Most people know that colorectal screening is on the “to do” list when they reach 50 years of age, barring any high risk concern for where screening would begin earlier. Screening saves lives and prevents many colon cancers. With the increase in public awareness and availability of colonoscopy screening, the rates of colon and rectal cancers have been declining and survival rates increasing for people between the ages of 50 and 74. This is great news for our mature population, but a recent study indicates a concerning trend of increased risk of colorectal cancer in young people, ranging from ages 20 to 34 and 35-49 year olds.
Swedish Cancer Institute and Seattle Radiology have been screening for lung cancer by low dose CT scan since 2000 as Principal Investigators in the International Early Lung Cancer Action Program, an international screening registry. This program, in addition to the large National Lung Screening Trial by the National Cancer Institute and several other international lung screening research trials, has been instrumental in delivering the need for lung cancer screening to the forefront and addressing this dreadful cancer in a complete face off. This research has clearly demonstrated an ability to significantly improve survival and save lives by early detection of lung cancer through routine low dose CT scan imaging.
Nearly a year ago the United States Preventive Services Task Force made a formal Grade B recommendation for lung cancer screening, by low dose CT scan, in high-risk people. People ..
For most parents, the newborn period is a time of profound joy, incredible challenges, and LOTS of questions. As pediatricians, some of the questions we are frequently asked are related to a simple blood test done on all infants in Washington State. Commonly referred to as the “newborn screen” or “NBS”, “PKU”, or “newborn metabolic testing”, this test checks for several congenital disorders that are rare but can be life-threatening.
Often parents want to know:
What does the test involve? The newborn screen is done by pricking the heel of the infant at around 24 hours of age, then collecting a few drops of blood onto a piece of test paper. This is dried and then sent to the state lab, where the testing is performed. Because some of the conditions may take several days to show up, the test is repeated at 7-14 days old (usually by your primary care doctor; it can also be done in the hospital if the baby is still there for any reason).
Does it hurt? The needle prick is performed by trained nurses and is done quickly. It may feel similar to pricking your finger to test blood sugar. And you can significantly decrease the discomfort of the quick poke by breastfeeding your baby during or immediately after the test!
Why do we need this? The diseases we check for are typically rare, but if undiagnosed and untreated can cause a variety of complications, including blindness, poor growth, brain damage, and even death. The reason that testing every baby is essential is that babies with these conditions can look and act perfectly healthy even while the disease is damaging their bodies, until they get so sick they need to be hospitalized or have permanent damage. Starting treatment as early as possible can prevent many of the complications.
What are you testing for? The ...
A typical scenario is a child whose pain seems worst in the mornings after awakening and towards the evening, especially after dinner or before bedtime. Often the child doesn’t want to eat breakfast and if forced, tells his parents he feels nauseated. When asked where the pain is, the child most often points to the area around his belly button.
More often than not, depending on a few other factors, the diagnosis ends up being ...
A Canadian medical research study has recently been published questioning the value of doing screening mammograms on women in their forties. The article has spurred controversy because the results contradict multiple other similar research studies which showed that women in that age group who get regular mammograms actually are spared death from breast cancer more often that women who are not invited to screening.
Some problems with the methods of Canadian study, published in the journal BMJ, were pointed out by a scientist at the University of Washington, Judith Malmgren, who has worked with Swedish Medical Center doctors to see how women in their forties have fared in our system. Click here to read Dr. Malmgren’s letter to the editor of BMJ.
There are two ironic features to the Canadian study. First, the authors say it is okay for women to not get screening starting in their forties “when adjuvant therapy for breast cancer is readily available.” This means that it is okay to diagnose breast cancer later because you can mop up bigger and more advanced cancers with treatment like chemotherapy, radiation and bigger surgery. But at Swedish, we do not think that many women prefer more severe therapy rather than earlier detection.
Love also means keeping them safe.
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
Vitamin K injection
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease.
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B.
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not ...
How do we find early cancers?
Some cancer screenings can be done yourself at home at essentially no cost or risk. This includes regular self-examination of the breasts, testicles and skin. Home fecal occult blood testing can also be done to screen for colorectal cancer. Additional information on cancer screening and self-examinations can be found on websites such as www.cancer.org or www.webmd.com.
Other screening requires medical interventions. There is good evidence that well-targeted screening saves lives. However, screening tests such as mammography, colonoscopy and prostate-specific antigen (PSA) are ...