Nearly One In Three Men And Women Age 50 And Over Have Not Been Screened For Colon Cancer

Posted on June 18, 2011 by

Main Category: Colorectal Cancer
Also Included In: GastroIntestinal / Gastroenterology; Cancer / Oncology
Article Date: 17 Jun 2011 – 9:00 PDT

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Results from a nationwide research poll released today by the Colon Cancer Alliance and Quest Diagnostics (NYSE: DGX) show that 31 percent of men and women age 50 years and over have never been screened for colon cancer by standard screening methods such as a colonoscopy, fecal occult blood tests (FOBT) and fecal immunochemical tests (FIT). The poll also shows that among men and women age 50 and older who have not been screened for colon cancer, more than 1 in 4 (28 percent) said their healthcare provider, such as a doctor or nurse, did not recommend they be screened.

Among those age 50 and older who have not been screened for colon cancer, the top reasons they were not screened were (respondents were asked to select options that applied):

– 28 percent — healthcare provider, such a doctor or nurse, didn’t recommend I get screened

– 18 percent — too busy or time constraints

– 16 percent — fear

– 16 percent — didn’t know I needed to be screened

– 15 percent — can’t afford the health insurance co-payment

– 10 percent — no insurance

– 9 percent — modesty or embarrassment

American Cancer Society guidelines recommend that men and women of average risk for developing colon cancer begin screening at age 50 by colonoscopy or other tests. The Colon Cancer Alliance and Quest Diagnostics’ survey supports earlier research that a large percentage of men and women age 50 and older are not adhering to the screening guidelines. In addition, among the 69 percent who reported in the survey that they have been screened for colon cancer, 87 percent said they have been screened with a colonoscopy.

“Our survey suggests that while more men and women of screening age are being tested than in the past, a significant screening gap remains,” said Andrew Spiegel, CEO of the Colon Cancer Alliance. “Health care professionals have a tremendous opportunity to educate patients about screening options.”

DNA blood tests for aiding the detection of colon cancer have recently been introduced in the U.S., although they have yet to be reviewed for inclusion in medical guidelines. When respondents were polled on their attitudes about a blood test, 78 percent said they were likely to take a blood test for colon cancer screening compared to 18 percent who said they were unlikely to take a blood test and 4 percent who didn’t know. Three out of four people (75 percent) said they were more likely to get screened more frequently for colon cancer if a blood test were available.

“With technological advances, physicians and patients have a range of options to choose from for colon cancer screening, from colonoscopy to FITs. But as options increase, so does the risk that patients will be confused about how, when and under which circumstances to be screened,” said Dr. Jon R. Cohen, senior vice president and chief medical officer, Quest Diagnostics. “It is vital that physicians engage their patients in a dialogue about their options and help them resolve the fears or misinformation that prevents testing.”

When those who said they had never been screened due to fear were asked the specific source of their fear, the number one reason cited (61 percent) was having to undergo unpleasant bowel preparation (including laxatives and fasting). Some tests, most notably a colonoscopy, involve bowel preparation, but others, such as FITs, do not. Other reasons were: afraid of test results (36 percent), side effects, such as pain discomfort and gas (35 percent), afraid of medical tests (28 percent) and fear of being sedated by anesthesia (17 percent).

Colon cancer is the second leading cause of cancer death in the United States, but is often treatable when caught in early stages. Sixty percent of colon cancer deaths could be prevented if people were screened as indicated by guidelines, according to the U.S. Centers for Disease Control and Prevention.

Polling Methodology

The Colon Cancer Alliance and Quest Diagnostics engaged national survey firm ORC International, an infoGroup company, to conduct a national probability phone study among 1,304 men and women 50 years of age and over to gauge their level of awareness about colon cancer screening, adherence to American Cancer Society guidelines and barriers to screening. A total of 614 men and 690 women were surveyed in May 2011. The survey was funded through an educational grant from Quest Diagnostics.

Source:

Colon Cancer Alliance

Quest Diagnostics

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NYC Restaurants Making The Grade; Violations For Not Posting Results

Posted on June 17, 2011 by

Editor’s Choice
Main Category: GastroIntestinal / Gastroenterology
Also Included In: Public Health
Article Date: 15 Jun 2011 – 11:00 PDT

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5 (1 votes)

This week, The New York City Health Department has issued hundreds of violations to restaurants failing to post a letter grade reflecting the result of an inspection. More than 800 violations have been issued for not displaying a grade, or putting it in a place where patrons can’t spot it easily. The grading system was started last July and about three-quarters of the city’s more than 24,000 restaurants have been inspected. The rest must post a “Grade Pending” sign.

An A, B or C reflects cleanliness, food safety and other requirements such as number of sinks. The Health Department conducts unannounced inspections of restaurants at least once a year. Inspectors check for compliance in food handling, food temperature, personal hygiene and vermin control.

Each violation of a regulation earns a certain number of points. At the end of the inspection, the inspector totals the points, and this number is the restaurant’s inspection score, the lower the score, the better. An inspection score of 0-13 is an A, 14-27 points is a B, and 28 or more points is a C. Grade cards must be posted where they can easily be seen by people passing by.

The following disclaimer appears on the department’s Web site regarding inspection data:

“As a result of an inspection, the Department of Health and Mental Hygiene may issue violations to the establishment. Owners have the opportunity to dispute these violations at the Department’s Administrative Tribunal, except when there are only general violations that result in fewer than 14 points. In these instances the violations must be corrected, but are not heard at the Administrative Tribunal. The information presented here may reflect inspections that have not yet been adjudicated.”

Americans dine out frequently due to their rushed schedules, and while it makes for a nice treat every once in a while doing so also means facing considerable health risks as well. Whether the effects settle in the present or the future, they still have considerable impact on their overall well-being. Sanitation, allergy, infections, and additives both intentional and unintentional can all lurk undetected in restaurant food, waiting for unsuspecting consumers to chomp down so they can spread their ugliness further.

Most restaurant trips, of course, will not result in a traumatic experience of explosive diarrhea or potential injury. But patrons still need to be made aware of the possible dangers that exist when dining at restaurants, no matter if they be dive or five stars.

The New York State Restaurant Association (NYSRA) which originally opposed the new grading system in 2010, also alerts their members that there is a scam being conducted which involves a phony government official calling restaurants and falsely claiming to be a health department inspector. The phony official will often ask to collect specific information (Ids, account numbers, etc.) from the restaurant and notify the recipient that they will receive an inspection in the coming weeks. NYSRA is unaware of any follow up inspection ever occurring.

New York City Department of Health and Mental Hygiene (DOH) inspections are conducted in person and an owner/manager may always ask to see an inspector’s ID and badge.

Sources: The New York City Department of Health and The New York State Restaurant Association

Written by Sy Kraft

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Revising MRE Protocol May Reduce Costs, Complexity While Maintaining Integrity Of Diagnosis For Crohn’s Disease

Posted on June 16, 2011 by

Main Category: Crohn’s / IBD
Also Included In: Radiology / Nuclear Medicine
Article Date: 16 Jun 2011 – 3:00 PDT

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A new study from Rhode Island Hospital has found that MR enterography (MRE) without the use of an anti-peristaltic agent were as reliable as CT enterography (CTE) in determining the presence of Crohn’s disease. Additionally, MRE reduces the patient’s exposure to ionizing radiation. The study is now published online in advance of print in the European Journal of Radiology.

Lead author David J. Grand, M.D., director of the Body MRI program at Rhode Island Hospital, found that MR enterography without anti-peristaltic agents results in high diagnostic confidence for the presence or absence of Crohn’s disease when compared to CT enterography. To limit exposure to ionizing radiation in young patients, MR enterography may be considered a first-line study for the evaluation of known or suspected Crohn’s disease.

“This is an important discovery in the diagnostic process for Crohn’s disease,” said Grand. “This information will help us to develop safer approaches toward testing, helping to lower patients’ exposure to radiation, while still maintaining the integrity of diagnosis.”

The study included 26 patients to be tested for known or suspected Crohn’s disease. The patients underwent CTE immediately followed by MRE without the use of an anti-peristaltic agent. Two fellowship-trained abdominal imagers evaluated each study on a 10-point scale for exam quality, level of diagnostic confidence and presence of Crohn’s disease. The CTE and MRE images were reviewed in random order with at least two weeks separating interpretation of the test results of a single patient.

While the quality of the MREs was ranked slightly lower than the quality of the CTEs, both tests were judged with similarly high rankings for level of confidence in interpretation.

Crohn’s disease, a form of imflammatory bowel disease (IBD), is a chronic, relapsing, auto-immune disorder that may affect any portion of the gastrointestinal tract, most commonly the terminal ileum. The incidence of IBD has increased 31 percent in the U.S. since 1991. Cross-sectional imaging is currently a mainstay of evaluation of patients with Crohn’s disease due to its ability to assess the entire bowel and extra-luminal complications including fistula and abscess. Recently, however, MRE has demonstrated excellent efficacy both in detection of Crohn’s disease as well as in differentiation of active from chronic small bowel changes.

While CTE has proven to be an effective tool in diagnosing Crohn’s disease, the radiation dose the patient receives is up to five times higher than that of small-bowel follow through, the test it has largely replaced. In one population-based study, diagnostic imaging exams exposed the majority of Crohn’s patients to an additional annual radiation does equal to the annual background radiation in the U.S., while a subset of patients received up to 11 times this additional dosage.

MRE can eliminate ionizing radiation exposure in the population of patients who often present while young and undergo multiple imaging exams throughout their lives.

Additionally, all published literature to date has used a pharmacologic anti-peristaltic agent to minimize motion artifacts. While the agents may improve subjective image quality, their use has not been shown to be diagnostically necessary and administration complicates exam protocol and increases expense. This study demonstrates that the anti-peristaltic agents may not be necessary, and suggests a simplified protocol of MRE which maintains diagnostic yield while decreasing complexity and expense.

The principle affiliation of Grand is Rhode Island Hospital (member hospital of the Lifespan health system in Rhode Island). Direct financial and infrastructure support for this project was received through the Lifespan Office of Research Administration. The researcher also has an academic appointment at The Warren Alpert Medical School of Brown University.

Source:
Ellen Slingsby

Lifespan

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