Breast Cancer Rx Linked to Heart Failure risks in older women:
DailyRx News October 23, 2013
Roughly one in four breast cancers has too much of a protein called HER2, which makes the cancer grow faster. A new study has shown that older breast cancer patients taking Herceptin had higher risks of congestive heart failure than patients who didn’t take the medication. Mariana Chavez-MacGregor, MD, MSc, assistant professor of breast medical oncology at The University of Texas MD Anderson Cancer Center and CERCIT investigator, was the lead investigator of this study that evaluated the rates of and risk factors associated with Herceptin-related congestive heart failure (CHF) in older patients. The authors conclude that “It is possible that among high-risk patients, early cardiology referral, the use of prophylactic cardioprotective agents, and close monitoring may be beneficial.”
Many older men still getting PSA test for prostate cancer, against recommendations
CBS News, Oct. 16, 2013
Many doctors still give their patients who are 75 and older prostate-specific antigen tests for prostate cancer, even though many medical groups have recommended against it. A research letter published in the Journal of the American Medical Association on Oct. 16 reveals that about 41 percent of men in that age group had the PSA procedure done — and 29 percent had been recommended for the test by their primary care physician. “Our results suggest that a major reason for the continued high PSA rate is decision-making by the physicians,” said senior author Dr. James Goodwin, director of UTMB's Sealy Center on Aging. Lead author Dr. Elizabeth Jaramillo said that overtesting can create harms, including overdiagnosis. “The vast majority of prostate cancers are so slow growing that an elderly man is much more likely to die of another condition in his lifetime than from the cancer,” she said. The news also appears in UPI.com, MedPage Today, Everyday Health, Drugs.com, HealthDay and U.S. News & World Report, among other outlets.
More Hispanic Texans die from cancer than any other cause
UPI.com, Oct. 1, 2013
More Hispanic Texans die from cancer than any other cause and only 3 percent of Hispanic Texans are age 75 and older, researchers say. The report, published in a special issue of the Texas Public Health Journal, found cancer was the leading cause of death among Hispanic Texans age 76 and younger, but survival after a diagnosis of cancer is superior for Hispanics compared to non-Hispanic whites. Principal investigator Dr. James S. Goodwin of UTMB said even though cancers tend to be more advanced when diagnosed in Hispanics, death rates were lower than in the white population.
CERCIT releases report on Cancer in Texas Hispanic/Latino population
September 19, 2013
In response to the growing Texas Hispanic population and their health needs, Comparative Effectiveness Research on Cancer in Texas (CERCIT) investigators have developed and released ‘A Comprehensive Report on Cancer among Hispanics in Texas.’ This report, presented as a supplemental issue of the Texas Public Health Journal, provides current cancer incidence, survival, and screening statistics for Hispanics/Latinos in Texas that can be used for planning, program evaluation and policy purposes. If you would like a hard copy of the supplemental TPHJ issue mailed to you, please contact us. For more information about the Texas Public Health Association and its journal, please visit www.texaspha.org.
Early detection key to combating bladder cancer
El Paso Times, 07/14/2013
While most people know that cigarette smoking is the No. 1 risk factor for lung cancer, few realize that it is the single biggest risk factor for bladder cancer as well. Bladder cancer is the fifth most common cancer in Americans and the most common cancer of the urinary tract. But it is largely out of the public eye, even though nearly 71,000 new cases of bladder cancer are diagnosed each year in the United States alone.
CERCIT Featured in the Texas Public Health Journal
Using research to keep Texans informed about cancer care – that is at the heart of CERCIT (Comparative Effectiveness Research on Cancer in Texas). A description of this project and selected articles from its four research areas are featured in the Spring 2013 issue of the Texas Public Health Journal, a quarterly publication of the Texas Public Health Association (pages 22-55).
Click on the following links to read each article:
- CERCIT: Research to Keep Texans Informed About Cancer Care
The "Cores" of CERCIT: Data, Training, Knowledge
- Utilization of BRCA testing in older women with breast and/or ovarian cancer in the state of Texas
- Prostate Cancer Treatment Patterns in the State of Texas, 2004-2007
- The Current Utilization of Breast and Prostate Cancer Screening in Older Adults in Texas
- The Human and Economic Burden of Cervical Cancer in Texas
If you would like a complimentary hard copy of the entire issue mailed to you, please contact us.
More than one third of Texas women still receive unnecessary breast biopsy surgery
UPI, UTMB Newsroom, May. 16, 2013
Many women in Texas who are found to have an abnormality on routine mammogram or discover a lump in one of their breasts end up having an old-fashioned surgical biopsy to find out whether the breast abnormality is malignant. Since 2001, national expert panels have recommended that the first course of action for women with breast lumps or masses should be minimally invasive biopsy.
Do you really need that colonoscopy?
AARP, April 25, 2013
A recent study published in JAMA Internal Medicine suggests that almost a quarter of colonoscopies are either performed too often or given to patients who are too old to benefit. "It looks like some patients are getting screened inappropriately," says UTMB’s Kristin Sheffield who led the study. The study didn't fault colonoscopies doctors performed because a patient had a problem or worrisome symptom, such as blood in the stool or abdominal pain. Nor does it address colonoscopies to check patients who previously have had colorectal cancer or precancerous growths.
PMCH Symposium Awards
April 3, 2013
UTMB PMCH held its third annual Public Health Symposium on April 3 - Public Health is Return on Investment: Save Lives, Save Money. The following awards were presented: The Laura Ray Scholarship - Lawrence Panas. The Sigma Xi Overall Poster Award for Public Health Research - Amol Karmarkar for "Diabetes Comorbidity On Health Outcomes In Patients Undergoing Medical Rehabilitation After Lower Extremity Joint Arthroplasty".Preventive Medicine and Community Health Poster Awards - Amit Kumar for "Body Mass Index versus Waist Circumference as Predictors of Disability Incidence in Mexicans Aged 50 Years and Older", Gabriela Vargas for "Physician Follow-up and Guideline Adherence in Post-Treatment Surveillance of Colorectal Cancer" and Abhishek Parmar for "Quality of Post-Treatment Surveillance of Early Stage Breast Cancer in Texas". (pictured, l to r: Abishek Parmar, Gabriela Vargas, Christine Arcari, Lawrence Panas, Amit Kumar and Amol Karmarkar).
Seniors Getting Unnecessary Colonoscopies
U.S. News & World Report, March 12, 2013
Older U.S. adults may get too many colonoscopies, costing Medicare an estimated $500 million a year and putting patients at an increased risk of side effects such as bleeding, UTMB researchers found. About one-quarter of colonoscopies in Medicare recipients ages 70 and older may be inappropriate based on screening guidelines, according to analysis of insurance claims data released yesterday in the journal JAMA Internal Medicine. “Inappropriate colonoscopies involve an unnecessary risk with no added benefit for the older patient,” said Kristin Sheffield, the study’s lead author. “The harms are greater than the expected benefit.” The news appears widely throughout the world, appearing in such outlets as The New York Times, MSN, the Fort Worth Star-Telegram, Yahoo! News, Houston Business Journal, Businessweek, Chicago Tribune The Washington Post and Lifescript.
Cancer in Texas: Analyzing the Links
Me and My Doctor blog 09 Mar 2013 08:44 AM PST By Vivian Ho, PhD
Researchers have documented dramatic differences in cancer care and cancer survival rates across the country. Texas is no different, with analysis of Texas Cancer Registry data showing substantial variation in cancer treatment and mortality in different areas of the state. Recent studies by the Comparative Effectiveness Research on Cancer in Texas (CERCIT) consortium suggest that differences in the local availability of specialists who treat cancer may affect treatment variation across the state. One study found that greater availability of colonoscopists and primary care physicians led to higher rates of colon cancer screening by colonoscopy for whites but not for blacks and Hispanics. Another study found that billings for intensity-modulated radiation therapy (IMRT) for breast cancer patients were higher in areas with a greater density of radiation oncologists. This advanced form of radiation therapy manipulates beams of radiation to conform to the shape of a tumor.
Overuse of surveillance colonoscopy after resection
Medical Xpress, Feb. 1, 2013
Approximately one-third of patients with normal results on their first and second colonoscopies after undergoing curative resection for colorectal cancer undergo subsequent surveillance colonoscopies within two years, which is earlier than recommended by current guidelines, according to research published in the January issue of Clinical Gastroenterology and Hepatology. CERCIT investigator, Dr. Amanpal Singh and colleagues used data from the Surveillance, Epidemiology, and End Results-Medicare linked database for 1992 to 2005 to analyze the timing for the first three colonoscopies after patients underwent curative surgery for colorectal cancer.
Minimally invasive breast biopsy lags in Texas
The Oncology Report, Jan. 25, 2013
More than a fifth of women in Texas with image-detected breast abnormalities failed to undergo minimally invasive breast biopsy as recently as 2008, according to a review of statewide Medicare data, even though in 2005 a U.S. consensus panel declared the minimally invasive approach the procedure of choice and that few patients should have excisional biopsy as their initial procedure. “Our studies identify targets for interventions to improve minimally invasive breast biopsy rates, such as the Hispanic disparity and geographic variations in practice pattern," said Dr. Taylor S. Riall, a UTMB cancer surgeon. “Our findings highlight that the strategies for intervention need to vary by geographic region and the underlying etiology of the failure to adopt this cost-effective practice.".
Avoiding over-diagnosis with PSA screenings
Galveston Daily News, Oct. 15, 2012
In this guest column, UTMB’s Dr. Elizabeth Jaramillo writes about the Prostate-Specific Antigen test and decreasing the rate of over-diagnosis, false positives and unneeded biopsies. “Prostate cancer has some aggressive forms, but usually it is a very slow-growing cancer. Especially in older men, the cancer grows so slowly that other diseases will likely cause mortality before the cancer causes symptoms or spreads.”
Screening for prostate cancer is an exception to the rule
Houston Chronicle, Sept. 7, 2012
September is Prostate Cancer Awareness Month, and the U.S. Preventive Services Task Force and the American Cancer Society no longer recommend using the PSA test to screen for prostate cancer. In this guest column, UTMB’s Dr. James S. Goodwin writes that, “For most cancers, the rule of thumb is ‘earlier is better,’ as in the earlier a cancer is caught, the better the outcome. Prostate cancer is an exception to the rule, however. With prostate cancer, looking for it has been found to cause more harm than good.”
Pancreatic cancer patients' choices easier with new study
Medical News Today, Aug. 25, 2012
Should patients with pancreatic cancer who know there time is ending soon spend a great amount of that little time undergoing aggressive and difficult treatment that will only add a brief period of additional life? UTMB's Dr. Casey Boyd and colleagues analyzed both hospital and medical care days in pancreatic cancer patients with stage, treatment and survival, which was able to give them a quantitative look at the whole experience of a patient with this disease. She hopes that this paper will help doctors give patients the information they need to make important decisions. The news also appeared in Science Daily and Guidry News.
The controversy over cancer screening
Austin American-Statesman, Aug. 15, 2012
Continuing coverage: The Comparative Effectiveness Research on Cancer in Texas research group is studying cancer screening patterns in Texas and investigating associated outcomes. UTMB leads this research consortium, which includes the University of Texas MD Anderson Cancer Center, the University of Texas School of Public Health, Rice University, Baylor College of Medicine and the Texas Cancer Registry. The column also appears in The Galveston Daily News and Houston Chronicle.
Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement
Annals of Internal Medicine, July 17, 2012
The USPSTF recommends against PSA-based screening for prostate cancer (grade D recommendation). This recommendation applies to men in the general U.S. population, regardless of age. This recommendation does not include the use of the PSA test for surveillance after diagnosis or treatment of prostate cancer; the use of the PSA test for this indication is outside the scope of the USPSTF.
Confusion causes rates to lag for colon-cancer screening
Houston Chronicle, March 24, 2012
March is National Colorectal Cancer Awareness Month — a good time to remind Texans of the importance of being screened for colorectal cancer, which is the second-leading cause of cancer death in the United States, writes UTMB's Dr. James S. Goodwin in this guest column. "These deaths can largely be prevented with appropriate screening. But our research shows that in Texas, the number of people getting screened varies greatly from region to region and among different age and ethnic groups."
New Cancer Research Effort to Benefit Texans
UTMB, February 6, 2012
Galveston - A research initiative that will impact clinical cancer care for Texans is underway. But unlike similar initiatives, the results of this one will be shared with a much broader audience and not just researchers and physicians. This research is exploring important questions about screening patients for certain cancers.
Zwelling, Goodwin and Elting: Cancer survivors present unique new challenges
El Paso Times, Jan 29, 2012
More docs no help for racial colonoscopy gap
MedPage Today, Dec. 17, 2011
Communities that have more physicians available to perform colonoscopies actually have bigger — not smaller — disparities in screening rates between minority and white patients, according to a recent study of Texas Medicare claims data. In the study of claims for nearly 975,000 Texas Medicare beneficiaries, colonoscopy use was higher in whites (40.7 percent) than in blacks (35.0 percent) or Hispanics (28.7 percent), reported Dr. Taylor S. Riall and colleagues from UTMB
Some facts to consider in prostate-cancer debate
Houston Chronicle, Oct 25, 2011
by CERCIT Investigators, Drs. Leonard A. Zwelling and James S. Goodwin