Author Interviews, Breast Cancer, JAMA, Race/Ethnic Diversity / 25.04.2023
Breast Cancer Screening: One-Size-Fits-All Approach May Not be Optimal, Equitable or Fair
MedicalResearch.com Interview with:
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Dr. Fallah[/caption]
Mahdi Fallah, MD, PhD
Study and Group Leader
Risk Adapted Prevention (RAD) Group
Division of Preventive Oncology
National Center for Tumor Diseases (NCT)
German Cancer Research Center (DKFZ)
Heidelberg, Germany
MedicalResearch.com: What is the background for this study?
Response: Breast cancer is a significant public health problem, being the most commonly diagnosed cancer and the second leading cause of cancer death in women in the US. Breast cancer screening from age 50 has been associated with a reduction in mortality and is recommended by the US Preventive Services Task Force. However, there is a significant disparity in mortality rates between Black and White individuals, with Black women having a higher death rate, especially before age 50. The current one-size-fits-all policy for breast cancer screening may not be equitable or optimal, and risk-adapted starting ages of screening based on known risk factors, such as race and ethnicity, may be recommended to optimize the benefit of screening. Our study aimed to provide evidence for a risk-adapted starting age of screening by race and ethnicity.
Dr. Fallah[/caption]
Mahdi Fallah, MD, PhD
Study and Group Leader
Risk Adapted Prevention (RAD) Group
Division of Preventive Oncology
National Center for Tumor Diseases (NCT)
German Cancer Research Center (DKFZ)
Heidelberg, Germany
MedicalResearch.com: What is the background for this study?
Response: Breast cancer is a significant public health problem, being the most commonly diagnosed cancer and the second leading cause of cancer death in women in the US. Breast cancer screening from age 50 has been associated with a reduction in mortality and is recommended by the US Preventive Services Task Force. However, there is a significant disparity in mortality rates between Black and White individuals, with Black women having a higher death rate, especially before age 50. The current one-size-fits-all policy for breast cancer screening may not be equitable or optimal, and risk-adapted starting ages of screening based on known risk factors, such as race and ethnicity, may be recommended to optimize the benefit of screening. Our study aimed to provide evidence for a risk-adapted starting age of screening by race and ethnicity.
Dr. Potter[/caption]
MedicalResearch.com Interview with:
Kelly Potter, PhD, RN, CNE
T32 Postdoctoral Scholar
CRISMA Center, Department of Critical Care Medicine
University of Pittsburgh
MedicalResearch.com: What is the background for this study?
Response: While it is well-recognized that survivors of critical illness often experience persistent problems with mental, cognitive, and physical health, very little is known about how these problems (collectively known as post-intensive care syndrome (PICS)) affect resumption of meaningful activities, such as driving.
Dr. Mosley[/caption]
Jonathan Mosley, MD, PhD
Associate Professor
Division of Clinical Pharmacology
Departments of Internal Medicine and Biomedical Informatics
Vanderbilt University Medical Center
MedicalResearch.com: What is the background for this study?
Response: Prostate cancer is an important source of morbidity and mortality among men. Earlier detection of disease is essential to reduce these adverse outcomes. Prostate cancer is heritable, and many single nucleotide polymorphisms (SNPs) associated with disease risk have been identified. Thus, there is considerable interest in using tools such as polygenic risk scores, which measure the burden of genetic risk variants an individual carries, to identify men at elevated risk of disease.
Dr. Roca[/caption]
Anna Roca PhD
MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine
Fajara, The Gambia
MedicalResearch.com: What is the background for this study?
Response: Context specific interventions are needed to decrease the high burden of severe neonatal morbidity and mortality in sub-Saharan Africa. Severe bacterial infections are a main cause of neonatal mortality in the continent. Oral intra-partum azithromycin is a cheap intervention easily scalable. Before embarking on this trial, we conducted a proof-of-concept trial that showed the intervention reduced maternal and neonatal bacterial carriage of the most prevalent bacteria causing neonatal sepsis in the continent.
Dr. Gaudino[/caption]
Mario FL Gaudino, MD, PhD, MSCE, FEBCTS, FACC, FAHA
Dr. Stevermer[/caption]
James Stevermer, M.D., M.S.P.H.
Vice chair for clinical affairs
Professor of family and community medicine
University of Missouri
Medical director of MU Health Care Family Medicine–Callaway Physicians,
Dr. Stevermer joined the U.S. Preventive Service Task Force in January 2021.
MedicalResearch.com: What is the background for this study?
Response: Genital herpes is a common sexually transmitted infection (STI) that unfortunately has no cure and cannot accurately be detected in people who do not have signs of the condition. The current screening tests have limitations and there is a high chance that test results will say a person has the condition when they do not. In addition, the available treatments are focused on managing symptoms and preventing the condition from reoccurring. As a result, the Task Force concluded that the harms of screening outweigh the benefits.
Dr. Mahdavi[/caption]
Dr. Sara Mahdavi, PhD
Clinical Scientist and Clinical Instructor
Research Appointment in the Faculty of Medicine
University of Toronto
Toronto, ON
MedicalResearch.com: What is the background for this study?
Response: This was a long-term study spanning 16 years and began with a population of young adults who were medically assessed on a regular basis. It was remarkable to see just how striking the effects of coffee were in the group that had the susceptible genetic variant, what we termed “slow caffeine metabolizers” yet no effect whatsoever in those who did not were termed “fast metabolizers”.
Dr. Pierce[/caption]
Karen Pierce, Ph.D.
Professor, Department of Neurosciences, UCSD
Co-Director, Autism Center of Excellence, UCSD
MedicalResearch.com: What is the background for this study?
Response: The mean age of ASD diagnosis and eventual treatment remains at ~52 months in the United States1 - years beyond the disorder’s prenatal origins2, and beyond the age when it can be reliably diagnosed in many cases3.
Currently the only way to determine if a child has autism spectrum disorder (ASD) is to receive a developmental evaluation from an experienced clinician (usually a licensed clinical psychologist). There are often long waiting lists, and only a small number of clinicians have the experience required to make early-age (i.e., between 12-36 months) diagnoses of ASD. Thus, there are many places in the country as well as world wide wherein children wait months or years to receive a formal diagnosis due to a lack of available expertise. Moreover, diagnostic evaluations are expensive and usually cost the parent and/or insurance approximately ~$2,000 or more per evaluation. Finally, clinical evaluations usually take between 2-3 hours to complete and result in fatigue for both the parent and toddler.
Eye-tracking, which generates biologically-relevant, objective, and quantifiable metrics of both visual and auditory preference profiles in babies and toddlers in just minutes, is a technology that can dramatically change how ASD is diagnosed.
Dr. Caraballo-Cordovez[/caption]
César Caraballo-Cordovez, MD
Casey Hribar[/caption]
Casey Hribar
Fourth-year medical student
University of North Carolina
MedicalResearch.com: What is the background for this study?
Response: Several great pieces of literature already exist about patient perception of doctors wearing white coats, formal attire, business attire, and the like. But recently, scrubs are garnering favor, especially as a result of the COVID-19 pandemic.
While there has been some interest in what is worn over scrubs (jackets, vests, name tags, etc.), to our knowledge, there has not been any investigation into scrub color. Scrubs are a highly variable article of clothing, from fit, to pockets, pattern, and color, and it makes sense that these variations could have their own associated perceptions. Our study served as a way to open up the conversation around scrubs and the potential impact of their color on patients.
Dr. Goldman[/caption]
Anna L. Goldman, M.D., M.P.A., M.P.H
Assistant Professor of Medicine
General Internal Medicine
Dr. Harris[/caption]
MedicalResearch.com Interview with:
Rebecca Arden Harris, MD, MSc
Assistant Professor of Family Medicine and Community Health at the Hospital of the University of Pennsylvania
Senior Fellow, Leonard Davis Institute of Health Economics
Perelman School of Medicine, University of Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: The impact of the nationwide overdose epidemic on Black women has received little attention from policy-makers, researchers, or the press.
MedicalResearch.com: What are the main findings?
Response: Over the 7-year study period, preventable overdose deaths among Black women resulted in nearly 0.75 million years of life lost (YLL). Women aged 25-34 have suffered a rising proportion of this burden.
Dr. Kubik[/caption]
Martha Kubik, Ph.D., R.N.
Professor, School of Nursing
College of Health and Human Services
George Mason University
Member, U.S. Preventive Services Task Force
MedicalResearch.com: What is the background for this study?
Response: Obstructive sleep apnea is a health condition in which part or all of a person’s airway gets blocked during sleep, causing their breathing to stop and restart many times. Untreated sleep apnea is associated with heart disease, stroke, and diabetes. However, there is currently very limited evidence on screening people who don’t have signs or symptoms like snoring and excessive daytime sleepiness.
Dr. Dai[/caption]
Dr. Hongying Daisy Dai, PhD
Professor and Associate Dean of Research
The College of Public Health
University of Nebraska Medical Center.
MedicalResearch.com: What is the background for this study?
Response: Tobacco use landscape has been changing in the United States with fewer combustible cigarette smokers and more e-cigarette and other emerging tobacco users. Nicotine concentration level is a key product characteristic of modern e-cigarette products and high-nicotine vaping devices have recently become available. This study seeks to examine whether biomarkers of exposure to tobacco-related toxicants have changed since 2013 among adult nicotine e-cigarette users, non-nicotine e-cigarette users, and cigarette smokers.