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Moving To The U.S. Increases Cancer Risk For Hispanics
Results of a new study confirm trends that different Hispanic population groups have higher incidence rates of certain cancers and worse cancer outcomes if they live in the United States, than they do if they live in their homelands.
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Massachusetts Officials Issue Directive That Seeks To Streamline HIV Testing Consent Process
The Massachusetts Department of Public Health yesterday issued a directive recommending that health care providers include written consent for HIV testing in the general permission forms given to patients receiving medical care, the Boston Globe reports. State health care providers typically give patients separate consent forms for HIV testing, a practice health officials say poses as a barrier to HIV testing for patients and their providers. The new Massachusetts recommendation states that HIV testing should be explicitly mentioned on standard general consent forms. Reinforcing a provision in the CDC"s 2006 HIV testing guidelines, the directive also recommends routine HIV testing for all residents age 13 to 64 in health care settings. Patients in Massachusetts must still opt in to HIV testing, whereas the CDC recommends that HIV testing be performed unless a patient opts out, according to the Globe (Cooney, Boston Globe, 6/25).
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New Drug Combination Offers Novel Treatment Strategy For Non-Hodgkin's Lymphoma
Patients diagnosed with non-Hodgkin"s lymphoma who become resistant to standard therapies may have a new treatment option. Scientists in the Lymphoma Translational Research Laboratory at Roswell Park Cancer Institute analyzed the mechanisms to overcome treatment resistance, including a new drug combination. Francisco J. Hernandez-Ilizaliturri, MD , Departments of Medicine and Immunology, Roswell Park Cancer Institute (RPCI), will present the findings at the American Society of Clinical Oncology (ASCO) 2009 annual meeting, May 29 - June 2, in Orlando, FL.
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Reminder Program Dramatically Increases Mammography Rates, Kaiser Permanente Study Finds

A reminder program aimed at screening for breast cancer when it is most treatable boosted mammography rates by more than 17 percentage points, according to a new study by Kaiser Permanente"s Center for Health Research in the August issue of the American Journal of Preventive Medicine. The program used electronic health records to identify women who would soon be due for a mammogram and reached out to them via postcards, automated voice messages and personal phone calls. The study of 35,000 Kaiser Permanente members is the largest to test a reminder program involving this three-pronged approach. By the second year of the program in 2008, mammography rates jumped from 63 to more than 80 percent among women aged 50-69. "We know mammograms are effective, but too many women put them off, even when they have health insurance," said lead author Adrianne Feldstein, MD, MS, an investigator at Kaiser Permanente"s Center for Health Research in Portland, Ore., and a practicing physician. "This study is the first to show that these reminder programs can be effective in such a large group of women. If we could improve the country"s mammography rate by the same amount, we could detect as many as 25,000 additional cases of breast cancer each year." "Our study shows that a reminder program can spark a big improvement in a short amount of time," said study co-author Nancy Perrin, Ph.D., senior investigator at Kaiser Permanente"s Center for Health Research in Portland, Ore. "Automated reminder programs make it more convenient for people to focus on staying healthy by getting the screenings they need." Breast cancer is the most common cancer among women in the United States, with one in eight developing breast cancer and 46,000 dying from it annually. Although regular mammograms can reduce breast cancer deaths by more than 30 percent and the U.S. Preventive Services Task Force recommends screenings every 1-2 years for women over age 40, current screening rates fall short of these guidelines. The study is part of Kaiser Permanente"s ongoing effort to encourage preventive health through diligent cancer screenings. Nationwide, Kaiser Permanente has an array of services designed to ensure screening for breast cancer, ranging from mobile screening vans, breast health fairs, to built-in prompts in its electronic health records system, KP HealthConnect™ - the world"s largest civilian electronic health record. Funded by the National Cancer Institute, this study involved employees using Kaiser Permanente"s robust electronic health records database to identify women (aged 50-69) who hadn"t had a mammogram for 20 months. Starting in January 2006, these women were sent a postcard telling them that they soon would be due for another mammogram. If they didn"t make an appointment within a month, they received their first automated reminder call. A month later, they received a second automated call, and one month after that, if they still had not made an appointment, they received a call from a clerk in the radiology department. Within 10 months of their first reminder, more than 75 percent of these women had completed their mammograms - compared to only 63.4 percent before the program started. After the second year of the reminder program, 80.6 percent of women had completed their mammograms. While previous trials have examined the effectiveness of mammogram reminder programs, few have addressed implementation and maintenance of these programs. This trial is noteworthy because of its size - most previous trials involved fewer than 1,000 women - and because it incorporated automated calls; most of the previous research had focused only on mail and live telephone counseling reminders. The study was not a randomized controlled trial, and women in the comparison groups were not the same age as those in the target group. However, screening rates in the comparison groups did not improve, which leads the authors to believe that improvements in the target group were indeed a result of the reminder program. Study authors include: Adrianne Feldstein, MD, MS; Nancy Perrin, Ph.D.; A. Gabriela Rosales, MS; Jennifer Schneider, MPH; and Mary M. Rix, RN, all with the Kaiser Permanente Center for Health Research in Portland, Ore.; Stephanie Schoap, MBA, and Kara Keels of Kaiser Permanente Northwest in Portland, Ore.; and Russell E. Glasgow, Ph.D., of the Institute for Health Research, Kaiser Permanente, Penrose, Colo. Emily Schwartz Golin/Harris International


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