December 28, 2009 |
A few weeks ago, a healthy patient in her early 40s came to my office requesting a CT scan of the chest. She was a smoker and wanted to be sure that she didn't have lung cancer. I explained to her that a CT, or computerized tomography, scan was not a good test for lung cancer. I even pulled up the U.S. Preventive Services Task Force guidelines on my computer to show her that there was no compelling evidence to support screening. She refused to accept this explanation. "I want to know that I don't have cancer," she repeated.
November 8, 2010
The growing ranks of Americans without health insurance ? more than 50 million, according to the Census Bureau's latest estimate ? are a clear symptom of a dysfunctional healthcare system. A more subtle sign of trouble emerged shortly before last week's elections, when a blue-ribbon panel of doctors canceled a meeting to discuss guidelines for preventive care. The 15 primary-care physicians who make up the Preventive Services Task Force, an independent group sponsored by the federal Agency for Healthcare Research and Quality, review the evidence about screening and other techniques for detecting and preventing disease, then advise doctors on which ones to use. The panel had been set to meet Nov. 1-2 to discuss, among other things, possible new guidelines for prostate and cervical cancer screening.
July 4, 2010 |
You've been told you have high cholesterol and need to get the numbers down. But how bad are your levels, really, and what might happen if they don't improve? What's the best way to get them in line? Or maybe you have a history of breast cancer in your family and wonder what kinds of screenings you should be getting and when. Should you consider genetic testing? Dr. Shantanu Nundy addresses these and other preventive healthcare questions in his new book, "Stay Healthy at Every Age: What Your Doctor Wants You to Know."
November 17, 2009 |
A government panel's recommendation Monday that women under the age of 50 do not need regular mammograms set off a furious debate about the importance of the routine screening tool, leaving many women confused about how best to protect their health. In issuing its guidelines, the U.S. Preventive Services Task Force concluded that risk of breast cancer is very low in women age 40 to 50 and that the risk of false positives and complications from biopsies and other invasive procedures is too high for the procedure to be used routinely.
November 20, 2009
Everyone who knows the prevailing medical wisdom on hormone replacement therapy for menopausal women, please stand up. Feels lonely up there, doesn't it? Hormone therapy after menopause was standard practice after a 1991 study found that it reduced the risk of cardiovascular disease -- until a study 11 years later found the opposite. Since then, the treatment has been linked to other health problems -- and found to have some advantages as well. Some doctors highly recommend hormones; others warn their patients away from them.
November 23, 2009 |
Although we all would like to think that public health pronouncements are the unmitigated truth about any issue, rarely is that the case. We can only give our best guess, based on the current available data and our current understanding of the disease. Luckily, research continues, hypotheses are reformulated and new recommendations are made. The path to the truth in science and medicine is nonlinear. Sometimes clinical practice gets ahead of the data and has to be pulled back. This is what happened with post-menopausal hormone therapy when the large Women's Health Initiative trial demonstrated that the then-common practice of giving women hormones at menopause was causing more harm than good.
October 7, 2011 |
If the world of primary-care physicians had a supreme wizarding council that only weighed in on screening tests and pills promising to head off disease, it would be called the U.S. Preventive Services Task Force. On Friday, the U.S. Preventive Services Task Force recommended against routine prostate cancer screening for men using the prostate-specific antigen (PSA) test, saying that patients are more likely to be harmed by anxiety and aggressive treatment prompted by ambiguous test results than they are to reap benefits such as better health or longer life. The practice of medicine in the United States is buffeted daily by a swirling mix of commercial interests, politics, tradition and consumerism.
November 23, 2012
Early treatment for HIV is more successful than later treatment. But that's not the only reason to praise the recommendation of the U.S. Preventive Services Task Force that doctors should test almost everyone ages 15 to 64 for the virus that causes AIDS. The U.S. Centers for Disease Control and Prevention reports that 1.2 million people in the United States are infected with HIV but that close to 1 in 5 don't know it. Even before there was any effective treatment for HIV, large-scale testing as a preventive measure could have kept a tremendous amount of suffering and death at bay. It should have begun years ago. Decades ago. Fear and prudishness got in the way. During the early years of AIDS, there was widespread ignorance about how easily the infection might be transmitted.
April 29, 2013 |
Citing recent evidence that HIV infections are best managed when treated early, an influential panel of medical experts has finalized its recommendation that all people ages 15 to 65 be screened for the virus that causes AIDS. The recommendation from the U.S. Preventive Services Task Force seeks to address one of the key challenges in the fight against HIV/AIDS: The window during which patients respond best to treatment is also the time when symptoms of the disease are least noticeable.