Testing for uncommon conditions: the heroic search for positive test results

Article Abstract:

There has been much concern lately about the ordering of unnecessary laboratory tests by physicians, primarily in relation to the cost incurred and the subsequent impact on the health care system. Little attention has been directed at the effect of excessive testing on patients. This article discusses testing for uncommon conditions, either screening large numbers of asymptomatic people or testing people with symptoms for diseases that have a low probability of underlying the symptoms. Such testing has persisted because identification of undetected cases is considered important, leading to frequent testing of blood cell counts, electrocardiograms, and other procedures. Two assumptions support this practice, that early detection is beneficial, and that routine testing is not harmful to people without disease. However, survival time of people following early detection of some cancers or other diseases may ultimately not be improved, and people without disease may be subject to adverse physical and psychological effects of the test procedure and of test results. In addition, testing may divert limited health system resources from those who need them. The factors which lead to the perception that such excessive testing is in fact beneficial are discussed, including the reasoning underlying use of supplementary tests, psychological and environmental factors, values adopted during training, benefits observed during the practice of medicine, patients' expectations, time pressures, financial incentives, institutional factors, and medicolegal issues. It is important that physicians begin to question these practices and begin to order tests only on the basis of sound medical principles so that such testing is always in the best interest of each patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diagnosis, Laboratory, Laboratory diagnosis

---

A positive family history of breast cancer: does its effect diminish with age?

Article Abstract:

A family history of breast cancer increases a woman's chances of developing breast cancer. To see whether that risk changes with increasing age, 2,712 women with breast cancer, 2,972 women with benign breast disease and 3,316 women without breast disease were compared. The incidence of a positive family history (mother, sister, grandmother or aunt) was calculated for each age group. The odds were highest in the 30 to 34 age group. After the age of 45, the odds decreased. The chances of patients over the age of 60 getting breast cancer were similar to the chances of patients without a family history getting breast cancer. Therefore, a family history of breast cancer is a risk factor only for women under the age of 60 years. Although the reason for this is unclear, the genetic predisposition may manifest itself at an earlier age. Other factors such as diet and the reproductive history of the patients may also be involved. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Genetic aspects, Cancer, Cancer genetics, Carcinogenesis, Familial diseases

---

Breast cancer in black women

Article Abstract:

Many factors may contribute to the lower survival rates seen in black women with breast cancer. Recent studies show that fewer black women (95.8 per 100,000) than white women (112.7 per 100,000) develop breast cancer. However, 5-year survival estimates for black women (64%) are lower than for white women (80%). Black women typically have more advanced disease when first seen by a doctor than white women. Differences in socioeconomic factors may contribute to this variation. Biological characteristics of the breast cancer including the tumor's complexity and types of hormone receptors tend to differ between the two races. Black women also tend to have more medical problems such as heart disease, high blood pressure, diabetes, and kidney disease that could complicate their breast cancer.

Health aspects, Women, Black, Black women

Similar abstracts:

• Abstracts: Balloon dilatation of the prostate. Bicalutamide for prostate cancer
• Abstracts: Is autism more common now than ten years ago? Outcome and prognosis of anorexia nervosa. Anorexia nervosa in a Swedish urban region: a population-based study
• Abstracts: Pica as a presenting symptom in childhood celiac disease. The duodenal string test. A gut issue
• Abstracts: Prediction of 24-h energy expenditure and its components from physical characteristics and body composition in normal-weight humans
• Abstracts: Fatal swine influenza pneumonia during late pregnancy. Respiratory syncytial virus infections on an adult medical ward

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.