The relationship of Papanicolaou testing and contacts with the medical care system to stage at diagnosis of cervical cancer

Article Abstract:

Early detection of cervical cancer is imperative because, if it is detected before it has spread, five-year survival is almost 100 percent. If the cancer is localized, the survival rate is 88 percent, but if it is regional, only half of the patients survive for five years. Once it has spread to other sites in the body, only 14 percent of patients live for five years, and there has been no progress in reducing the mortality when cervical cancer is diagnosed at this advanced stage. But there has been a substantial decline in mortality from cervical cancer because of early detection through widespread use of the Papanicolaou (Pap) test, which is designed to reveal cancerous or precancerous cells taken from the cervix. To assess the relationship of Pap testing and physician visits to stage of cervical cancer at the time of diagnosis, 363 women with cervical cancer were interviewed. Almost one-third of these women had invasive cancer, and the rest had the earliest stage (in situ). More women with in situ cancer had had Pap tests within the three years prior to diagnosis than those who had advanced cancer. However, the proportion of women who have Pap tests declines with age. Two-thirds of the women between 65 and 79 years of age had never had a Pap test prior to diagnosis, even though they saw their physicians regularly. Although there were too few women in that age group to evaluate the relationship between testing and cancer stage, the women in the earliest stages had had more Pap tests over their lifetimes than women who were diagnosed with advanced cancer. Women between the ages of 35 and 64 years who had advanced cancer were less likely to have visited their physicians or to have had check-ups than those diagnosed with in situ cancer. Two major points are made: first, physicians miss opportunities when older women utilize the health care system but do not receive routine Pap tests; and second, many women do not have regular check-ups or physician visits, and an effort must be made to bring them into the system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Diagnosis, Women, Cervical cancer, Women's health, Medical screening, Health screening, Pap test

---

Diabetic autonomic neuropathy and cardiovascular risk: Pittsburgh epidemiology of diabetes complications study III

Article Abstract:

Diabetes is associated with many complications, among them diabetic autonomic neuropathy (DAN). This condition involves degeneration of tissues of the autonomic nervous system, which is involved in many of the body's involuntary controls and responses. DAN is a life-threatening condition; the mortality rate is calculated to be about 56 percent. It is not known, however, precisely why the neuropathy develops or why the mortality is so high for this condition. In an examination of 168 patients with insulin-dependent diabetes mellitus with and without DAN (aged 25 to 34), correlations between DAN and common risk factors for cardiovascular disease were studied. It was found that the concentration of low-density lipoprotein cholesterol correlated with DAN, as did the presence of hypertension. Therefore, the increased cardiovascular risk observed in patients with diabetic autonomic neuropathy may be due to the coexistence of known cardiovascular risk factors. However, no cause and effect relationship can be inferred from the data in this study. The DAN and the cardiovascular risk factors may have a common, as yet unknown, cause, or the DAN itself may result in changes of which the risk factors are only symptoms. A prospective study will be needed to evaluate these possibilities, and perhaps also to provide an indication of whether diabetics with autonomic neuropathy may lower their risk by adopting measures to reduce the cardiovascular risk factors. A curious finding of this study was the correlation of DAN with being female. This is consistent with the observation that, although men in general have higher rates of cardiovascular disease, among diabetics women have rates almost as high as men. The cause for the increased risk experienced by women diabetics is not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Diabetes, Diabetes mellitus, Nervous system diseases

---

Lipids, vascular disease, and dementia with advancing age: epidemiologic considerations

Article Abstract:

Ischemic heart disease (IHD, reduced blood flow to the heart) is the leading cause of death among the elderly. Risk factors for IHD include diabetes mellitus, high blood pressure, family history, male sex, poor diet, belly fat, and high levels of fats (lipids) and lipoproteins (high- and low-density lipoproteins, or HDL and LDL) in the blood. All of these increase the risk of cardiovascular disease in middle-aged people, but normal levels of lipids and lipoproteins have not been established for the elderly, and there is uncertainty about the effect of different levels on disease and mortality. Although many clinicians believe that the effort to lower lipid values among the elderly is not worthwhile because the effect is diluted by an increase in other risk factors, several large-scale studies suggest that the risk of CHD is greater for those with high cholesterol. Even though the relative risk of high cholesterol decreases, the benefit from reducing the risk is significant. The 10-year-long Bronx Aging Study is testing whether lipid levels are a risk factor for both cardiovascular disease and dementia, and the early results suggest a connection that should be looked at further. The most important issue here is whether lowering cholesterol levels will reduce mortality or the development of dementia. Whether to screen the elderly for high cholesterol is unclear because of inconsistent results and scarce data. Beyond that is the question of whether lowering cholesterol levels with drugs would compromise quality of life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aging, Care and treatment, Causes of, Dementia, Hypercholesterolemia

Similar abstracts:

• Abstracts: The expression of progesterone receptors coincides with an arrest of DNA synthesis in human breast cancer. Steroid-hormone receptors in nonpalpable and more advanced stages of breast cancer: a contribution to the biology and natural history of carcinoma of the female breast
• Abstracts: Depression in medical outpatients: underrecognition and misdiagnosis. Depression: underrecognition and undertreatment by psychiatrists and other health care professionals
• Abstracts: Beyond the Cruzan case: The U.S. Supreme Court and medical practice. Life, death, and the American College of Physicians: the Cruzan case

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