Tag: USPSTF
The American Cancer Society’s new mammography guidelines: Déjà vu all over again
One of the things that feels the weirdest about having done the same job, having been in the same specialty, for a longer and longer time is that you frequently feel, as the late, great Yogi Berra would have put it, déjà vu all over again. This is particularly true in science and medicine, where the same issues come up again and...
An aspirin a day to prevent heart attacks, strokes, and cancer?
Taking an aspirin a day has always been controversial when it comes to preventing disease before it occurs. Now a task force is recommending daily use under some circumstances. Do the benefits really outweigh the risks?
Vitamin D: To Screen or Not to Screen?
Vitamin D, the so-called sunshine vitamin, has generated a lot of attention in recent years. It has been claimed to benefit a wide variety of diseases, everything from cancer to multiple sclerosis. It is widely used along with calcium for bone health. It is added to milk and prenatal vitamins and is prescribed for breastfed babies. Some doctors are recommending everyone take...
Mammography and the acute discomfort of change
As I write this, I am attending the 2014 meeting of the American Association for Cancer Research (AACR, Twitter hashtag #AACR14) in San Diego. Basically, it’s one of the largest meetings of basic and translational cancer researchers in the world. I try to go every year, and pretty much have succeeded since around 1998 or 1999. As an “old-timer” who’s attended at...
More evidence that routine multivitamin use should be avoided
If scientific evidence guides our health decisions, we will look back at the vitamin craze of the last few decades with disbelief. Indiscriminate use is, in most cases, probably useless and potentially harmful. We are collectively throwing away billions of dollars into supplements, chasing the idea of benefits that have never materialized. Multivitamins are marketed with a veneer of science but that...
Do vitamins prevent cancer and heart disease?
The US Preventive Services Task Force has released an update on vitamin and mineral supplements to prevent heart disease and cancer. The evidence was not good and did not support taking vitamins as "nutritional insurance."
Calcium supplements and heart attacks: More data, more questions
Why take a drug, herb or any other supplement? It’s usually because we believe the substance will do something desirable, and that we’re doing more good than harm. To be truly rational we’d carefully evaluate the expected risks and benefits, estimate the overall odds of a good outcome, and then make a decision that would weigh these factors against any costs (if...
Clinical Practice Guidelines: Cholesterol Tests for Children?
The American Academy of Family Physicians journal American Family Physician (AFP) has a feature called Journal Club that I’ve mentioned before. Three physicians examine a published article, critique it, discuss whether to believe it or not, and put it into perspective. In the September 15 issue the journal club analyzed an article that critiqued the process for developing clinical practice guidelines. It discussed...
Prostate Cancer Dilemmas: To Test or Not to Test, To Cut or Not to Cut
Diagnosing prostate cancer based on the prostate-specific antigen (PSA) test is a tricky proposition. The cancer itself can be slow-growing, and the treatment harmful. Medicine is complicated, particularly when it comes to cancer screening.
Re-thinking the Annual Physical
Please note: the following refers to routine physicals and screening tests in healthy, asymptomatic adults. It does not apply to people who have been diagnosed with diseases, who have any kind of symptoms or signs, or who are at particularly high risk of certain specific diseases. Throughout most of human history, people have consulted doctors (or shamans or other supposed providers of...