Blog

According to French researchers, the incidence of cancer is expected to increase by more than 75% by the year 2030 in developed countries, and over 90% in developing nations. The study is published Online First in the Lancet Oncology.

The researchers, led by Dr Freddie Bray of the International Agency for Research on Cancer (IARC) in Lyon, France, set out to determine how the current and future patterns of incidence and mortality of different types of cancer vary between nations with different levels of development, as measured by their Human Development Index (HDI).

In nations transitioning towards higher levels of human development, there appears to be a reduction in incidence rates of some types of cancer, such as stomach cancer and cervical cancer. However, the incidence of breast, colorectal, and prostate cancer is expected to increase substantially in higher-HDI countries.
Dr Bray explained:

“Cancer is already the leading cause of death in many high-income countries and is set to become a major cause of morbidity and mortality in the next decades in every region of the world; this study serves as an important reference point in drawing attention to the need for global action to reduce the increasing burden of cancer.”

Using data from GLOBOCAN, the researchers examined estimates of cancer incidence and mortality in 2008 in 184 countries. The team found the patterns of the most prevalent types of cancer varied according to four levels of human development.
The team then used these findings to project how the burden of cancer is likely to change by the year 2030. Their projections took into account predicted changes in population size and aging, in addition to the changing trends in incidence rates of 6 of the most prevalent types of cancer in nations with medium, high, and very high levels of HDI.

At present, there is a high incidence of cancers associated with infection in nations with a low HDI (mainly countries in sub-Saharan Africa), particularly cervical cancer, as well as stomach cancer, liver cancer and Kaposi’s sarcoma, depending on the region or country. By contrast, the burden of lung, breast, colorectal and prostate cancer is greater in countries with a higher HDI, such as the UK, Russia, Australia, and Brazil.
According to the researchers, by 2030, the number of cancer cases are expected to increase by 78% in medium HDI countries, such as China, India, and South Africa, and by 93% in low HDI countries.

The researchers also found the following trends:

• Even though very high HDI countries only contain 15% of the world’s population, they accounted for 40% of cancer cases in the world in 2008.
• Although the incidence of stomach and cervical cancer is decreasing in nations with medium, high, or very high levels of HDI, there are a number of exceptions for cervical cancer.
• The incidence of female breast cancer and prostate cancer seems to be increasing in the majority of countries currently with medium, high, or very high levels of HDI.
• Lung cancer incidence rates appears to be decreasing in men in countries with high and very high HDI levels, but increasing in women.
• Although lung cancer is currently not a leading cancer in low HDI regions, it will become a leading cause of cancer unless tobacco smoking is controlled in these areas.

Dr Christopher Wild, International Agency for Research on Cancer Director, explained:

“This study reveals the dynamic nature of cancer patterns in a given region of the world over time. Countries must take account of the specific challenges they will face and prioritize targeted interventions to combat the projected increases in cancer burden via effective primary prevention strategies, early detection, and effective treatment programs.”

Read more at Medical News Today.

Last week the Maryland State Public Health Laboratory identified Listeria preliminarily determined to be Listeria monocytogenes from retail cheeses produced by Roos Foods out of Kenton, Delaware. Roos Foods produces Latin-style cheeses under several product labels (Santa Rosa de Lima, Amigo, Mexicana, Suyapa, La Chapina, La Purisima, Crema Nica) and distributes its products to VA, MD and DC. Food safety inspectors from the Virginia Department of Agriculture and Consumer Services have also reported the presence of this bacterium in a sample of cheese collected from a Virginia retail location. As a measure of precaution District food safety officials are pulling the products from shelves at retail locations.

As of February 21, 2014, no cases of Listeria associated with this cheese have been reported to the DC Department of Health, but we would like clinicians to be aware of this potential health risk. Listeriosis associated with contaminated food can cause a wide spectrum of clinical symptoms ranging from febrile gastroenteritis to potentially fatal bacteremia and meningitis in higher risk groups such as older adults and persons with certain medical conditions1. Pregnant women infected with this bacterium frequently experience a mild influenza-like illness or an asymptomatic infection1. Pregnancy-associated listeriosis can result in fetal loss, preterm delivery, invasive neonatal infection, and infant death1. Anyone who purchased the product should be advised not consume it and to discard any remaining portions.

Listeriosis is a reportable disease in DC. Healthcare providers are required to report cases of Listeriosis to the DC Department of Health, Division of Epidemiology– Disease Surveillance and Investigation (DE-DSI) by fax at (202) 442-8060. If you have any questions, please contact us at (202) 442-8141.

                                   Some Listeria facts:

Listeria can be found in:

• Ready-to-eat deli meats and hot dogs
• Refrigerated pates or meat spreads
• Unpasteurized (raw) milk and dairy products
• Soft cheese made with unpasteurized milk, such as queso fresca, brie, feta, camembert
• Refrigerated smoked seafood
• Raw sprouts

Incubation period: 3-70 days

Symptoms: Fever, stiff neck, confusion, weakness, vomiting, sometimes preceded by diarrhea

Duration of illness: Days to weeks

Who’s at risk:

• Pregnant women
• Older adults
• People with weakened immune systems
• Organ transplant patients who are taking drugs to prevent them from rejecting the organ
• People with certain diseases such as HIV/AIDS, cancer, end-stage renal disease, liver disease, alcoholism, diabetes

Read more at NBC News.

While overall mortality from heart disease is declining, the number of younger women with heart disease is growing. A new study by the Canadian-led global INTERHEART group shows that nine factors account for 90% of the risk for a first myocardial infarction:

• Smoking
• Lipids
• Hypertension
• Diabetes
• Obesity
• Diet
• Physical Activity
• Psychosocial Factors

Cardiovascular disease has been the leading killer of American women since 1908. Death rates from heart disease are increasing in women aged 35 to 54 years, most likely as a result of obesity. Cardiovascular disease causes one death per minute in the U.S.– that amounts to a staggering 421,918 deaths every year. More than 12 million women in the U.S. are suffering from Type II diabetes. Across the globe, heart disease is the leading cause of death in women in every major developed country and most emerging economies.

Waking up and not feeling rested isn’t just annoying. Researchers say that “non-restorative sleep” is the biggest risk factor for the development of widespread pain in older adults.

Widespread pain that affects different parts of the body — the main characteristic of fibromyalgia — affects 15 percent of women and 10 percent of men over age 50, according to previous studies.

To identify the triggers of such widespread pain, British researchers compiled demographic data as well as information on the pain and physical and mental health of more than 4,300 adults older than 50. About 2,700 had some pain at the study’s start, but none had widespread pain.

The results, published Feb. 13 in Arthritis & Rheumatology, show that restless sleep as well as anxiety, memory problems and poor health play a role in the development of this type of pain.

Three years after the study began, 19 percent of the participants had new widespread pain, the researchers found.

This new pain in various parts of the body was worse for those who had some pain at the beginning of the study. Of those with some prior pain, 25 percent had new widespread pain. Meanwhile, 8 percent of those with no pain at the start of the study had widespread pain three years later.

“While osteoarthritis is linked to new onset of widespread pain, our findings also found that poor sleep, [memory], and physical and psychological health may increase pain risk,” concluded the study’s leader, Dr. John McBeth, from the arthritis research center at Keele University in Staffordshire, England.

“Combined interventions that treat both site-specific and widespread pain are needed for older adults,” McBeth added in a journal news release.

Increasing age, however, was linked to a lower chance of developing widespread pain. Muscle, bone and nerve pain is more common among older people. Up to 80 percent of people 65 and older experience some form of pain on a daily basis, according to the news release.

While the study finds an association between poor sleep and widespread pain, it does not establish a direct cause-and-effect relationship.

SOURCE: Arthritis & Rheumatology, news release, Feb. 13, 2014

Regardless of how much time older Americans spend being active, those who sit for more hours each day are more likely to be disabled, according to a new study. Researchers found that every hour people 60 years old and older spent sitting daily was tied to a 46 percent increased risk of being disabled – even if they also exercised regularly.

“It was its own separate risk factor,” Dorothy Dunlop told Reuters Health. Dunlop is the study’s lead author from the Northwestern University Feinberg School of Medicine in Chicago. “We know that being active is good for your health and we know a sedentary lifestyle is bad for your health,” she said. But few studies have examined whether moderate to vigorous physical activity offsets the possible negative effects of being sedentary.

Dunlop and her colleagues write in the Journal of Physical Activity and Health that Americans already lead sedentary lifestyles. Among older Americans disability is also a major concern because it has been linked to increased medical spending and a higher risk of going into a nursing home or other care facility.

If future studies can confirm that sedentary behavior causes disability, which this study does not, then older people may possibly avoid becoming disabled by being more active throughout the day. For the new report, Dunlop and her colleagues analyzed data collected in 2003 through 2006 as part of a long-term government study of American health. The researchers used information on 2,286 adults who were 60 years old or older, had worn a device that measures physical activity for at least four days and had a physical exam. Participants were considered to have a disability if they couldn’t perform a self-care task, such as getting dressed, by themselves. Survey participants spent about 14 hours awake each day, on average. Of that, an average of nine hours was spent sitting or otherwise not moving.

After taking into account the amount of time people spent doing moderate to vigorous physical activity, their age, their health and whether they were well-off, the researchers found that each hour of daily sitting was linked to a 46 percent increased risk of having a disability. The study can’t say whether a sedentary lifestyle leads to disability or if having a disability leads to a sedentary lifestyle, however. In addition, the authors note that their records of physical activity may not take into account some forms of exercise, because the devices that participants wore may not pick up upper body movement or cycling. Participants also didn’t wear the devices while swimming.

Stephen Kritchevsky told Reuters Health it’s too early to tell if interventions that get people moving during the day will prevent disability, but they couldn’t hurt because other studies suggest activity improves functioning. He heads the Sticht Center on Aging at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina and wasn’t involved in the new research. “The fact that people are physically limited in some way is even a bigger reason to try and do things, because there is plenty of research that shows that’s likely to improve function,” Kritchevsky said.

Dunlop said older adults should be as physically active as possible. They should also know that being sedentary is possibly bad for their health. “The goal here is to accumulate more light activities to replace the sitting and keep going on the moderate activity that you’re already engaged in,” she said.

SOURCE: (Reuters) Journal of Physical Activity and Health, online February 19, 2014.

A study at the National Cancer Institute (NCI) has shown that women who take aspirin daily may reduce their risk of ovarian cancer by 20%. Prior research has suggested that the anti-inflammatory properties of aspirin and non-aspirin NSAIDs may reduce overall risk of cancer, but studies specific to ovarian cancer have been inconclusive. This is the largest study to date on risk reduction in ovarian cancer and these medications. Britton Trabert, PhD, and Nicolas Wentzensen, MD, PhD, and their colleagues from NCI’s Division of Cancer Epidemiology and Genetics examined data from 12 large epidemiological studies (9 from the US) of nearly 8,000 women with ovarian cancer and close to 12,000 women without ovarian cancer. Eighteen percent reported that they used aspirin, 24% used non-aspirin NSAIDs, and 16% used acetaminophen. Daily aspirin users had a 20% lower risk of ovarian cancer compared to those who took it less than once a week. Women who reported using NSAIDs at least once a week showed a reduction in risk that was not statistically significant, and acetaminophen was not associated with a reduction in ovarian cancer risk.

Source: MPR

Worldwide prevalence of dementia is expected to reach 65.7 million and 115.4 million in 2030 and 2050, respectively. Currently, there is no effective therapy to delay the onset or halt the progression of dementia, a growing public health problem with priority for research. The potential protection on cognition has been examined for some nutrients such as fatty acids, vitamins, fish, fruit and vegetables but observational and experimental studies have provided inconsistent results. Defining the effect of diet on health by the overall dietary pattern instead of a single or a few nutrients allows to study the synergy among nutrients and avoids problems due to confounding, multiple testing and collinearity among them. The Mediterranean diet (MedDiet) is characterized by the use of olive oil as the main culinary fat and high consumption of plant-based foods (fruits and nuts, vegetables, legumes and minimally processed cereals). It also includes moderate-to-high consumption of fish and seafood and low consumption of butter or other dairy products and meat or meat products. Regular but moderate intake of alcohol, preferentially red wine during meals, is customary. An intervention with MedDiets enhanced with either EVOO or nuts appears to improve cognition compared with a low-fat diet. (Journal of Neurology, Neurosurgery, and Psychiatry)

Read more here.

According to the Centers for Disease Control and Prevention, cancer is the second most common cause of death, surpassed only by heart disease. It accounts for nearly one of every four deaths in the U.S. each year. At the Presidential Healthcare Center, we offer many different types of cancer screenings–customized to your lifestyle and risk factors–in order to catch diseases in their earliest stages.

Breast cancer is the most common cancer among American women, other than skin cancer. Mammography can detect breast cancer at an early stage when treatment may be more effective and a cure is more likely.

According to the Centers for Disease Control and Prevention, colorectal cancer is the second leading cause of cancer deaths in the U.S. More than 130,000 new cases are diagnosed each year. Regular colorectal screening can prevent colorectal cancer. Screening can detect precancerous polyps, which can be removed before they have the chance to turn into cancer. There are many types of screening tests available, although they have different testing frequencies.

An estimated 12,000 new cases of cervical cancer are diagnosed each year. When detected early, however, cervical cancer is preventable. Cervical cancer can be found early by having regular Pap tests. A Pap test can find changes in the cervix before cancer develops; it can also find cervical cancer early, in its most treatable stage.

At PHC, our preventive executive physicals provide the most extensive cancer screening available to ensure that our patients catch any abnormalities early, before they become major health issues. Each patient receives a custom-tailored program designed specifically for the individual’s needs, concerns, and risk factors, including family history. Celebrate Cancer Prevention Month by scheduling a preventive executive physical for yourself and your loved ones!

A new study links consumption of more sugary foods with a higher risk of death from heart disease. The assessment is the latest addition to a growing body of evidence that “too much sugar does not just make us fat, it can also make us sick,” according to health policy professor Laura Schmidt at the University of California, San Francisco.

Schmidt wrote a commentary accompanying the new study in the journal JAMA Internal Medicine. The study focuses on sugar added to foods as opposed to those occurring naturally in fruits and vegetables.

Those who ate the most added sugar – making up more than one-fifth of their daily calories – were twice as likely to die from heart disease as those who ate a healthy diet with less than 10 percent added sugar. Soda, energy drinks and other sugar-sweetened beverages were the biggest sources.

One can of soda contains about 140 calories, or about 7 percent of an average, 2,000-calorie diet. The researchers used data from a large, ongoing national study on all kinds of health issues.  Thousands of people across the country answer questions about their diet and other health behaviors and get a physical.  The researchers also check to see if participants show up in national death records.

While other studies have looked at the link between added sugar and obesity, diabetes, heart disease and more, “this paper is the first to look at death from heart disease,” said nutrition professor Rachel Johnson at the University of Vermont, “so, sort of the ultimate end point.” Johnson heads the nutrition committee for the American Heart Association but was not involved with this research.

“Most of us consume much more [added sugar] than healthy diets recommend,” said study co-author Quanhe Yang, an epidemiologist at the U.S. Centers for Disease Control and Prevention. The study found the average American consumed about 15 percent of the day’s calories as added sugar.

“Compared with people in the lowest consumption group, you have roughly a 30 percent increased risk of dying from cardiovascular disease,” Yang said. Add one can of soda a day, however, and the risk goes way up.

“If you just [drank] one can of sugar sweetened beverage, you may put yourself into another category, which is doubling your risk of cardiovascular mortality,” he added.

New York City is trying to limit the size of sodas, but is fighting a legal challenge.  Mexico has recently imposed a tax on soda and other sugary foods.  Johnson said state and local governments in the United States also are considering taxes as a way to discourage consumption.

“I think we’re going to continue to see a lot of policy initiatives around how do we make the healthy choice the easy choice for people,” she added.

Many of these initiatives face opposition from those who see them as restricting individual freedom.

Source: Voice of America

While adults make up 95 percent of those who die annually from vaccine preventable diseases, a new study from the University of Colorado School of Medicine shows their vaccination rates remain stubbornly low, representing a growing public health concern.

The study, published recently in the Annals of Internal Medicine, is the first to examine several important aspects of adult vaccination. Every year, 30,000 people on average die of vaccine preventable illnesses, almost all of them adult.

“Our study suggests that missed opportunities for adult vaccination are common because vaccination status is not being assessed at every (physician’s) visit, which is admittedly an ambitious goal,” said Laura Hurley, MD, MPH lead author of the study and an assistant professor of medicine at the CU School of Medicine. “Also, most physicians are not stocking all recommended vaccines.”

Recent estimates show only 62 to 65 percent of adults aged 65 and older received a pneumococcal or influenza vaccine respectively; just 20 percent of high risk adults between 19 and 64 received a pneumococcal vaccine and only 16 percent of those 60 and older got their herpes zoster (shingles) vaccination.

Hurley and her fellow researchers designed a national survey of primary care physicians in collaboration with the Centers for Disease Control and Prevention looking at how doctors assessed vaccination status and stocked the 11 recommended adult vaccines in 2012.

“Physicians reported a variety of barriers to vaccine stocking and administration but financial barriers dominated the list,” the study said. “Physicians in smaller, private practice often assume more risks from stocking expensive vaccine inventories and may be particularly affected by these financial barriers.”

According to Hurley, who also practices at Denver Health, many doctors expressed difficulty getting reimbursed by insurance for vaccines.

For example, the herpes zoster vaccine has been recommended since 2008 but is not widely stocked by physicians. One major reason for this, the study says, is that zoster is covered by Medicare Part D, a pharmaceutical benefit, and physicians report problems with reimbursement. At the same time, the vaccine can require substantial out-of-pocket costs for patients, making it less attractive to them as well.

As a result of these difficulties, many physicians are referring patients to pharmacies or public health facilities for vaccinations. “The most commonly reported reasons for referring patients elsewhere for vaccines included insurance not covering the vaccine,” the study said.

There were also problems coordinating vaccine records when done by someone who is not the patient’s primary care physician. The study makes recommendations for improving the overall situation.

It suggests using Immunization Information Systems or IIS, a confidential database that records all vaccine doses administered by providers in a certain area. The system can allow doctors to know the vaccination status of their patients.

The authors point out that the Affordable Care Act addresses financial barriers to vaccination for privately insured patients by requiring insurers to cover recommended vaccines with no co-pays when delivered by in-network providers. There have also been recommendations for legislative action aimed at making Medicare Part D less of an obstacle to adult vaccinations.

“I feel we need to take a more systematic approach to this issue,” Hurley said. “As the population ages this could easily grow into a more serious public health issue.”

Source: Science Daily