Women should be aware that all cancers detected during breast cancer screenings are not necessarily lethal. More intensive screening tends to reveal even cancers that may lie dormant or cause no harm. A recent study in the British Medical Journal shows that nearly 52% of mammograms in areas offering organized screening are over-diagnosed, with one in three overdiagnosed overall. The danger lies in the health problems that may result from unnecessary treatment (such as chemotherapy, radiation or surgery).
A mammogram uses x-rays to detect masses in the breast tissue, allowing doctors to detect breast cancer in its early stages when it’s most likely to be cured. Women over the age of forty are encouraged to get a mammogram every 1-2 years. Although a mammogram is beneficial when lethal cancers are detected, it may be harmful when perceiving those that are not.

It is estimated that one in three breast cancer mammography screenings are overdiagnosed. Overdiagnosis occurs when the patient dies before cancer complications occur, whether it's because the cancer grows too slowly or simply remains dormant.

Because it is impossible to discriminate between types of cancers that will not cause death or symptoms and those that will, all types of cancer are treated. In fact, 37% of women age 40-54 who died from causes other than breast cancer had invasive or non-invasive cancer legions at autopsy, half of which were visible on radiography.

Researcher Karl Julh Jørgensen, co-author and researcher of the study, wrote “The increase in incidence of breast cancer was closely related to the introduction of screening and little of this was compensated for by a drop in incidence of breast cancer in previously screened women.”

Jørgensen, along with director Peter C Gøtzsche, both of The Nordic Cochrane Center in Copenhagen, Denmark, gathered information for the review by compiling several studies from Norway, Sweden, Australia, Canada, and the United Kingdom, using data seven years prior to screening and seven years after.

Researchers obtained information from women too young to be screened to use as a control. This information was compared with pre-screening trends of the screened group to establish a background incidence.

The rate of diagnosis for women younger than 50 and greater than 74 remained constant, but when the post-screening trend in women age 50-69 was examined, breast cancer diagnosis was almost 42% higher than expected.  This was followed by a 15% decline in diagnosis for women over the age of 70. Over-diagnosis for breast cancer alone was 35%, which jumped to 52% when carcinoma in situ (at its original site) was included.

Although factors such as the use of hormone replacement therapy (associated with an increased risk of breast cancer) and incidence of ductal carcinoma in situ (DCIS) may play a factor in the statistics, researchers still attribute much of this change in diagnosis to organized and more frequent screening.

Other deviations due to the nature of different types of cancer must still be accounted for, but the study’s findings do stress taking precautions in breast cancer screening.

Digital mammography readings, for example, in lieu of traditional mammograms (that tend to detect a higher rate of false positives due to poorer image quality) may be the best procedure, but knowing the facts about breast cancer’s risks can help prevent complications as a result of overdiagnosis.

Visit our Breast Cancer Community.

Prescription drug sharing among teens is becoming a great concern in the United States, where 1 in 3 self-reportedly loan or borrow medication.
According to a survey funded by the National Center on Birth Defects and Developmental Disabilities (NCBDDD), 20.6% of teens reported loaning drugs, most commonly pain relievers and allergy medications, and 19.4% reported borrowing them. Girls were almost twice as likely to give away prescription medications than boys (27.5% of girls, compared to 17.4% for boys).

Information for the study was gathered in malls, parks and public streets, in eleven urban and suburban locations in the United States. Researchers obtained data from 594 teens—289 male and 305 female—ages 12-17.

“Prior to our study, no one had asked adolescents how often they shared prescription medications,” said lead author Richard Goldworthy, Ph.D., director for research and development at Academic Edge, Inc.

Researchers first asked participants whether or not they had ever loaned or borrowed prescription medications. Those who responded positively were then asked what type(s) of drugs were borrowed, whether they gave or received written or verbal instructions, and whether or not they had shared to avoid a doctor’s visit—74% of borrowers said yes.

Of the 86 teens trying to steer clear of the doctor’s office, 32.4% ended up going anyway when the problem persisted. Herein lies the danger: 43 of them reported experiencing an allergic reaction or other side effect, but less than half of borrowers (about 40%) reported telling their doctors they had used the medication.

Drug sharing has a number of negative consequences. Conditions often worsen when not taken care of in a timely manner, and using medications improperly only increases the danger. Sharing antibiotics, for example, unnecessarily increases bacterial resistance to treatment.

“Other researchers have studied people selling prescription drugs,” said co-author Chris Mayhorn, an associate professor in the Human Factors and Ergonomics Psychology Program at North Carolina State University. “ but we looked at people with good intentions, trying, for instance, to help a friend who lacked money or transportation.”

Taking a friend’s acne medication may seem innocent to a teen, however, drugs such as Accutane increase risk of depression and can cause serious birth defects in he event of an unplanned pregnancy.

The study has provided a greater incentive to boost educational programs, pushing efforts to reduce the growing drug sharing problem by training both patients and providers about proper drug use.

Melissa Haddow, executive director of the Community Partnership of the Ozarks, says, "This work highlights the diversity of medications being abused this way, which had not been recognized (before)."

More about child health.

A recent study conducted by the Indiana University School of Medicine and Medco Health Solutions Inc. suggests that taking heartburn medications while using anticlotting drugs called clopidogrel can increase patients’ likelihood of heart attack by 50 percent. The Society for Cardiovascular Angiography and Intervention recommends patients taking anticlotting drugs discontinue the use of heartburn medications called proton-pump inhibitors.

Patients who have experienced a heart attack or stroke, or who have a heart stent to treat blocked arteries often take anticlotting drugs. Doctors commonly prescribe the proton-pump inhibitors when patients experience side effects like acid reflux and stomach bleeding while taking clopidogrel. No risk has been identified in taking heartburn medications alone.

The society suggests patients use alternative treatments for bothersome gastro-intestinal side effects. Effective medications include over-the-counter antacids and prescription heartburn medications.

Challenge your heart disease knowledge using the Healia Heart Diseases Quiz. If you need more information on heart diseases and treatments, check out the Healia Heart Disease Health Guide. Share your personal experiences with heart disease medications at the Healia Heart Diseases Online Health Community and Support Group.


_{Photo: Publik15, Flickr, Creative Commons}

Actor Dennis Quaid gave a passionate appeal for hospitals to implement electronic medical records and advanced technologies in order to prevent medical errors at the 2009 Healthcare Information Management and Systems Society conference in Chicago yesterday. Quaid relayed how in 2007, his 10-day-old twins nearly died after they were mistakenly given 1,000 times more of the blood thinner drug heparin than intended at a Los Angeles hospital. The near-lethal dose caused massive hemorrhaging. The mistake was attributed to very similar packaging of different heparin bottles intended for infants and adults. The twins are now healthy.

Quaid believes that technologies such as computer physician-order entry and bar coding would have reduced the chance of confusing drug packaging. Since the incident, Quaid and his wife have started the Quaid Foundation to promote awareness of the need for more information technology as a way to prevent medical errors.

As part of the Administration's $787 billion economic stimulus package, $20 billion is intended for investment in healthcare IT. Government funding will be used to promote adoption of electronic medical records, increase use of computer physician-order entry systems, and create health information exchanges to better share healthcare data among providers.

Next time you are hospitalized or see your doctor, ask the provider what drugs you are receiving and, if they are not using an electronic medical record system, why not.

Have more ideas for preventing medical errors in hospitals? Share them with others at Healia Communities.

_{Photo: NathanF, Flickr, Creative Commons}

Healia and the American Medical Student Association (AMSA), the nation’s oldest and largest independent association for more than 67,000 physicians-in-training, announced this morning that AMSA medical students and interns/residents are answering the public's online health questions for free on Healia Communities. Trained medical students will answer common health questions anytime and at no cost to consumers.

According to the Pew Internet&American Life Project, between 75% and 80% of American Internet users have looked for health information online.

There are many online Q&A websites but very few of them are appropriate for answering health questions because their members are seldom qualified health professionals. In contrast, the health Q&A service on Healia Communities shows the profiles of those who have posted answers to questions; all medical students or interns/residents have been verified by AMSA.

The free online health Q&A service is available immediately. Sign up and submit your health questions at Healia Communities.

See the full press release about this new health Q&A service.

Healthcare reform is needed this year because of increasing healthcare costs, decreasing access to care and worsening gaps in coverage, according to a government report released on Monday by the US Department of Health and Human Services.

According to the report, the United States spent about $2.2 trillion on health care in 2007 or about $7,421 per person.  As a percentage of GDP, it is almost twice what other developed countries spend. After doubling from 1996 to 2006, health care costs are projected to rise to 25% of GDP in 2025 and 49% in 2082. In 2007 and 2008, about 87 million people were uninsured on at least a temporary basis. And the United States achieved an overall score of 65 out of a possible 100 when rated across 37 performance indicators of quality of care.

The White House and Congress have signaled that healthcare reform should be accomplished this year. But several controversial issues that have doomed previous efforts at healthcare reform will need to be addressed. One issue is how to provide coverage to the uninsured. Should the government setup a federal health insurance plan and use its size and clout to drive down costs and compete with private insurance companies? Should the government mandate that everyone – healthy or sick -- get health insurance coverage? Insurance companies have indicated support for a government mandate for coverage as a core requirement for attaining universal healthcare coverage. Their argument is that universal coverage is only feasible if the insurance risk is spread across the entire population.

What do you think about healthcare reform and health insurance? Share your thoughts about healthcare reform on Healia’s Online Community on Health Insurance.


_{Photo: daniel.baker, Flickr, Creative Commons}