July 31, the US Food and Drug Administration approved eight anticancer therapeutics, expanded the use of 10 previously approved medications to treat new cancer types, and approved two diagnostic imaging agents, Coussens said at a news conference Wednesday.

Increased funding for cancer research is a cornerstone of President Joe Biden’s relaunched Cancer Moonshot initiative.

Biden – who lost a son to brain cancer – said this month that his goal is to cut cancer death rates in the United States by at least half in the next 25 years.

“Cancer does not discriminate red and blue. It doesn’t care if you’re Republican or Democrat. Beating cancer is something we can do together,” said Biden, who initially helmed the initiative when he was vice president under Obama.

The new report urges Congress to fully fund and support Biden’s goal to “end cancer as we know it.”

“The reignited Cancer Moonshot will provide an important framework to improve cancer prevention strategies; increase cancer screenings and early detection; reduce cancer disparities; and propel new lifesaving cures for patients with cancer,” the report says, adding that the “actions will transform cancer care, increase survivorship, and bring lifesaving cures to the millions of people whose lives are touched by cancer.”

Although nearly 3.5 million cancer deaths were avoided between 1991 and 2019, more than 600,000 people in the US are still expected to die from cancer this year, according to the association.

“In the United States alone, the number of new cancer cases diagnosed each year is expected to reach nearly 2.3 million by 2040,” the report says.

About 40% of cancer cases in the US are attributable to preventable risk factors, such as smoking, drinking too much alcohol, eating a poor diet, not exercising enough and being obese, according to the report.

But there are also ongoing challenges such as health disparities that affect racial and ethnic minorities and barriers to health care such as limited health insurance coverage and living in rural areas.

In a recorded statement played at the news conference, US Rep. Nikema Williams said she learned after her mother died of cancer that “health care in America is not a human right yet.”

“We have two health care systems in this country: one for people who can afford preventative services and quality treatment and one for everyone else,” said Williams, a Democrat from Georgia.

The reversal of Roe v. Wade is also expected to affect cancer care by limiting health care options for pregnant women with cancer, the report said.

“With the recent Supreme Court decision to overturn Roe v. Wade, which ends the constitutional right to an abortion, there is uncertainty surrounding how a particular cancer treatment may lead to the termination of a pregnancy. Such uncertainty may prohibit some physicians from prescribing a drug or performing other health services in a timely manner due to the potential legal consequences for both physician and mother,” according to the report.

The Covid-19 pandemic had an effect on cancer in the US, with nearly 10 million breast, colorectal and prostate cancer screenings missed in 2020.

The report offers recommendations to build on the progress and regain momentum.

“Making progress to end cancer means more birthdays, more Christmases, more graduations and everyday moments for families everywhere,” Williams said.

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