Nav: Home

More precise colon cancer screening?

August 10, 2015

1. Clinical scoring system suggests possibility of more precise colon cancer screening

Free abstract: http://www.annals.org/article.aspx?doi=10.7326/M14-1720
Editorial: http://www.annals.org/article.aspx?doi=10.7326/M15-1677
URLs go live when embargo lifts

A clinical scoring system for colon cancer risk could help physicians identify which average-risk patients could potentially skip a colonoscopy and instead be screened with a less-invasive method. The researchers suggest that this approach could increase the uptake and efficiency of colorectal cancer (CRC) screening. The cross-sectional study is published in Annals of Internal Medicine.

Several screening tests are proven effective and are recommended for detecting colorectal cancer, yet screening is still underused, costly, and inefficient. Not all average-risk patients have the same risk for colorectal cancer. Risk stratification could potentially enable physicians to tailor screening based on a patient's risk for colorectal cancer.

Researchers studied a convenience sample of 4,460 patients scheduled to undergo their first screening colonoscopy in the Midwest. A clinical score was given based on the patient's complete health data and presence of the five most common risk factors for CRC - age, sex, waist circumference, cigarette smoking, and family history. The data showed that patients classified as low-risk did, in fact, have far fewer advanced adenomas compared with patients classified as high-risk. The authors suggest that patients at lower risk for cancer would be able to have a less invasive test (sigmoidoscopy, occult blood tests), while higher-risk patients would need a colonoscopy.

The author of an accompanying editorial cautions that the score should not be used for choosing the type of screening test an average-risk person should have. However, a sensitive algorithm may have a role in choosing appropriate follow up for a patient with a negative screening result.

Notes: For an embargoed PDF, please contact Cara Graeff. To speak with the lead author, please contact Lisa Welch at llwelch@regenstrief.org or 317-274-9234.


2. Adding corticosteroids improves outcomes in patients with community-acquired pneumonia

Free abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-0715
URLs go live when embargo lifts

For hospitalized adults with community acquired pneumonia (CAP), evidence suggests that adjunctive corticosteroid therapy may reduce mortality and need for mechanical ventilation, while shortening hospital stay. The research is published in Annals of Internal Medicine.

CAP is common and often severe. Researchers reviewed published studies on randomized trials of systemic corticosteroids in hospitalized adults with CAP to determine the impact of adjunctive corticosteroid therapy on mortality, morbidity, and duration of hospitalization. They found that corticosteroids reduced mortality by approximately 3 percent and need for mechanical ventilation by approximately 5 percent, while shortening hospital stay by approximately one day. Benefits were more pronounced in patients with severe illness. Based on their findings, the researchers conclude that clinicians should seriously consider using corticosteroids in hospitalized patients with CAP, especially in the most severe cases.

Notes: For an embargoed PDF, please contact Cara Graeff. To speak with the lead author, please contact Veronica McGuire at vmcguir@mcmaster.ca or 905-525-9140 ext. 22169.


3. Evidence suggests wide variations in hospital cleaning practices

Free content: http://www.annals.org/article.aspx?doi=10.7326/M15-1192
Editorial: http://www.annals.org/article.aspx?doi=10.7326/M15-1798
URLs go live when embargo lifts

A systematic overview published in Annals of Internal Medicine finds important gaps in the evidence for the bestmethods for cleaning hospital rooms to prevent healthcare-associated Infections, and recommends additional researchto help lower risk for patients.

The cleaning of hard surfaces in hospital rooms is critical for reducing healthcare-associated infections. Environmental cleaning is a complex, multifaceted process, and involves the physical action of cleaning surfaces and also the application of disinfectant. Monitoring strategies must also be employed to ensure that cleaning and disinfecting is done properly.

Researchers reviewed published research to summarize the modalities currently used for cleaning, disinfecting, and monitoring cleanliness of patient rooms as well as contextual factors that may impact the implementation and effectiveness of the cleaning process. Studies focused on three key healthcare-associated pathogens - MRSA, VRE, and c. diff. The researchers suggest that evaluating the clinical effectiveness of cleaning and disinfection modalities is challenging and there are several unanswered questions about practices. The authors of an accompanying editorial say that unlike handwashing, there is yet to be a consensus on the importance of cleaning the inanimate health care environment as a way to prevent the spread of infection. The authors suggest that in addition to more studies, effective communication and education are needed to ensure consistent practices.

The study was funded by the Agency for Healthcare Research and Quality and conducted by researchers at the ECRI Institute-Penn Medicine Evidence-Based Practice Center.

Notes: For an embargoed PDF, please contact Cara Graeff. To speak with the lead author, please contact Steve Graff at Stephen.Graff@uphs.upenn.edu or 215-349-5653.


Also in this issue:

Good Publication Practice for Communicating Company-Sponsored Medical Research: GPP3


Wendy P. Battisti, PhD; Elizabeth Wager, PhD; Lise Baltzer; Dan Bridges, PhD; Angela Cairns; Christopher I. Carswell, MSc; Leslie Citrome, MD, MPH; James A. Gurr, PhD; LaVerne A. Mooney, DrPH; B. Jane Moore, MS; Teresa Peña, PhD; Carol H. Sanes-Miller, MS; Keith Veitch, PhD; Karen L. Woolley, PhD; and Yvonne E. Yarker, PhD
Research and Reporting Methods
M15-0288
Free Content: http://www.annals.org/article.aspx?doi=10.7326/M15-0288

Increased Cardiovascular and Cerebrovascular Mortality in Ankylosing Spondylitis

Patients With Ankylosing Spondylitis Have Increased Cardiovascular and Cerebrovascular Mortality: A Population-based Study
Nisha Nigil Haroon, MD, DM, DNB, MSc; J. Michael Paterson, MSc; Ping Li, PhD; Robert D. Inman, MD; and Nigil Haroon, MD, PhD, DM
Original Research
M14-2470
Free abstract: http://www.annals.org/article.aspx?doi=10.7326/M14-2470

The 8 Basic Payment Methods in Health Care

Kevin Quinn, MA
Medicine and Public Issues
M14-2784
Free abstract: http://www.annals.org/article.aspx?doi=10.7326/M14-2784

Evolving the palliative care workforce to provide responsive, serious illness care

Arif H. Kamal, MD, MHS; Jennifer M. Maguire, MD; and Diane E. Meier, MD
Ideas and Opinions
M15-0071
Free abstract: http://www.annals.org/article.aspx?doi=10.7326/M15-0071
-end-


American College of Physicians

Related Cancer Articles:

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.
Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.
Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.
More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.
New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.
More Cancer News and Cancer Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...