Women Should Get Annual Mammograms Starting at Age 45: Cancer Society

By Dennis Thompson
HealthDay Reporter

TUESDAY, Oct. 20, 2015 (HealthDay News) — The American Cancer Society is delaying the recommended age when a woman should start receiving annual mammograms, based on new research that shows the average risk for breast cancer increases near menopause.

Most women should receive annual mammograms between the ages of 45 and 54, then transition to screening every two years for as long as they remain healthy, according to the new breast cancer screening guidelines.

The guidelines are more conservative than the American Cancer Society’s previous approach, which recommended yearly mammograms starting at 40 and continuing as long as a woman is in good health.

The cancer society shifted its guidelines, in part, because it started looking at breast cancer risk in five-year increments, rather than considering women in their 40s versus women in their 50s or 60s, said lead author Dr. Kevin Oeffinger. He is chairman of the American Cancer Society (ACS) breast cancer guideline panel and a family physician at Memorial Sloan Kettering Cancer Center in New York City.

“We found that women who are 45 to 49 are very similar to women 50 to 54 with respect to the burden of cancer, the risk of dying from cancer and the reduction in mortality from mammography,” Oeffinger said. “That helped us in our thought process. We felt the evidence is very clear.”

The new guidelines are published in the Oct. 20 issue of the Journal of the American Medical Association.

With this announcement, the new cancer society guidelines move closer to those of the U.S. Preventive Services Task Force (USPSTF), which is the nation’s leading panel of experts in preventive medicine.

The USPSTF received some criticism back in 2009 when it recommended that most healthy women without increased breast cancer risk wait until age 50 to begin mammography, and then undergo the procedure every other year.

“In some ways they converge a bit more than they did in the past, especially in terms of the ACS pulling back a bit and recommending a slightly later date for mammography screening,” said Dr. Lydia Pace, a women’s health specialist at Brigham and Women’s Hospital in Boston, who co-authored an accompanying journal editorial about the new guidelines.

For its part, the USPSTF issued a statement noting the similarities between its recommendation and the new cancer society guidelines.

“We plan to examine the evidence that the ACS developed and reviewed as we finalize our own [updated] recommendations on mammography,” the task force said. “Women deserve the best information and guidance on screening mammography so that they can make the best choice for themselves, together with their doctor.”

Under the new guidelines, the cancer society recommends that:

• Women 40 to 44 discuss mammography with their doctor, and have the option of starting annual screening if they want it or their risk factors warrant it.
• Women 45 to 54 receive annual mammography screening.
• Women 55 and older receive screening every other year, and only discontinue mammography when their life expectancy drops below 10 years.

The cancer society is shying away from saying when a woman can stop getting a mammogram, even though there isn’t strong evidence on the benefits or harms of mammography past age 74, Oeffinger said.

“We know women in our country are not only living longer, but healthy and active lives,” he said. “We didn’t want to put a cap on the age. It’s really as long as women have a reasonable likelihood of being in good health for another 10 years or so.”

The cancer society based its new guidelines on an extensive review of the current scientific evidence, including new evidence from a number of large studies, Oeffinger said.

The guidelines also are based on the results of a new study that reviewed the cases of 15,440 breast cancer patients between ages 40 and 85 that is being simultaneously published in the journal JAMA Oncology.

That study, conducted by the Breast Cancer Surveillance Consortium, found that annual mammography was better than every-other-year mammography at catching treatable breast cancers in women approaching menopause.

“Our findings suggest that menopausal status may be more important than age when considering breast cancer screening intervals,” Diana Miglioretti, of the University of California, Davis School of Medicine, and coauthors concluded, noting that this is “biologically plausible” because the female hormone estrogen tends to promote tumor growth.

Pace said of the JAMA Oncology study, “They’re really trying to sort out what we know to be true, which is that although younger women have a lower absolute risk of developing breast cancer, it does appear when they do [develop cancer] some of those tumors are much more aggressive than among older women.”

However, Pace does not believe the JAMA Oncology study provides enough evidence to support annual mammography for women in their late 40s.

“I think it’s probably a bit early to draw the conclusion that women 45 to 54 should actually be screened more frequently than older women,” she said. “They weren’t able to conclude that less frequent screening led to high breast cancer mortality.”

Even though the cancer society and the USPSTF are moving closer together in their recommendations, it appears that mammography screening for younger women will continue to be a controversial topic.

The American College of Radiology and the Society of Breast Imaging released a joint statement saying they will continue to recommend that women get yearly mammograms starting at age 40.

“Early detection of breast cancer is critical for improving breast cancer survival, regardless of therapy advances,” said Dr. Debra Monticciolo, chair of the American College of Radiology Breast Imaging Commission. “Moving away from annual screening of women ages 40 and older puts women’s lives at risk.”

Beyond mammography, the new cancer society guidelines agree with those of the USPSTF on another important topic related to breast cancer screening.

Both groups now take a skeptical stance involving clinical breast examinations, in which a trained health professional looks at and feels a woman’s breasts for signs of cancer.

The ACS now recommends against clinical breast exams for breast cancer screening, regardless of age. Prior to this, the cancer society had recommended clinical breast exams every three years or so for women in their 20s and 30s, and annually for women 40 and older.

“We simply could find no evidence that suggested that clinical breast examinations were saving lives,” Oeffinger said. “At the end of the day, a medical visit is kind of a zero-sum scenario. There are only so many minutes. So we felt rather than do something we don’t have evidence to support, it would be very worthwhile to spend that same time discussing mammography with women.”

More information

For more on breast cancer, visit the U.S. National Cancer Institute.

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Count the Moles on Your Arm to Predict Melanoma Risk?

MONDAY, Oct. 19, 2015 (HealthDay News) — Having 11 moles or more on your right arm might indicate higher risk of melanoma, British researchers say.

The study results could help doctors more easily identify patients at highest risk for the potentially deadly skin cancer, according to researchers from King’s College London.

“The findings could have a significant impact for primary care, allowing [primary care doctors] to more accurately estimate the total number of moles in a patient extremely quickly via an easily accessible body part. This would mean that more patients at risk of melanoma can be identified and monitored,” study lead author Simone Ribero, of the department of twin research and genetic epidemiology, said in a college news release.

Between 20 percent and 40 percent of melanomas develop from pre-existing moles, the researchers said. The risk is thought to increase slightly with each additional mole on the body, but a total body count can be time-consuming in a doctor’s office.

In a report published online Oct. 19 in the British Journal of Dermatology, Ribero’s team analyzed data from nearly 3,700 white twins in the United Kingdom who underwent a mole count on 17 body areas.

The results showed that the mole count on the right arm was the most predictive of the total number of moles on a person’s entire body.

For example, women with more than seven moles on their right arm had a ninefold increased risk of having more than 50 moles on their body. Those with more than 11 moles on their right arm were more likely to have more than 100 moles on their body, putting them at higher risk for melanoma, the researchers said.

The area above the right elbow was especially predictive of the total number of moles on a person’s body, according to the researchers. The number of moles on the legs was also strongly associated with total count, as were moles on men’s backs.

Changes in the size, shape or color of a mole may be a warning sign of melanoma.

But the study only found an association between the presence of moles and melanoma risk. It did not prove cause and effect.

More information

The U.S. National Cancer Institute has more about skin cancer.

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Finally! How to Get Rid of Lurkers, or Hidden Pimples

Photo: Getty Images

Every morning before I apply my makeup, I inspect my skin for signs of fine lines, wrinkles, and breakouts — and the first thing I said today was “uh-oh.” I generally have a clear complexion, but today I found myself suffering from a few painful pimples. You know the ones . . . hard bumps that lurk under the skin and seemingly never come to a head. And for good reason: according to NYC dermatologist Dr. Neal Schultz, host of DermTV.com and creator of BeautyRx by Dr. Schultz, they’re called blind pimples or cysts.

Like most pimples, lurkers are caused by a combination of bacteria, clogging from dead cells, and excessive oil production. But what distinguishes them is that they are deep below the skin’s surface, extending into the subcutaneous (fatty) layer. This makes them painfully lurk for weeks — even months. “The oil contains a lipid called triglycerides, and the bacteria make an enzyme that actually splits the triglycerides into free fatty acids,” explained Dr. Schultz. “These are very irritating chemicals, which cause a lot of inflammation, resulting in rapid pus accumulation in the cyst.” This fast pus growth stretches the cyst wall and surrounding nerves, causing pain.

Frequent sufferers of blind pimples, you do have some options! “You can avoid them by taking internal medication that affects either the oil or the bacteria,” said Dr. Schultz. He said on a short-term, prevention basis, people usually take antibiotics or birth control pills. Antibiotics can kill the bacteria that causes free fatty acids (which makes these pimples so painful), while birth control pills decrease oil production. And, if you try to flatten them at home like I do via layers and layers of topical ointments, you’re doing it wrong. “It’s much better to try and get the blind pimple to come to a head and rupture,” said Dr. Schultz, who suggested applying warm compresses several times a day to make it surface. “Then the pus can drain out, shrinking the cyst, stopping the pain, and healing.”

If you don’t have time to coddle your blind pimple until it comes out of lurking mode, there is a quick fix! To stop the swelling in one day, have your dermatologist open the cyst with a sterile needle and then inject the inflamed cyst wall with cortisone. That way, the cyst will rapidly shrink and heal.

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POPSUGAR Beauty puts the focus on hair, makeup, nails, and fragrance — from inspiring celebrity photos and fun polls, to easy how-tos to re-create the latest trends at home, to expert tips from the world’s top stylists! Find out the latest color trends for your face, hair, and nails with hot new products and daring nail design ideas. DIY ideas turn your home into a spa, and make you knowledgeable on any beauty topic. Let POPSUGAR Beauty be your guide to all things skin care, makeup, and hair care!

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Teens Swayed by Alcohol Ads

TUESDAY, Oct. 20, 2015 (HealthDay News) — Advertising strongly influences which brands of alcohol teens drink, a new study finds.

The study found that 13- to 20-year-olds are over five times more likely to drink brands advertised on national television and 36 percent more likely to drink brands advertised in national magazines, compared to brands that don’t advertise in these media.

The results are from an online national survey conducted by the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health and the Boston University School of Public Health. More than 1,000 underage drinkers were asked which of nearly 900 alcohol brands available in the United States they had consumed in the past month. The survey was conducted between December 2011 and May 2012.

“Marketing exposure is increasingly recognized as an important factor in youth drinking, yet few studies have examined the relationship between overall advertising exposure and alcohol consumption at the brand level,” lead co-author David Jernigan said in a Hopkins news release. Jernigan is director of the center and an associate professor of health, behavior and society at Hopkins.

“These findings indicate that youth are, in fact, consuming the same alcohol brands that they are most heavily exposed to via advertising,” he said.

Co-lead author Dr. Michael Siegel said it used to be controversial to suggest that a relationship existed between cigarette marketing and youth smoking until researchers showed the impact of the Joe Camel advertising campaign on kids.

“Once the relationship between cigarette ads and the brands that youth were smoking was established, significant policy shifts occurred as state and federal policy makers took the issue of advertising exposure to youth much more seriously,” Siegel, a professor of community health sciences at Boston University, said in the news release.

Alcohol is the most widely used drug among American youth. Alcohol advertising is primarily self-regulated by the industry, the study authors said.

The study was published online Oct. 20 in the American Journal of Drug and Alcohol Abuse.

More information

The U.S. National Institute on Alcohol Abuse and Alcoholism has more on underage drinking.

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Men’s, Women’s Hearts Age Differently

TUESDAY, Oct. 20, 2015 (HealthDay News) — The heart ages differently for women and men. And this suggests a possible need for gender-specific treatments, according to a study published Oct. 20 in the journal Radiology.

“The shape of the heart changes over time in both men and women, but the patterns of change are different. Men’s hearts tend to get heavier and the amount of blood they hold is less, while women’s hearts don’t get heavier,” study author Dr. John Eng, from Johns Hopkins University School of Medicine in Baltimore, said in a journal news release.

Researchers used MRIs to examine the hearts of nearly 3,000 people without heart disease in the United States. The participants underwent another MRI about 10 years later, when they were aged 54 to 94 years.

Both women and men had decreases in the volume of their left ventricle, the chamber of the heart that pumps blood throughout the body. However, the mass of the left ventricle increased in men and decreased slightly in women.

Increased mass can occur when the ventricle walls thicken from having to work harder to pump blood due to high blood pressure or other conditions, the researchers explained.

Further research is needed to learn more about these gender differences, but the findings suggest that varying treatment approaches may be needed for men and women with heart disease.

“We’ve been talking a lot lately about personalized medicine, and here’s an example where perhaps men and women might have to be treated differently,” Eng said.

The researchers also found that increased left ventricular mass was associated with higher blood pressure and body mass index (BMI), an estimate of body fat based on weight and height.

More information

The U.S. National Institutes of Health explains how to reduce heart risks.

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Stereotypes Can Hurt a Patient’s Care

TUESDAY, Oct. 20, 2015 (HealthDay News) — Patients who fear being judged by health care providers have worse health than others, researchers report.

The study of 1,500 Americans found more than 17 percent felt vulnerable to being negatively viewed by health care providers because of their race, gender, social class, age or weight.

These people were more likely to have high blood pressure, depression and to rate their health worse. They were also more likely to distrust doctors, express dissatisfaction with their care and avoid preventive care, including flu vaccination, the study found.

“It’s time for us to implement policies that enhance medical school training in cultural competency and increase the diversity of our physicians and broader health care workforce,” said study author Cleopatra Abdou, an assistant professor in the department of psychology at University of Southern California Davis School of Gerontology.

She and her colleagues found that even public health campaigns meant to help specific groups of people sometimes reinforce negative stereotypes.

For example, campaigns about reproductive health in women of color, depression in women, memory problems in older adults and sexual health in the lesbian/gay/bisexual/transgender/questioning community can reinforce negative views about these groups, she said.

“It’s not that there aren’t real health concerns in specific communities that we need to do more — much more — to address, but how we communicate about these concerns is key,” Abdou said in a university news release.

The challenge is to find ways to educate people about good health while reducing health care stereotypes, according to the study.

It was published online Oct. 20 in the American Journal of Preventive Medicine.

“Hospitals and other health care institutions with inclusive policies which welcome diversity and celebrate tolerance, both symbolically and explicitly, hold great promise for reducing health care stereotype threat and the short- and long-term health disparities that we are now learning result from it,” Abdou concluded.

More information

The American Academy of Family Physicians offers advice on staying healthy.

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Kids More Likely to Be Overweight If Mom Gains Too Much in Pregnancy or After

By Steven Reinberg
HealthDay Reporter

MONDAY, Oct. 19, 2015 (HealthDay News) — Women who gain too much weight during and after pregnancy could increase the risk that their child will be overweight or obese in adolescence, a new study from the Netherlands suggests.

The study researchers explained that a mother’s excessive weight gain during pregnancy may be tied to changes in her chemistry that make the child more likely to be overweight or obese. The mother’s weight gain after giving birth and the child’s subsequent weight gain probably reflect the family’s lifestyle and health behaviors, the study authors said.

One U.S. doctor noted the importance of both factors.

“There is widespread recognition that environments and so-called ‘social determinants of health’ have a major influence on weight gain and obesity,” said Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Conn.

The first environment is the womb, and the first social influence is mothers’ behaviors, he said. This study highlights the importance of these factors and reaffirms a relationship between excessive weight gain during pregnancy and the likelihood of obesity in the child, said Katz, who wasn’t involved in the research.

Katz said the novelty of this study is the separation of the association of weight gain in pregnancy from maternal weight gain after pregnancy, which also is an obesity risk in children. “Essentially, we have evidence here that all environments are important, from the womb to the living room,” he said.

However, the study only found an association and not a cause-and-effect relationship between a mom’s pregnancy and post-pregnancy weight and her child’s weight.

The study was published Oct. 19 in Pediatrics.

The research included information on more than 3,300 Dutch children and their mothers. Children born to mothers whose pregnancy weight gain was deemed “excessive” had 20 percent greater odds of being overweight. Likewise, kids whose mothers gained too much weight in the year following delivery also faced an increased risk of being overweight themselves, the study found.

And children born to moms who gained too much weight both during and after pregnancy had more than three times higher odds of ending up overweight at age 14 compared to kids with slimmer moms, the research revealed.

Katz thinks these findings can be used to educate women before and during pregnancy about the importance of lifestyle, emphasizing healthy eating, healthy activity and weight management.

“Pregnancy is a teachable moment, and using it can benefit mother and baby alike,” Katz said.

Dr. David Mendez, a neonatologist at Nicklaus Children’s Hospital in Miami, said it isn’t clear how much of the risk of a child’s weight gain is tied to genetics or programming in the womb and how much is linked to the family’s lifestyle.

“Trying to sort one from the other continues to be a challenge,” Mendez said. “What is clear is that excessive weight gain during pregnancy has immediate consequences to mom and baby at the time of delivery.”

Particularly, excessive weight gain exposes the infant to high levels of sugar and causes the infant to produce a lot of insulin in an attempt to balance sugar levels, he said.

“Exposure to high levels of insulin can affect the baby’s metabolism during the transition from the womb,” Mendez said.

Mendez said existing guidelines suggest how much weight a woman should gain during pregnancy.

For women of normal weight, an average of 20 to 35 pounds is adequate, he said. For women who are overweight, the range is 15 to 25 pounds. For obese women, the range is 11 to 20 pounds. And for women who are underweight, it’s 28 to 40 pounds, he said.

“A healthy lifestyle before and during pregnancy means the best outcome for mom and baby,” Mendez said.

More information

For more information on weight gain during pregnancy, visit the March of Dimes.

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This Guilt-Free Salted Caramel Dip Is a Treat You Can Feel Good About

Pumpkin spice? Psh. Sorry, but the Internet has spoken: Fall’s hottest flavor is now salted caramel.

What’s a health-conscious eater to do? We could at least justify our love of pumpkin spice since pumpkin is loaded with vitamin A and fiber, and both cinnamon and ginger, key components of the “spice,” have health benefits as well.

But caramel, which is traditionally made from boiling sugar? That’s a tough one to justify.

RELATED: 9 Decadent Fruit Desserts

Until now. Thanks to the luscious, caramel-like flavor of dried dates, you can enjoy salted caramel guilt-free. They’re chock-full of fiber, potassium, iron, and antioxidants. And unlike traditional caramel, which can be tricky to make, date caramel requires no cooking (except for boiling some water).

Plus, it keeps well in the fridge (up to two weeks), and it’s so versatile. Here are just a few healthy suggestions for enjoying it: Slice up an apple and use it as a dip. Mix it into plain yogurt, oatmeal, or blend it into your favorite smoothie. It also makes a great spread for whole grain pancakes or waffles, or for an upgraded PBJ—just use it in place of jam.

Make it!

RELATED:  9 Peanut Butter Dessert Recipes

 

 

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College Kids Easily Find Contraband ADHD Drugs, Other Meds

MONDAY, Oct. 19, 2015 (HealthDay News) — It’s easy for U.S. college students to illegally obtain stimulants and other prescription drugs on campus, a new survey finds.

Seventy percent of the more than 3,900 respondents said it was somewhat easy or very easy to get the medications without a prescription. The 2015 College Prescription Drug Study, conducted by Ohio State University, included undergraduate, graduate and professional students at six public and two private colleges and universities in five states.

The survey found that undergraduates were more likely to misuse prescription drugs. Most claimed they used the drugs to help them study or improve their grades.

About 18 percent of undergraduates said they misused prescription stimulants, and 83 percent said they obtained them from friends.

Stimulant use was the most common practice, but students are misusing a number of other types of prescription drugs.

“Overall, one in four undergraduates reported that they used prescription pain medications, sedatives or stimulants for nonmedical reasons in their lifetimes,” study author Anne McDaniel said in a university news release. McDaniel is associate director of research and data management at Ohio State’s Center for the Study of Student Life.

Pain medications were misused by 10 percent of undergraduates, and about one-third of students said it was easy or very easy to obtain them. About 9 percent of undergrads misused sedatives, and 44 percent said it was easy or very easy to get them on campus.

The reasons college students misuse prescription drugs have changed over the years, according to Kenneth Hale, a clinical professor of pharmacy at Ohio State and associate director of its Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery.

“At one time, college students most commonly misused drugs to get high. But today, students also use medications to self-medicate, to manage their lives. They are using drugs to control pain, to go to sleep, to relieve anxiety and to study,” he said in the news release.

Fifty-five percent of students who misused pain medications did so for pain relief, while 46 percent did so to get high. More than half who misused sedatives did so to sleep, while 85 percent did so to help them study or improve their grades, according to the survey.

More information

The U.S. National Institute on Drug Abuse has more about prescription drug abuse.

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Very Young Babies Sense Touch Differently

MONDAY, Oct. 19, 2015 (HealthDay News) — When you touch a newborn’s hands or feet, the infant doesn’t identify that sensation the same way older babies, children and adults do, a new study suggests.

This situation lasts for about the first four months of a baby’s life, according to the results published Oct. 19 in the journal Current Biology.

“Our findings are really the first to address what is quite a fundamental question about our sensory experience in early life,” Andrew Bremner of Goldsmiths, University of London, said in a journal news release. “When young babies feel a touch on their hand, can they appreciate where that touch is in the outside world?”

The answer is no, revealed the tickling tests on the feet of 4- and 6-month-old infants.

“We think [this means] that before around 6 months of age, human babies perceive touches just on their bodies, and not in the external world. If one tries to imagine what this must be like — it’s a bit of a dizzying idea,” Bremner said.

The researchers said that young babies perceive touches as just touches on the body. They don’t perceive them as being related to what they see, hear or maybe even smell, Bremner explained.

“[Touches are] not related to objects perceived in vision. To me this sounds like quite an alien sensory world to live in — the tactile world being quite separate from the other sensory worlds,” Bremner said.

The next phase of this research is to learn how and why infants develop a sense of themselves in the world, the investigators said.

More information

The U.S. National Library of Medicine has more about infant and newborn development.

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