CEA monitoring after surgery for colorectal cancer: when is the evidence sufficient?
Article Abstract:
Carcinoembryonic antigen (CEA) monitoring may not be an effective method for diagnosis of a recurrence of colon cancer. CEA is a protein that is secreted by certain types of cancer cells. Patients with colorectal cancer, especially those with extensive disease, often have increased blood levels of CEA. A research study found that CEA monitoring identified only 59% of the cancer recurrences among 1,017 patients who had surgery for colon cancer. Blood levels of CEA were elevated in 16% of the patients who did not have a cancer recurrence. CEA testing was more sensitive for the detection of certain types of cancer than for others. This testing may be too expensive for routine usage.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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Who Is Responsible for the Common Good in a Competitive Market?
Article Abstract:
Asking all insurance companies and managed care plans to contribute money for teaching, research and charitable care seems to be the best way to ensure that these activities continue in a market-based healthcare system. Until recently, these activities were funded mostly through cost shifting and were implemented through an informal network of community and religious hospitals, academic health centers, and individual doctors. A 1999 study found that doctors in areas dominated by managed care were less likely to provide charitable care. Most teaching and research ultimately benefits patients. An all-payer pool of funds could provide money for these activities.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1999
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Screening sigmoidoscopy -- how often and how good?
Article Abstract:
Sigmoidoscopy exams every five years could lower the death rate from colorectal cancer in the elderly. And yet many elderly Americans are not being screened as recommended. Screening could be increased by training physician assistants and clinical nurse specialists to perform the procedure. Sigmoidoscopy uses a flexible tube with a small video camera to examine the inside of the colon.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 2003
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