Included below are news items from the last six months.
Only half of all Americans identified as having hepatitis C antibodies on screening tests have had a follow-up test to determine if active virus is present. Such follow-up testing is recommended by the CDC to ensure that those who are infected get appropriate care and treatment to prevent serious and potentially life-threatening health consequences, including liver cancer, which is the fastest-rising cause of cancer-related death in the U.S. The CDC recommends that everyone in the U.S. born from 1945 through 1965 as well as those with risk factors be screened for hepatitis C.
A new strain of avian influenza A H7N9 ("bird flu") has infected 131 people and caused 36 deaths, as of May 17, in China since the first cases were reported in March. The virus is raising concern because it does not typically infect humans; however, evidence suggests the majority of those affected came into contact with infected poultry or contaminated environments. While no cases have been found in the U.S. or in travelers returning to the U.S., the CDC is providing information about the virus to healthcare practitioners and public health professionals in an effort to protect against spread of the infection.
A test for mutations in the BRCA1 gene helped inform actress Angelina Jolie's recent headline-making decision to undergo a double mastectomy to mitigate what doctors estimated to be an 87% risk of developing breast cancer. The test confirmed she has a mutated BRCA1 gene, one of two genes for which mutations are linked with hereditary breast and ovarian cancers. However, the test is not useful for everyone – only 0.2% of the U.S. population carries a BRCA mutation. Those who should consider testing include people at higher risk due to family history or certain other risk factors.
Far too few Americans with prediabetes know they have the condition, according to a recent report from the Centers for Disease Control and Prevention. In 2010, about one in three U.S. adults 20 and older (about 79 million people) had prediabetes, which can lead to full-blown type 2 diabetes, but only about 11% were aware of it. Treating prediabetes early with dietary changes, weight loss, and increased physical activity can help prevent or delay the onset of type 2 diabetes.
The CDC announced that recent data analysis shows more than half a million U.S. children exceed the agency's current threshold for lead exposure. This report comes after the CDC reduced the "level of concern" by half last year and replaced it with a new reference value. While progress has been made in reducing blood lead levels of young children in the U.S., the CDC recognizes that there is more yet to be accomplished.
A recent study found that women with high blood levels of anti-mullerian hormone (AMH) are more likely to have a successful birth following in vitro fertilization than women of similar age with low levels of this hormone. The researchers concluded that AMH might be useful as a prognostic factor for determining the chances of successful pregnancy and live birth following IVF, providing additional information that could aid those who are struggling with infertility.
Not every test and procedure is appropriate for a particular condition, says a coalition of 41 medical organizations. The campaign, known as Choosing Wisely, has updated its list of tests and procedures that patients and doctors should discuss thoroughly because they may not be necessary. Patients who will undergo testing or medical procedures may wish to become familiar with the campaign and its recommendations.
The Pap test has been used successfully to routinely screen women for pre-cancerous changes and to detect cervical cancer in the earliest stages, when it is most treatable. A new study suggests that cervical samples collected during Pap smears contain DNA that can be evaluated for genetic changes caused by both ovarian and endometrial cancers. While this technique needs years of additional testing to see if it can accurately detect the cancers, in combining the new test with a traditional Pap smear, it may eventually become possible to effectively screen for three major cancers affecting women using one sample.
A joint policy statement by the American Academy of Pediatrics (AAP) and the American College of Medical Genetics and Genomics (ACMG) recommends that the best interest of each child be the determining factor for offering and performing genetic testing. The organizations issued updated recommendations in light of recent and rapid advances in genetics, which health care providers as well as patients and parents of minor children need to be aware of when considering genetic testing.
A non-invasive maternal blood test called cell-free fetal DNA (cffDNA) can detect certain fetal chromosomal disorders, including Down syndrome, early in pregnancy and is gaining attention as a potential new method of prenatal screening. Several organizations support its use in pregnant women at high risk of having a child with a disorder caused by an abnormal number of chromosomes. However, at this time, invasive diagnostic tests, such as chorionic villus sampling and amniocentesis, are still needed to confirm the results.
People getting blood tests to check their cholesterol levels are generally told to fast for 9 to 12 hours before the blood draw, which can lead to canceled or postponed test appointments. A recent study suggests that, for many people, eating before the test does not impact the results enough to affect the interpretation and that fasting is largely unnecessary. It remains to be seen, however, whether fasting recommendations will change.
Two new studies from the Centers for Disease Control and Prevention (CDC) found that recent screening guidelines that call for less cervical cancer screening are generally being followed by younger women, but too many older women and women who've had total hysterectomies are still undergoing the screening, which is not recommended because of the very low risk of cervical cancer in these women. Unnecessary screening can result in false positives and lead to further unnecessary testing and procedures, says the CDC.
The U.S. Preventive Services Task Force has released draft guidelines to update their screening recommendations for HIV and to recommend, for the first time, screening guidelines for hepatitis C virus. After reviewing more recent evidence, the Task Force now strongly recommends that clinicians screen all people ages 15 to 65 for HIV infection. New draft guidelines for hepatitis C advise screening adults at high risk and routine testing of adults born between 1945 and 1965, as prevalence is highest among this group. Expanded testing and treatment for these infections could reduce transmission and save lives, says the Task Force.