Mammogram Advice Was Confusing
The most recent recommendations on when to get a mammogram confused close to one-third of women and helped educate only about 6% of them, according to a study published in the American Journal of Preventive Medicine.
In November 2009, the U.S. Preventive Services Task Force offered different recommendations for women aged 40–49, 50–74, and 75 years and over. Months after the task force report, confusion reigned – especially among women 40–49, women who never had had a mammogram, and women who had had their last mammogram more than 2 years ago – the study found.
The researchers surveyed 1,221 women and analyzed news articles and social-media posts on the recommendations. Care in crafting future recommendations and testing messages before releasing them might avert confusion, the researchers said.
States Weighing Abortion Curbs
State legislators around the country introduced 916 measures related to reproductive health in the first 3 months of 2011.
Slightly more than half of the bills aimed to restrict access to abortion, according to an analysis by the Guttmacher Institute. Bills would curb insurance coverage of abortion, restrict abortions after certain gestation points, and require a woman to view ultrasound images of a fetus before an abortion.
As of March 31, seven states had enacted 15 new laws on such issues, including North Dakota's mandate that physicians performing abortions personally inform women of all possible complications. Abortion rights supporters appear to be “playing defense at the state level,” according to the Guttmacher Institute analysis.
Heart Ills Led Maternal Deaths
Cardiovascular disease was the leading cause of women's pregnancy-related deaths 2002–2003 in California, according to an analysis from the state's Department of Public Health. Of the 386 deaths during childbirth or within a year, 98 were directly related to pregnancy or its management. And of those, 20 deaths were due to cardiovascular disease.
Other major causes of pregnancy-related death included preeclampsia and eclampsia, amniotic fluid embolism, obstetric hemorrhage, and sepsis or infection. The state has been conducting a detailed review of maternal deaths because of their dramatic rise from 8.0 per 100,000 live births in 1999 to 14.0 deaths per 100,000 live births in 2008.
A Call for Cultural Sensitivity
The American College of Obstetricians and Gynecologists is offering specific examples of how ob.gyns. should be sensitive to patients' cultural backgrounds. A four-page “committee opinion” in the May issue of Obstetrics & Gynecology lists nine problem scenarios and then offers the “culturally sensitive approach” to each. For instance, the preferred way to deal with a patient's sexual orientation: “The physician uses intake forms that do not assume heterosexuality. The form asks if the patient is sexually active and then asks with men, women, or both …” In a statement, Dr. Maureen G. Phipps, chair of the Committee on Health Care for Underserved Women, said, “Health care should not be one-size-fits-all.”
FDA Device Review Questioned
The Government Accountability Office said that the Food and Drug Administration has not done enough to ensure the efficiency and effectiveness of its recall procedures for high-risk medical devices. Back in January 2009, the GAO hound fault with the 510(k) device-approval process and recalls. The agency is again urging the FDA to quickly issue final rules to more strictly and clearly regulate 510(k) devices. Since the 2009 report, the FDA has published a strategic plan but issued a final rule on only one type of device, the GAO said. The agency is not collecting data that would let it identify risks posed by devices, even though 3,510 were voluntarily recalled for problems in 2005–2009, said the GAO. “Taken together, GAO's preliminary work suggests that the combined effect of these gaps [in the FDA's recall process] may increase the risk that unsafe medical devices could remain on the market,” said the new report.
AIDS-Related Cancers Drop
The incidence of AIDS-related cancers is falling among people infected with HIV, while other cancers are increasing in this population, according to a study from the Centers for Disease Control and Prevention and the National Cancer Institute. Cases of Kaposi sarcoma, non-Hodgkin lymphoma, and invasive cervical cancer – three malignancies regarded as indicators of AIDS – fell from 34,000 in 1991–1995 to about 10,000 in 2001–2005. Antiretroviral therapy emerged between those two periods. However, cases of all other cancers in HIV-infected individuals climbed from 3,000 to 10,000. People with HIV carry an increased risk for Hodgkin lymphoma and anal, lung, and liver cancers, and these four malignancies made up nearly half of all the cancers diagnosed in the HIV-positive population 2001–2005.