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Obesity and strokes in younger people

Angiology, 08/09/2014

 

This study showed that obesity was strongly associated with significant atherosclerosis of the carotid arteries in patients ages 39-55 years old. Of course, weight, cholesterol, diabetes and smoking was also taken into account. It is actually very easy to screen and detect carotid blockages. However, unless you have certain symptoms, or we physicians can actually hear a murmuring sound (bruit) when the stethoscope is placed on the carotid artery, your insurance company WILL NOT pay for this.

The test that we do in the office only takes about 15 minutes and uses sound waves to determine if any carotid artery blockages are present.

Since we know that insurance companies will not cover it, we only charge $99 for the screening.

 

 

New way to screen for colon cancer in the future?

Cancer Prevention Research

Let’s face it-a colonoscopy is not one of our favorite things to do (unless you are a gastroenterologist). However, as of today it is still the absolute best way to screen and detect colon cancer at an early stage. This study, called The Human Gut Microbiome looks at the bacteria in the gut as a marker for developing colon cancer. They looked at 30 healthy people and compared their gut bacteria to 30 patients with precancerous colon polyps and 30 patients already diagnosed with colon cancer. What they found was when combined with other risk factors like race, age and BMI (weight) there was a 5-fold increase in their ability to detect invasive colon and rectal cancer based on the bacteria make up alone.

Their conclusions were that, although it is too early to tell if this will ever replace colonoscopies, that eventually it could lead to a 50-fold increase in polyp and cancer detection.

 

Coronary artery calcium screening for heart disease

There is a growing discordance between the ability of current risk  tools used to estimate heart disease and actual outcomes.

Recent imaging advances have made it possible to detect subclinical coronary atherosclerosis. The coronary artery calcium score (CACS) is a marker of vascular injury that correlates closely with the overall atherosclerotic burden. Individual data derived from this and other imaging tests may provide useful prognostic information for patient management and can complement current risk prediction models.

Although most insurance companies do not pay for this test, this is an ultrafast CT scan of the heart that only costs $50 and takes minutes to complete. (It wasn’t that long ago that a test like this cost almost $500!)

• In low-risk patients, all modalities were considered “usually not appropriate”, but the panel did comment that CACS may be useful in low-risk patients who have a strong family history of coronary risk.

• In intermediate-risk patients, CACS was determined to be “usually appropriate“, as it can be used to stratify and reclassify patient risk more accurately than traditional methods.

• In high-risk patients, it was determined that more invasive studies like angiograms and stress-and-rest studies using MRI, single-photon emission CT, MPI, and ultrasound “may be appropriate.”

In other words, CACS is most useful for low to intermediate risk patients.

 

Do Women 65 – 69 Still Need Pap Tests?

University of Maryland in Baltimore

 

The government has suggested that regular PAP testing be stopped at age 65. Ready for this? If we account for women who have had hysterectomies (which the government most surely does), then the rate of cervical cancer in the US is 11.7 cases per 100,000 women. However, if we take out those who no longer have a cervix and reevaluate, the incidence then rises to 27.4 cases/100,000 in white women and 53/100,000 in blacks. Nearly a decade ago, another group of researchers found that such a correction resulted in a higher prevalence of the disease in the United States (Ann Epidemiol. 2006;16:880-887). Yet the government still says NO to PAP testing!

Since there was only a small decrease in these number after age 69, the question is-just when DO we stop screening for cervical cancer?

If you currently do not have a gynecologist, and want to be checked,  Dr. Daniela Kassabov is available to do your PAP testing in our office.

Call 941-747-2090 to schedule your well woman’s exam.

 

 

Should We Withhold the Best Lung Cancer Screening Test to Save $3

2014 Annual Meeting of the American Society of Clinical Oncology

 

2014 Annual Meeting of the American Society of Clinical Oncology

 This would be funny if it were not true. There has never been a great way to screen for lung cancer until recent studies from Johns Hopkins showed that low dose CT scanning could pick up lung cancer in “at risk” patients at stages earlier enough to result in cures.

But a MEDICARE panel just came out with their decision NOT to cover testing because it would cost $9 billion dollars

According to the Fred Hutchinson Cancer Research Center in Seattle, screening patients over the age of 65 would detect almost 55,000 new cases of lung cancer over a 5 year period –at an early and treatable stage!

The total 5-year expenditure would amount to an increase in premiums of $3.00 per month per Medicare member and it is predicted that early diagnosis would double

Lung cancers diagnosed at an advanced stage would decrease, from the current 57% to 40%.

How much is your life worth?

If any of our patients think Johns Hopkins knows a little more about this than the government and would like to be screened, there are several Radiology practices in the area that will perform this test for $75.

 

 

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