Mammogram rate drops slightly in U.S.

Thu, 25 Jan 2007 22:14:31 GMT
By MIKE STOBBE, AP Medical Writer
ATLANTA - The percentage of American women getting mammograms has dropped slightly over the past few years, in what health officials said Thursday is a troubling sign that the battle against breast cancer may be flagging.
The share of women 40 and older who said they had a mammogram in the previous two years slipped from 76.4 percent to 74.6 percent between 2000 and 2005, according to study released by the Centers for Disease Control and Prevention.

The rate had risen dramatically over the past two decades, from 29 percent in 1987, according to American Cancer Society statistics.

The CDC and other researchers said possible explanations for the drop include a shortage of mammography screening centers and specialists, and a lack of health insurance among patients.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the decline may also reflect complacency among women.

"This is a group of women who have `grown up' with mammography as they've aged, they've perhaps had it done many times over the years and they've decided, `Well, it's been OK, maybe I can put it off for a while,'" he said.

He warned that the recently reported declines in breast cancer incidence rates and cancer deaths are at risk if the decline continues. "If we don't pay attention now, we run the risk of seeing some of the gains we've made reversed," he said.

The decline of less than 2 percentage points may seem small, but it could be terribly significant, Lichtenfeld said. But if you consider that about 80 million U.S. women should be getting a mammogram every year, it means more than 1 million fewer women are getting the screening test, he said.

And that may mean thousands of cases of breast cancer may not be diagnosed. Women whose breast cancer is caught early have more treatment options and a better chance of beating the disease.

The decline may also at least partly explain a recent drop in U.S. breast cancer rates: It may be that if fewer women are getting mammograms, fewer cases of breast cancer are being discovered.

Some researchers instead tied the drop in breast cancer to reduced use of hormones for menopause.

The study is being published this week in a CDC publication, Morbidity and Mortality Weekly Report. It was based on a national telephone survey of more than 14,000 women in each of the survey years.

The study is not the first to spot the decline. The cancer society keeps statistics, derived from a different national survey, that showed a slight decline in mammogram from 2000 to 2003. Another study of HMO patients showed a decline in screening rates from 1999 to 2002.

Mammography rates increased substantially during the 1990s, so there seems to have been some turning point around 2000.

Obama calls for universal health care

Thu, 25 Jan 2007 20:53:12 GMT
By NEDRA PICKLER, Associated Press Writer
WASHINGTON - Every American should have health care coverage within six years, Democratic Sen. Barack Obama said Thursday as he set an ambitious goal soon after jumping into the 2008 presidential race.
"I am absolutely determined that by the end of the first term of the next president, we should have universal health care in this country," Obama told a conference of Families USA, a health care advocacy group.

The Illinois senator did not provide specifics on his plan for coverage.

Obama was previewing what is shaping up to be a theme of the 2008 Democratic primary. His chief rivals, Sen. Hillary Rodham Clinton and John Edwards, also are strong proponents of universal health care and have promised to offer their plans.

Obama said while plans are offered in every campaign season with "much fanfare and promise," they collapse under the weight of Washington politics, leaving citizens to struggle with the skyrocketing costs.

He said it's wrong that 46 million in this country are uninsured when the country spends more than any one else on health care. He said Americans pay $15 billion in taxes to help care for the uninsured.

"We can't afford another disappointing charade in 2008, 2009 and 2010," Obama said. "It's not only tiresome, it's wrong."

Obama's call was an echo of a speech he made last April when he said Democrats "need to cling to the core values that make us Democrats, the belief in universal health care, the belief in universal education, and then we should be agnostic in terms of how to achieve those values."

His argument Thursday not only will be considered through the prism of the presidential campaign, but weighed against rival Sen. Hillary Rodham Clinton's ill-fated plan to overhaul the health care insurance system when she was first lady.

Even after leading that calamitous attempt in 1993, Clinton remains in favor of universal health care and has made it a central theme of her presidential bid.

"One of the goals that I will be presenting ... is health insurance for every child and universal health care for every American," she said at a community health clinic in New York Sunday, the day after entering the 2008 Democratic field. "That's a very major part of my campaign and I want to hear people's ideas about how we can achieve that goal."

On Thursday, she criticized Bush's proposal to make health care more affordable through tax breaks, arguing that it would lead to less funding for hospitals.

Addressing the U.S. Conference of Mayors, Clinton was self-deprecating in describing her own experience in the health care debate and joked that Bush would need some heavy-duty protection as he wades into the fight.

"I welcome his participation in the health care debate. I'm going to send him a suit of armor because I know anybody who puts a foot in the health care debate is gonna need that. I've got the scars and experience to show for it," said the New York senator.

Another candidate, Ohio Rep. Dennis Kucinich, also backs universal health care.

___

Associated Press Writer Beth Fouhy in New York and Devlin Barrett in Washington contributed to this report.

New birth control pills could win approval

Thu, 25 Jan 2007 07:39:56 GMT
By ANDREW BRIDGES, Associated Press Writer
WASHINGTON - New birth-control pills that are less effective in preventing pregnancy than the original contraceptives of the 1960s still could win federal approval if they promise other benefits, under a recommendation by health advisers.
http://www.fda.gov/

Spain clothiers to modify fashion sizes

Wed, 24 Jan 2007 21:32:26 GMT

MADRID, Spain - Spain's government has reached an agreement with major fashion designers, including the owner of the Zara chain, to standardize women's clothing sizes with the aim of promoting a healthier image. Designers such as Cortefiel, Mango, El Corte Ingles and Inditex, which owns Zara, agreed to take part in the program, which was announced Tuesday.
The program, designed by the Health Ministry, will also prevent those companies from using window displays featuring clothes smaller than a European size 38 . They will have five years to phase in the change.

"It is not reasonable for a modern and advanced society to establish stereotypes of beauty that are far removed from the social reality of a community. It is everyone's commitment that beauty and health go hand in hand," Health Minister Elena Salgado said at a signing ceremony Tuesday.

The agreement follows last year's unprecedented decision by Spain's main fashion show, Madrid's Pasarela Cibeles, to ban some models from the catwalk on grounds they were too thin, saying this looked encouraged eating disorders among young people.

The Health Ministry's program aims to end a situation in which a woman who buys a size 40 dress from one designer may not fit in a size 40 garment from another designer. The ministry said the differences sometimes lead women to feel compelled to lose weight.

Designers should be encouraged to "promote a healthy physical image that conforms with the reality of the Spanish population," the ministry said in a statement.

The agreement also stipulates that European size 46 no longer be specifically labeled as a larger size.

As part of the effort to standardize sizes, the ministry plans to measure 8,500 Spanish girls and women between the ages of 12 and 70 to determine the true shapes of Spanish women's bodies.

Weight loss improves heart function in obese

Thu, 25 Jan 2007 18:21:39 GMT

NEW YORK - A new study shows that people who are obese can reverse some early heart and blood vessel dysfunction by adopting a healthy lifestyle and losing weight. But exercise alone, without weight loss, does not appear to be enough to improve cardiovascular function.
Dr. Chiew Y. Wong of the University of Queensland in Australia and colleagues had 106 obese men and women with no cardiovascular disease complete an eight-week lifestyle intervention program. Sixty-two cut their calorie and fat intake and exercised, while 44 exercised but did not change their diet.

Forty-eight of the study participants lost an average of 4.5 percent of their body weight, while the remaining 58 kept their weight stable or gained weight.

Among those who lost weight, the researchers noted improvements in their arteries' response to changes in blood pressure, as well as a 15 percent improvement in peak VO2, a measure of how well the body uses oxygen during exercise.

The more weight people lost, the greater their improvements in blood vessel function and fitness. People who lost weight also showed some improvement in their left ventricular function.

While the men and women who didn't lose weight did show improvements in peak oxygen uptake -- a measure of how well the body uses oxygen -- no significant changes were seen in their heart or blood vessel function.

This study "supports the argument that increasing cardiorespiratory fitness alone is not sufficient to produce the same cardiovascular benefits," the researchers conclude.

SOURCE: American Journal of Cardiology, December 15, 2006.

Psychic distress common with Parkinsons dementia

Wed, 24 Jan 2007 18:54:47 GMT

NEW YORK - People with dementia associated with Parkinson's disease often suffer from a range of psychiatric and neurological symptoms such as anxiety, agitation and hallucinations, researchers report.
Dr. D. Aarsland, of Stavanger University Hospital, Norway, and colleagues examined the pattern of neuropsychiatric symptoms in 537 patients with Parkinson's disease-related dementia, assessed using the 10-item Neuropsychiatric Inventory.

The subjects were an average of 73 years old, had had Parkinson's disease for some 10 years, and had been demented for about 2 years.

Overall, 89 percent of them had at least one neuropsychiatric symptom, and 77 percent had two or more, the team reports in the Journal of Neurology, Neurosurgery, and Psychiatry.

The most common symptoms were depression, apathy, anxiety, and hallucinations. In general, patients with more severe dementia and advanced Parkinson's disease exhibited more neuropsychiatric symptoms.

The investigators noted five distinct patterns or clusters of symptoms. These included a "mild" cluster with few symptoms; a "mood" cluster with high scores on depression and anxiety; an "apathy" cluster with high scores on apathy and low scores on other items; an "agitation" cluster with high scores on agitation and high total scores; and a "psychosis" cluster with high scores for delusions and hallucinations.

Patients in the psychosis and agitation clusters had the most advanced disease, and these two groups were also associated with the highest distress scores among caregivers.

Classifying patients into these subgroups has "potential treatment implications," Aarsland's team concludes. They also suggest that there may be "specific neurobiological changes underlying the different neuropsychiatric clusters."

SOURCE: Journal of Neurology, Neurosurgery, and Psychiatry, January 2007.

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