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Women with higher density on a mammogram has higher risk (four to five times) of developing breast cancer, opined the researchers who presented data regarding this during the Annual Meeting of the American Association for Cancer Research.

The presentation included data from three studies on latest research regarding mammographic density. The following two studies in the presentation indicate that mammographic breast density is an indicator of breast cancer risk.

1. Longitudinal breast density and risk of breast cancer: The study was conducted at the Mayo Clinic, Rochester,  and lead by Celine M. Vachon, Ph.D., associate professor of epidemiology in the College of Medicine and colleagues. They evaluated from data collected for Mayo Mammography Health Study, which included 19,924 women who had a mammogram at the Mayo Clinic between 2003 and 2006; the women were above 35 years and didnt have a history of breast cancer. The researchers evaluated whether change in breast density is associated with breast cancer and found that women who had an increase in breast density over six years has a higher risk (28 percent) of developing breast cancer. And it is likely that women with decreasing density has lower risk.

2. Change in mammographic density with estrogen and progestin therapy: A measure of breast cancer risk in the Women’s Health Initiative : Celia Byrne, Ph.D.and colleagues at the Lombardi Comprehensive Cancer Center at Georgetown University found that Change in mammographic density may be a useful intermediate marker to explain the increased breast cancer risk among postmenopausal women using estrogen and progestin therapy (EPT). The case-control study was conducted within the Women’s Health Initiative (WHI) randomized trial of EPT.

Mammography, which is basically an x-ray of the breast, is the gold standard for breast cancer screening and the American Cancer Society recommends yearly screening mammograms for all women aged above 40yrs of age. The new research has added a new dimension in the advantages of a mammogram, ie not just early breast cancer detection but also identification of potential risk of developing breast cancer later.

President Obama signed a bill to law on 16th April 2010, to stretch the eligibility criteria of the EHR incentive program for physicians in hospital outpatient departments or in hospital-affiliated clinics, who would not have been otherwise eligible for the above mentioned incentives under the Centers for Medicare and Medic-aid Services’(CMS).

HANYS and HANYS’ HIT Strategy Group insisted on expansion of the EHR plan for the out-patient medical practitioners along with CMS, important members from the Congress board, committees of jurisdicition in partnership with AHA and President Obama’s Adminstration.

The bill is meant to expand unpaid or lapsed unemployment insurance benefits and higher subsidies for individuals buying health insurance through the Consolidated Omnibus Budget Reconciliation Act (COBRA). Provisions to delay a Medicare physician fee schedule until the end of May is also proposed in this bill.

According to HANYS, “all-or-nothing” requirements must be flexed out for hospitals and physicians to fit the EHR incentive bill criteria. Failure to meet the requirements by 2015 may affect Medicare payment penalties. They further pressed on EHR incentive base payment should be made to all Hospitals, with or without a Medicare provider number with other institutions.

biospace med has announced that the company’s lead product, EOS ultra-low-dose 2D|3D imager, has been proven to reduce patient’s radiation exposure by upto 89 percent when compared to conventional computed radiography systems.

The findings of the study are published in the latest issue of the ‘Spine’ journal. The principal investigator of the 50 patient clinical study was Dr. Stefan Parent, M.D., Ph.D. from the Centre Hospitalier Universitaire Sainte-Justine, Montreal.

The study enrolled 9 girls and 11 boys with an average age of 14 and 8 years who were being followed up for spinal abnormalities. All patients recieved a CR (Computed Radiography) x-ray exam and an EOS exam for which skin dose was measured at skin level by dosimeters in 13 anatomical areas.

The study found that the quality of an EOS image is equal to or better than conventional or a CR x-ray system and exposes patient to upto 9 times lesser radiation.

EOS ultra-low-dose 2D|3D imager, developed by biospace med, is a new technology in orthopedic x-ray imaging and is used in the diagnosis and follow-up of bone and joint disorders, particularly spinal deformities. It can take local as well as whole body images; can also generate two dimensional or three dimensional images of the skeleton. The system allows full-body imaging of patients in sitting as well as in weight-bearing position that enables global assessment of balance and posture.

EOS has recieved approval from the FDA for use in adults and children and is now available in Europe and the USA.

A new study published online in March, in the American Journal of Gastroenterology, have found that the hazard of colo-rectal cancer death decreased by 3 percent with every one percent increase in complete colonoscopy rate.

The study included 2,412,077 persons who were men and women aged 50-90 years of age living in Ontario on January. The mean age was 64 years with 53.7 percent of the people included were women, and all the individuals involved in the study had been exposed to different intensities of colonoscopy.

They were followed up for 14 years from January 1st 1993 to December 2006.  Age- and sex-standardized colo-rectal-cancer (CRC) incidence rates were calculated and all CRC deaths were identified. Multivariable cox proportional hazards models were used to evaluate the association between colonoscopy rate and death from CRC, adjusting for age, sex, comorbidity, income, and location of residence (urban/rural).

Colonoscopy, which is the endoscopic examination for the visualization of the colon and distal part of the small intestine and is the gold standard screening test for colorectal cancer and precancerous conditions. It has the advantage that it can also be used in the detection and removal of adenomas and polyps during the same procedure.

With this study, the researchers have attempted to prove that colonoscopy rates is inversely proportional to CRC death rates, that is, as the rate of colonoscopy increases in the population, the CRC death rates decreases.

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius wrote to governors and independent insurance commissioners of each state asking about their interest in participating in the temporary high risk pool program (which is part of the healthcare reform law).

The temporary high risk pool program is part of the new health insurance reform law and it addresses the people who could not be insured due to pre-existing medical conditions.

The letter, dated April 2, 2010, asks the states to express their interest in participating in the program and how they want to involve in it.

Sebelius announced that implementing the temporary new high risk pool program is amomg the initial tasks to be done in the new healthcare reform law and that the HHS will work closely with the states to clear their doubts regarding this.

A sum of $5 billion is allocated towards this program in the new insurance reform law, which will be available from July 1^st , as it is the start of the fiscal year in many states, till January 1, 2014. The amount disbursed to each state depends on its population and costs. Unissued funds will be reallocated after two years.

States can participate in this program through multiple options which includes:

• They can form a new high risk pool along with a current state high risk pool
• They can establish a new high risk pool if they don’t have one
• If they have a different program, states can build upon their existing one.
• States can also contract with a current HIPAA carrier to cover eligible individuals.

The letter asks the states to let their intentions be known by April 30^th. The letter also states that a conference call will be held in mid-April to enable learning additional details about the of the program, application requirements, as well as to respond to any questions regarding this program.

Scientists plan to take-up their concerns, regarding radiation hazards from excessive radiology procedures, to the public on tuesday at a Food and Drug Administration (FDA) meeting, The New York Times reports.

The two-day public meeting (March 30th and 31st) is called by FDA to evaluate the issues regarding unnecessary radiation exposure from routine procedures and to discuss steps devicemakers can take to reduce patient exposure to radiation.

The report states that according to reports from FDA and interviews with the agency scientists, the FDA has ignored warnings from government experts regarding riskes from powerful Computed Tomography (CT) scans used for colo-rectal cancer screening.

Cancer risk from unnecessary radiology diagnostic procedures, doctors prescribing unneccesary scans, lack of standardization of CT scanners and other radiation emitting equipment are all much debated issues nowadays with regard to reducing radiation exposure. Use of CT scans for cancer screening in healthy adults is another hot topic.

The average life time dose of diagnostic radiation has increased around 7 times in the last thirty years. The increasing popularity of CT scans, driven by overzealous doctors and companies, is in particular a cumulative factor for this. The radiation emitted by a single whole body scan is equivalent to that emitted by about 500 conventional x-rays. Studies have showed that CT scans increase the cancer risk by about 0.05 percent.

New York Times reports that it is a very difficult position for the patients side because doctors, patient advocacy groups and manufacturers advocate these tests for their econimic interests; radiologists who own and use equipment favour the tests while patient groups are funded by manufacuters or physician groups.

Also the FDA, who has to sort out the issue, is also divided with internal dispute, the newspaper says. A group of agency scientists might testify that the FDA managers ignored their concerns thereby endangering the public.

Researchers at the Henry Ford Hospital analyzed cardiac computed tomography angiography (CCTA) data from 8, 200 patients and found that people with a family history of coronary artery disease has higher risk of developing obstructive CAD (28 percent) and atheromatous coronary artery plaques than those without a family history.

Cardiac computed tomography angiography (CCTA) is a non-invasive imaging test which uses the CT scanner to image blood vessels of the heart. CCTA can see through the coronary artery and measure the extend of the plaques and CAD.

The Henry Ford Hospital study is the largest one to date using CCTA and the results are presented at the 59th annual American College of Cardiology Scientific Sessions in Atlanta.

“This is the first study to show that family history of premature coronary artery disease is a significant predictor of obstructive coronary artery disease using coronary computed tomography,” says Mouaz Al-Mallah, M.D., director of Cardiac Imaging Research at Henry Ford and lead author of the study.

University of Nebraska Medical Center (UNMC) lymphoma experts say that patients who are completely treated for lymphoma are recieving unnecessary Computed Tomography (CT) and Positron Emission Tomography (PET) examinations during their follow-up visits, often on the patient’s requests.

UNMC oncologist, Julie Vose, M.D., and co-author Malik Juweid, M.D. published their comments regarding this issue in a letter the editor in the March Edition of the ‘New England Journal Of Medicine’. They said that only a small percent of the Hodgkin’s lymphoma recurrences are diagnosed by PET/CT while majority is detected by the patient himself or during the doctor’s routine examination of the patient without imaging.

This leads to unnecessary radiation exposure and also unnecessary expediture. The radiation exposure has the risk of other cancers like lung and breast cancer.

During follow-up, physical examination, educating the patient about symtioms, routine blood tests and a yearly chest x-ray would be sufficient. Dr. Vose said that that the policy is not to do a scan unless there are symptoms or positive examination findings.

“In patients at low risk of recurrence, reducing the exposure to excessive radiation is an important goal,” she said.

The NHS Database in England might be pulling in information from patient’s confidential medical records without consent, doctors have warned.

The British Medical Association (BMA) said it has “serious concerns” that patient medical records are being uploaded too quickly to a national database.

The system will eventually link more than 30,000 GPs to nearly 300 hospitals through an online appointments system (Choose and Book), a centralised medical records system for 50 million patients, e-prescriptions and faster computer network links.The centralised medical records system, Summary Care Record (SCR), will include dats on the patient’s allergies, medication and adverse reactions, and more with time.

Amidst criticism that the NHS IT upgrade is taking time, the department of health announced in december that they would accelerate the development of the medical records system will be accelerated.

The process will pull the required information from the patient’s medical records to the NHS, the patient will be notified during the process and then they can opt out if they want.

The British Medical Association fears that when the speed with which the programme is being implemented is raising concern.

Hamish Meldrum, chairman of the BMA, said “Patients’ right to opt out is crucial, and it is extremely alarming that records are apparently being created without them being aware of it.”

Even when the Medicare and Medicaid Services denies CT colonoscopy (CTC) coverage for senior citizens, President Obama himself underwent this screening test for colon cancer screening as part of his first physical exam as commander-in-chief.

CT colonoscopy (CTC), also called virtual colonoscopy, is a non-invasive test that is widely accepted by radiologists and gastro-enterologists as a patient friendly and quite effective screening test for large bowel cancer. Inspite of recommendations from organizations like American College of Radiology, and various studies supporting it,  the medicare has refused to cover the test.

Now the news that Obama has recieved virtual colonoscopy test has spiced up  the controversy again. The American College of Radiology (ACR) stated in their press release that the administration has to ensure that seniors have the same access as the President to this less invasive, cutting-edge care.

“……The President and his doctors have unparalleled access to the latest medical and scientific information. The fact that he opted for CTC should put to rest any empty arguments against the viability of CT colonography. It’s time for all patients who want a CT colonography to be covered for this lifesaving exam. Medicare needs to provide coverage now,”said James H. Thrall, MD, chair of the ACR Board of Chancellors.

Contrary to the opinion of ACR, American College of Gastroenterology (ACG) wrote to the President that “while a ‘virtual’ exam is better than no exam, for most people, colorectal screening by colonoscopy is the preferred strategy.”

ACG president Dr. Philip O. Katz, wrote that, “Our 11,000 physician members are concerned that you missed an important opportunity to set an example of the power of prevention by taking the test proven to prevent colorectal cancer by polyp detection and removal.”