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Some Routine Cancer Screenings Not Proven To Reduce Deaths, Experts Say
Routine screenings for cancers -- including breast cancer in younger women -- have not proven to reduce the chance of death for people without specific symptoms or risk factors, and experts suggest that some tests could lead to harm, the New York Times reports.According to Ned Calonge, chair of the United States Preventive Services Task Force, screening is only useful if it prevents enough deaths to outweigh harm from treatments that are not medically necessary. He said that although screening in some cases will detect life-threatening cancers that respond to intervention, it also can result in false positives that cause needless worry and unnecessary procedures. Screening also might fail to diagnose an existing cancer, causing patients to ignore symptoms; find slow-growing or stable cancers that are not life-threatening and normally do not need treatment; or find aggressive, life-threatening cancers that do not respond to treatment, Calonge said. Only a handful of screening tests have been proven to significantly reduce death among certain age groups: pap tests to screen for cervical cancer beginning no later than age 21; mammograms to screen for breast cancer starting at age 40; and colon cancer screening beginning at age 50. According to the Centers for Disease Control and Prevention, there is no medical proof that routine screening for many other cancers -- including ovarian cancer -- reduces deaths.The Times reports that the Breast Cancer Education and Awareness Requires Learning Young Act of 2009 (HR 1740) -- also known as the Early Act -- has become a central issue in the debate because it would create a breast cancer detection campaign for women younger than age 45. Rep. Debbie Wasserman-Schultz (D-Fla.) introduced the bill in March, and it now has more than 350 co-sponsors. The bill would provide $45 million over five years for teaching young women and their physicians to check for abnormalities; promote healthy lifestyle choices; and provide grants to groups supporting women with breast cancer. The bill focuses on certain ethnic or racial groups at higher risk of developing aggressive tumors. CDC would oversee an expert panel to create the campaign based on the latest medical research, Wasserman-Schultz said.Critics of the bill say that the legislation promotes techniques, such as self-exams, that have not proven to detect cancer at earlier stages or reduce deaths. They also argue that self-exams could lead to many insignificant nodules being biopsied, which can cause scarring and make it harder to detect breast cancer when women are older. According to Susan Love -- a breast cancer surgeon who has encouraged Wasserman-Schultz to abandon the bill -- the public health campaign could cause younger women to overestimate their chances of dying of breast cancer (Singer, New York Times, 7/17).
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Illicit Drug Use Mapped Using Wastewater
A team of researchers has mapped patterns of illicit drug use across the state of Oregon using a method of sampling municipal wastewater before it is treated.
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IOM Panel's Comparative Effectiveness Report Includes Pregnancy Prevention Measures
The U.S. should conduct research to compare the effectiveness of innovative programs aimed at preventing unintended pregnancy, according to a report issued Tuesday by a congressionally convened Institute of Medicine panel, the New York Times reports (Meier, New York Times, 7/1). The recommendations state that these strategies should include "over-the-counter access to oral contraceptives or other hormonal methods, expanding access to long-acting methods for young women, [and] providing free contraceptive methods at public clinics, pharmacies or other locations" (List of Priorities, IOM, 6/26). The report lists 100 health topics that should be prioritized as the Obama administration seeks to increase cost-effectiveness in medicine. The federal stimulus package passed earlier this year allotted $1.1 billion for comparative effectiveness research into different ways of treating certain conditions and addressing various health care issues. According to the Times, the report is a first step in an expansive effort by the administration and health experts to direct medical practice toward scientifically proven treatments, rather than a provider"s personal opinion or a medical product company"s promotional claims. Harold Sox, co-chair of the IOM panel that wrote the report and the editor of the Annals of Internal Medicine, said that based on public comments, the panel decided it was important to include pregnancy prevention and other public health issues in its recommendations (Meier, New York Times, 7/1). The report also recommends that researchers compare different comprehensive care coordination programs, such as the medical home model and chronic disease management, especially in communities known to have health disparities (Simmons, HealthLeaders Media, 6/30).
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Mississippi Department Of Health Prepares For Potential Hurricane Season Evacuations With The AmbuBus

With the 2009 hurricane season underway, Mississippi has joined other states in FEMA Region IV by deploying the AmbuBus from First Line Technology in a statewide effort to enhance special needs evacuation capabilities. Delivery of the initial 14 AmbuBus kits, purchased through grant funds, were delivered to 6 different locations around the state. A joint training session was conducted between the school districts and the Department of Health to prepare for summertime severe weather. Deploying the AmbuBus capability around the state allows for existing transport assets to be modified by the school district and utilized by the Department of Health for evacuation. When needed, the AmbuBus can quickly convert school and transit buses into non-ambulatory (stretcher) transport vehicles for the special needs population. The AmbuBus now enables the Department of Health to safely and efficiently evacuate hospitals, medical facilities, and nursing homes from the path of hurricanes. Once evacuation is complete, the retrofitted vehicles can be converted back into their normal use capability and the AmbuBus kit can be warehoused for future use. "Disaster prone states are realizing that there is not enough ambulance capacity to safely evacuate hospitals, nursing facilities, and special needs patients," said Amit Kapoor, First Line"s President. "The AmbuBus enhances statewide evacuation plans by quickly creating a mass transport fleet for special needs patients. By using existing assets like school buses and other vehicles of opportunity, states are able operate a mass transport capability without the expensive costs of maintaining a fleet of ambulances." The AmbuBus has been deployed state-wide in Georgia and Alabama and with numerous localities such as Hampton Roads, VA. Other states and localities have placed their orders with deliveries throughout the 2009 hurricane season. First Line Technology


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