geoffrey modest medical blogs

  A recent massive study found that there was earlier age of cancer onset in 17 of 34 the cancer types assessed (see cancer early onset increasing LancetPubHlth2024 in dropbox, or Lancet Public Health 2024; 9: e583–93) Details: -- Data on the incidence of 34 cancer types in 23,654,000 individuals aged 25-84yo from 2000-2020, from the North American Association of Central Cancer Registries (which included the Surveillance, Epidemiology, and End Results, SEER, database) that included 94% of the US population, and cancer mortality 7,348,137 the US National Center for Health Statistics     --they analyzed the incidence of the 34 most common cancer types diagnosed between ages 25-84     --they also analyzed the mortality of 25 cancers, but excluded Kaposi's sarcoma (low numbers of deaths); and breast, esophagus, oral cavity and pharynx (database did not include subtype classification) -- data were evaluated by 5-year birth cohort intervals from 1920-1990, a...

  I heard an impressive segment on NPR on May 6 about the rather extensive potential environmental damage done by asthma/COPD inhalers that use a propellant (the boot-shaped inhalers):  https://www.npr.org/sections/health-shots/2024/05/06/1248504466/could-better-asthma-inhalers-help-patients-and-the-planet-too  . This segment highlighted Dr. Miguel Divo, a pulmonologist in Boston, who is a strong advocate for using dry powder inhalers (DPIs) instead of the environmentally toxic ones using a propellant gas, now hydrofluoroalkanes (HFAs).   Details : From a 2021 report by the US environmental protection agency ( https://www.epa.gov/sites/default/files/2021-03/documents/epa-hq-oar-2021-0044-0002_attachment_1-mdis.pdf  ):     -- the pharmaceutical industry initially used chlorofluorocarbons (CFCs) as the propellant in metered dose inhalers (MDIs), though these were phased out and fully replaced by hydrofluoroalkanes (HFAs) by 2014    ...

  The US Preventive Services Task Force just published their final recommendations on breast cancer screening (see   mammog uspstf recs 2024  JAMA2024 in dropbox, or doi:10.1001/jama.2024.5534)   Summary of USPSTF recommendations: -- biennual screening mammogram for women aged 40 to 74 (grade B recommendation) -- insufficient evidence to assess the balance of benefits and harms of screening mammography in women 75 years or older (grade I statement) -- insufficient evidence to balance the benefits and harms of supplemental screening for breast cancer with breast ultrasound or MRI in women identified as having dense breasts on otherwise negative screening mammogram (grade I statement)   -- These recommendations apply to cisgender women (and includes transgender men and non-binary persons) at average risk of breast cancer, but also to those with some factors associated with increased risk (e.g. family history of breast cancer in first-degree relative, or having den...