The Annals of Internal Medicine, publisher of the controversial USPSTF Breast Cancer Recommendations (funded by AHRQ), is inviting feedback. On its website, you can take their survey and give them feedback on whether you will follow their recommendations.
To recap, the recommendations are, no annual screening for women between the ages of 40-49, no screening for women over age 75, and screening every other year for women between the ages of 50-74.
Alternately, if you want to go straight to the survey, just click here.
Friday, November 20, 2009
Wednesday, November 18, 2009
ACS Stands Firm
Today is the Great American Smokeout, sponsored by the American Cancer Society (ACS). I’m a big fan of the ACS this week – it takes real resolve to stick up for patients in the midst of an HHS-funded initiative to send women’s breast cancer screening back into the 1950’s and a healthcare reform bill that is weak on oncology treatment. Yet the ACS stands firm, so the least I can do is give them a shout out on their Great American Smokeout.
The American Cancer Society has a huge uphill battle on its hands. This is the 34th year the Great American Smokeout and so much progress has been made in anti-smoking and public health initiatives – until this year. The ACS finds itself the partner of the CDC which, under the leadership of Thomas R. Frieden, has been apathetic at best to plight of chronic disease in America caused by smoking. Dr. Frieden lost his will to combat smoking about the time he received his political appointment from President Barack Obama – a smoker (surely this is just a coincidence).
The unfortunate situation is that all of the progress that has been over the last several decades has gone up in one big puff of Presidential smoke – adult smoking rates are increasing for the first time in decades. The CDC is ignoring the issue. Thankfully, the American Cancer Society isn’t willing to buckle to political pressure and is willing to stand firm on anti-smoking measures.
Thank you to the American Cancer Society!
The American Cancer Society has a huge uphill battle on its hands. This is the 34th year the Great American Smokeout and so much progress has been made in anti-smoking and public health initiatives – until this year. The ACS finds itself the partner of the CDC which, under the leadership of Thomas R. Frieden, has been apathetic at best to plight of chronic disease in America caused by smoking. Dr. Frieden lost his will to combat smoking about the time he received his political appointment from President Barack Obama – a smoker (surely this is just a coincidence).
The unfortunate situation is that all of the progress that has been over the last several decades has gone up in one big puff of Presidential smoke – adult smoking rates are increasing for the first time in decades. The CDC is ignoring the issue. Thankfully, the American Cancer Society isn’t willing to buckle to political pressure and is willing to stand firm on anti-smoking measures.
Thank you to the American Cancer Society!
Monday, November 16, 2009
AHRQ: Ration Breast Cancer Screening
The U.S. Preventative Services Task Force (USPSTF) of HHS’ Agency for Healthcare Research and Quality (AHRQ) has launched an all-out jihad on women. The AHRQ and USPSTF are making some pretty radical recommendations: no mammography for women over age 74, a recommendation against mammo for women age 40-49 and mammo only every other year for women age 50-74. It’s not that there isn’t a compelling reason to skip on mammography, it’s that it costs too much. Under the new recommendations, a woman could develop advanced stage breast cancer and die by the time HHS would allow her to get screened.
This measure is nothing more than healthcare rationing. We’ve seen this move from the Administration before – several months ago, CMS decided to ignore scientific evidence and decline payments for virtual colonoscopies. Add to this, HHS’ desire to see prevention, screening and treatment for prostate cancer stripped from the books, I think it’s safe to say that the U.S. Department of Health & Human Services new approach to cancer is: Death is Cheap. To the Government, you are less of a financial burden if you’re dead.
These recommendations are all the more concerning because some would like for AHRQ’s recommendations to become standard. In fact, health reform legislation pending in Congress could mandate AHRQ recommendations as a basis for payment (or denial). I have to wonder if HHS is this willing to engage in care rationing before healthcare reform legislation is passed, how aggressive will they be after? If the Government is not willing to screen and treat for Cancer, what’s next? Childhood leukemia? And who gets to make these decisions?
Thankfully, everyone who supports the rights of women and believes in actually providing healthcare (vs. rationing care) has condemned this. Some of the criticisms include:
The Scientific Advisory Board over at Susan G. Komen opposes these new recommendations, although, for political reasons, they haven’t come out strongly on this issue: “We want to eliminate any impediments to regular mammography screening for women age 40 and older. It is our view, however, that the exact timing of assessments is less important than guaranteeing access to screening. New screening approaches and more individualized recommendations for breast cancer screening are urgently needed. Susan G. Komen for the Cure supports research initiatives designed to improve screening, and we believe that it is imperative that this research move forward rapidly.” I’ve long been a critic of Susan G. Komen and the way they operate. However, I’d like to applaud them for actually talking sense in this situation.
“I’m riled up; this is a giant step backward and a terrible mistake,” said the founder of Breastcancer.org, Dr. Marisa Weiss, an oncologist who practices at Lankenau Hospital in Wynnewood, Pa. “We know mammography overperforms and finds things that will never be life-threatening, and we know it underperforms in some women. But it has no chance to perform in women who don’t get it.” (quoted in the New York Times)
“You’re going to start losing a lot of women,” said Sylvia Moritz, 54, of Manhattan, who learned she had breast cancer at 48 after an annual mammogram. “I have two friends in their 40s who were just diagnosed with breast cancer. One of them just turned 41. If they had waited until she was 50 to do a routine mammogram, they wouldn’t have to bother on her part — she’d be dead.” (quoted in the New York Times)
"The USPSTF recommendations are a step backward and represent a significant harm to women's health. To tell women they should not get regular mammograms starting at 40 when this approach has overwhelmingly been shown to save lives is shocking. At least 40 percent of the lives saved by mammographic screening are of women aged 40-49. These recommendations are inconsistent with current science and apparently have been developed in an attempt to reduce costs. Unfortunately, many women may pay for this unsound approach with their lives," said W. Phil Evans, M.D., FACR, president of the Society of Breast Imaging (SBI).
“These unfounded USPSTF recommendations ignore the valid scientific data and place a great many women at risk of dying unnecessarily from a disease that we have made significant headway against over the last 20 years… These new recommendations seem to reflect a conscious decision to ration care,” said Carol H. Lee, M.D., chair of the American College of Radiology Breast Imaging Commission.
One thing is absolutely certain: it is open season on women’s health and it is open season on preventing cancer deaths.
If you do one thing tonight, call the women in your life – your mothers, your sisters, your grandmothers, your daughters – and tell them that you love them…while you still can.
This measure is nothing more than healthcare rationing. We’ve seen this move from the Administration before – several months ago, CMS decided to ignore scientific evidence and decline payments for virtual colonoscopies. Add to this, HHS’ desire to see prevention, screening and treatment for prostate cancer stripped from the books, I think it’s safe to say that the U.S. Department of Health & Human Services new approach to cancer is: Death is Cheap. To the Government, you are less of a financial burden if you’re dead.
These recommendations are all the more concerning because some would like for AHRQ’s recommendations to become standard. In fact, health reform legislation pending in Congress could mandate AHRQ recommendations as a basis for payment (or denial). I have to wonder if HHS is this willing to engage in care rationing before healthcare reform legislation is passed, how aggressive will they be after? If the Government is not willing to screen and treat for Cancer, what’s next? Childhood leukemia? And who gets to make these decisions?
Thankfully, everyone who supports the rights of women and believes in actually providing healthcare (vs. rationing care) has condemned this. Some of the criticisms include:
The Scientific Advisory Board over at Susan G. Komen opposes these new recommendations, although, for political reasons, they haven’t come out strongly on this issue: “We want to eliminate any impediments to regular mammography screening for women age 40 and older. It is our view, however, that the exact timing of assessments is less important than guaranteeing access to screening. New screening approaches and more individualized recommendations for breast cancer screening are urgently needed. Susan G. Komen for the Cure supports research initiatives designed to improve screening, and we believe that it is imperative that this research move forward rapidly.” I’ve long been a critic of Susan G. Komen and the way they operate. However, I’d like to applaud them for actually talking sense in this situation.
“I’m riled up; this is a giant step backward and a terrible mistake,” said the founder of Breastcancer.org, Dr. Marisa Weiss, an oncologist who practices at Lankenau Hospital in Wynnewood, Pa. “We know mammography overperforms and finds things that will never be life-threatening, and we know it underperforms in some women. But it has no chance to perform in women who don’t get it.” (quoted in the New York Times)
“You’re going to start losing a lot of women,” said Sylvia Moritz, 54, of Manhattan, who learned she had breast cancer at 48 after an annual mammogram. “I have two friends in their 40s who were just diagnosed with breast cancer. One of them just turned 41. If they had waited until she was 50 to do a routine mammogram, they wouldn’t have to bother on her part — she’d be dead.” (quoted in the New York Times)
"The USPSTF recommendations are a step backward and represent a significant harm to women's health. To tell women they should not get regular mammograms starting at 40 when this approach has overwhelmingly been shown to save lives is shocking. At least 40 percent of the lives saved by mammographic screening are of women aged 40-49. These recommendations are inconsistent with current science and apparently have been developed in an attempt to reduce costs. Unfortunately, many women may pay for this unsound approach with their lives," said W. Phil Evans, M.D., FACR, president of the Society of Breast Imaging (SBI).
“These unfounded USPSTF recommendations ignore the valid scientific data and place a great many women at risk of dying unnecessarily from a disease that we have made significant headway against over the last 20 years… These new recommendations seem to reflect a conscious decision to ration care,” said Carol H. Lee, M.D., chair of the American College of Radiology Breast Imaging Commission.
One thing is absolutely certain: it is open season on women’s health and it is open season on preventing cancer deaths.
If you do one thing tonight, call the women in your life – your mothers, your sisters, your grandmothers, your daughters – and tell them that you love them…while you still can.
Sunday, November 15, 2009
Niaspan Beats Zetia in Minor Study
Abbott Lab’s Niaspan beat out Merck’s Zetia (ezetimibe) in concomitant therapy with statins when looking at atherosclerosis. The study, which was presented at the American Heart Association scientific meeting in Orlando, was tiny in scope with only 208 patients participating.
This is bad news for Merck. The company’s Zetia has had negative news in previous trials. Also, sales of Vytorin have stumbled in recent years.
This is bad news for Merck. The company’s Zetia has had negative news in previous trials. Also, sales of Vytorin have stumbled in recent years.
Brilinta Trumps Plavix
AstraZeneca’s Brilinta topples Bristol-Myers Squibb and Sanofi-Aventis’ Plavix in a head-to-head trial – again. Previous trials showed similar results. Brilinta prevented more serious cardiovascular events and deaths than Plavix. Brilinta seems to have an equivalent safety profile.
This study was an analysis of over 8,400 of the sickest patients from the large PLATO trial – which looked at over 18,000 patients internationally.
AstraZeneca will be filing for U.S. approval for Brilinta soon and the company expects approval early next year. This is good news for AstraZeneca as it hopes to steal some of Plavix’s $9 billion in sales.
This study was an analysis of over 8,400 of the sickest patients from the large PLATO trial – which looked at over 18,000 patients internationally.
AstraZeneca will be filing for U.S. approval for Brilinta soon and the company expects approval early next year. This is good news for AstraZeneca as it hopes to steal some of Plavix’s $9 billion in sales.
Thursday, November 12, 2009
Smoking Increases – It’s Cool Again
In addition to acknowledging its underestimated of H1N1 deaths earlier today, the CDC also acknowledged that adult smoking rates have increased for the first time in decades. Adult smokers are now back over the critical 20% threshold.
I all but predicted this in a recent posting Politics and the Failure of Public Health. In that posting I noted that the CDC has all but given up on solving the problems of chronic disease and we know that smoking is at the root of many of those conditions – heart disease, cancer, obesity and a host of others.
In that posting, I also questioned whether the CDC’s lack of efforts in reducing smoking have something to do with our Smoker in Chief – President Barack Obama. Obama has made smoking cool again. There’s a swagger to being a smoker now that hasn’t existed in many years. The CDC’s head Dr. Thomas R. Frieden has made a crusade against smoking – a mission he seems to have promptly abandoned once he received his appointment from President Obama.
Chronic disease is a critical health issue. This is an area calling out for CDC leadership – and leadership from Dr. Thomas Frieden. Hopefully Dr. Frieden and the CDC will take today’s news to heart and begin focusing on fighting chronic disease in America.
Reference: Wall Street Journal
I all but predicted this in a recent posting Politics and the Failure of Public Health. In that posting I noted that the CDC has all but given up on solving the problems of chronic disease and we know that smoking is at the root of many of those conditions – heart disease, cancer, obesity and a host of others.
In that posting, I also questioned whether the CDC’s lack of efforts in reducing smoking have something to do with our Smoker in Chief – President Barack Obama. Obama has made smoking cool again. There’s a swagger to being a smoker now that hasn’t existed in many years. The CDC’s head Dr. Thomas R. Frieden has made a crusade against smoking – a mission he seems to have promptly abandoned once he received his appointment from President Obama.
Chronic disease is a critical health issue. This is an area calling out for CDC leadership – and leadership from Dr. Thomas Frieden. Hopefully Dr. Frieden and the CDC will take today’s news to heart and begin focusing on fighting chronic disease in America.
Reference: Wall Street Journal
H1N1 Death Tolls Soars
The CDC has previously estimated only 1,000 deaths due to H1N1 flu…until today. The CDC has finally begun acknowledging what medical professionals across the country have known for over a month. The CDC has finally come clean indicating that 3,9000 have died from the swine flu. This is the just going to be the tip of the iceberg.
While many have suspected that the CDC’s low-ball assessments were politically motivated, I’m going to cut the agency some slack and assume that they are just completely overwhelmed by the outbreak. Of course, they are also woefully under supported.
However, today’s OpEd on MSNBC really hit the nail on the head – calling the White House’s flu response “dismal at best.” The article states, “The Obama administration bears much of the blame for the fear the public and health care workers have of the swine flu vaccine.”
While President Barack Obama has finally declared a state of emergency and finally started paying attention, many critical months were lost when the country had the opportunity to respond. Clearly, Obama’s trust in HHS Secretary Kathleen Sebelius was misplaced at best.
Hang on, it’s going to get a lot worse before it gets better.
Reference: LA Times and MSNBC
While many have suspected that the CDC’s low-ball assessments were politically motivated, I’m going to cut the agency some slack and assume that they are just completely overwhelmed by the outbreak. Of course, they are also woefully under supported.
However, today’s OpEd on MSNBC really hit the nail on the head – calling the White House’s flu response “dismal at best.” The article states, “The Obama administration bears much of the blame for the fear the public and health care workers have of the swine flu vaccine.”
While President Barack Obama has finally declared a state of emergency and finally started paying attention, many critical months were lost when the country had the opportunity to respond. Clearly, Obama’s trust in HHS Secretary Kathleen Sebelius was misplaced at best.
Hang on, it’s going to get a lot worse before it gets better.
Reference: LA Times and MSNBC
Subscribe to:
Posts (Atom)
