News Trends Analysis

March 1, 2003
The ObservatoryMarch
NewsHHS to propose increased funding for cancer screening. President Bush will propose a $10 million increase in funding for breast and cervical cancer screening to help low-income and underserved women, Health and Human Services Secretary Tommy G. Thompson announced recently. The proposed increase is for the National Breast and Cervical Cancer Early Detection Program, administered by the Centers for Disease Control and Prevention, which provides screening services, including clinical breast examinations, mammograms, pelvic examinations and Pap tests, to underserved women. It also funds post-screening diagnostic services, such as surgical consultation and biopsy, to ensure that women with abnormal results receive timely and adequate referrals. HHS extends use of rapid HIV test to new sites nationwide. The U.S. Department of Health and Human Services has extended the availability of a recently approved rapid HIV test from the current 38,000 laboratories to more than 100,000 sites, including physicians offices and HIV counseling centers. The OraQuick Rapid HIV-1 Antibody Test, manufactured by OraSure Technologies, Inc., of Bethlehem, PA, provides results in as little as 20 minutes. It is performed on a fingerstick sample of blood, and studies show that it has an accuracy of 99.6 percent. Unlike other antibody tests for HIV, this test can be stored at room temperature, requires no specialized equipment and can be used outside of traditional laboratory or clinical settings. HHS Food and Drug Administration approved OraQuick last November for use in laboratories that perform moderate complexity testing. HHS granted the expanded use to additional sites under a Clinical Laboratory Improvement Amendment waiver.
Cholesterol Reference Method Laboratory Network updates website. The Cholesterol Reference Method Laboratory Network (CRMLN) has recently updated its website. The revised site includes current lists of diagnostic test methods for measurement of total cholesterol, HDL cholesterol and LDL cholesterol that have been certified through the CRMLN. The new URL for this website HPV types linked to cervical cancer. Researchers have now identified 18 types of human papilloma virus (HPV) that have been associated with cervical cancer, including three new ones, according to a recent report in The New England Journal of Medicine. It is now accepted that virtually all cases of cervical cancer are caused by HPV. The authors of this new study compiled data from 11 studies involving 1,918 women with confirmed cervical cancer. HPV DNA was found in almost 91 percent of the women with cancer. The authors state that if an effective vaccine can be developed against the five most common types of HPV, about 90 percent of cases of cervical cancer worldwide could be prevented.Task force recommends more diabetes screening. The U.S. Preventive Services Task Force recommends that adults with high blood pressure or high cholesterol be screened for type 2 diabetes. The recommendation is part of an integrated approach to reduce cardiovascular disease. The group concluded, however, that further research is needed to determine whether widespread screening of the general population would improve health outcomes. In a separate decision, it found insufficient evidence to recommend for or against routine screening for gestational diabetes in asymptomatic pregnant women. The task force is an independent panel of experts sponsored by the Agency for Healthcare Research and Quality. Its recommendations on screening for type 2 diabetes are published in the Feb. 4 issue of the Annals of Internal Medicine. The gestational diabetes conclusion is published in the February issue of the Journal of Obstetrics and Gynecology. The recommendations and materials for clinicians are available improves cardiovascular risk prediction in metabolic syndrome. Blood levels of C-reactive protein (CRP) can help predict cardiovascular risk in women with metabolic syndrome, according to Harvard research reported recently in Circulation: Journal of the American Heart Association. High levels of CRP, a marker of inflammation, have been associated with increased risk of heart attack, stroke and type 2 diabetes. Metabolic syndrome, associated with a significant increase in cardiovascular risk, is the clustering of three or more of five conditions: abdominal obesity, high triglycerides, low levels of HDL cholesterol, high blood pressure and high glucose levels. Harvard researchers studied data from 14,719 participants in the ongoing Womens Health Study, and reported that their analysis of women with metabolic syndrome showed that those with the highest CRP levels (greater than 3.0 mg/L) were 2.1 times more likely to have a cardiovascular event than those with the lowest CRP levels (less than 1.0 mg/L).AHA/CDC panel issues recommendations on CRP testing. A panel of experts convened by the American Heart Association and the Centers for Disease Control and Prevention is recommending limited use of a new blood test that has been widely promoted for assessing heart disease risk the highly sensitive C-reactive protein (hs-CRP) test. Several studies have shown that increased concentrations of CRP, a inflammatory marker found in the blood, appear to be associated with increased risk for coronary heart disease, sudden death and peripheral arterial disease. Thomas A. Pearson, M.D., Ph.D., co-chair of the AHA/CDC writing group that crafted the new recommendations, says there is no need for hs-CRP screening of the entire adult population as a public-health measure. Pearson says the test might be useful when a physician is undecided about a course of treatment for a patient who is considered intermediate risk.© 2003 Nelson Publishing, Inc. All rights reserved.