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Evidence-Based HIV/STD Prevention Intervention for Black Men Who Have Sex with Men

April 23, 2014 Comments off

Evidence-Based HIV/STD Prevention Intervention for Black Men Who Have Sex with Men
Source: Morbidity and Mortality Weekly Report (CDC)

This report summarizes published findings of a community-based organization in New York City that evaluated and demonstrated the efficacy of the Many Men, Many Voices (3MV) human immunodeficiency virus (HIV)/sexually transmitted disease (STD) prevention intervention in reducing sexual risk behaviors and increasing protective behaviors among black men who have sex with men (MSM). The intervention addressed social determinants of health (e.g., stigma, discrimination, and homophobia) that can influence the health and well-being of black MSM at high risk for HIV infection. This report also highlights efforts by CDC to disseminate this evidence-based behavioral intervention throughout the United States. CDC’s Office of Minority Health and Health Equity selected the intervention analysis and discussion to provide an example of a program that might be effective for reducing HIV infection- and STD-related disparities in the United States.

3MV uses small group education and interaction to increase knowledge and change attitudes and behaviors related to HIV/STD risk among black MSM. Since its dissemination by CDC in 2004, 3MV has been used in many settings, including health department- and community-based organization programs. The 3MV intervention is an important component of a comprehensive HIV and STD prevention portfolio for at-risk black MSM. As CDC continues to support HIV prevention programming consistent with the National HIV/AIDS Strategy and its high-impact HIV prevention approach, 3MV will remain an important tool for addressing the needs of black MSM at high risk for HIV infection and other STDs.

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Cannabis Use is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult Recreational Users

April 23, 2014 Comments off

Cannabis Use is Quantitatively Associated with Nucleus Accumbens and Amygdala Abnormalities in Young Adult Recreational Users (PDF)
Source: Neurobiology of Disease

Marijuana is the most commonly used illicit drug in the United States, but little is known about its effects on the human brain, particularly on reward/aversion regions implicated in addiction, such as the nucleus accumbens and amygdala. Animal studies show structural changes in brain regions such as the nucleus accumbens after exposure to9-tetrahydrocannabinol, but less is known about cannabis use and brain morphometry in these regions in humans. We collected high-resolution MRI scans on young adult recreational marijuana users and nonusing controls and conducted three independent analyses of morphometry in these structures: (1) gray matter density using voxel-based morphometry, (2) volume (total brain and regional volumes), and (3) shape (surface morphometry). Gray matter density analyses revealed greater gray matter density in marijuana users than in control participants in the left nucleus accumbens extending to subcallosal cortex, hypothalamus, sublenticular extended amygdala, and left amygdala, even after controlling for age, sex, alcohol use, and cigarette smoking. Trend-level effects were observed for a volume increase in the left nucleus accumbens only. Significant shape differences were detected in the left nucleus accumbens and right amygdala. The left nucleus accumbens showed salient exposure dependent alterations across all three measures and an altered multimodal relationship across measures in the marijuana group. These data suggest that marijuana exposure, even in young recreational users, is associated with exposure-dependent alterations of the neural matrix of core reward structures and is consistent with animal studies of changes in dendritic arborization.

Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality

April 23, 2014 Comments off

Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischaemic heart disease mortality
Source: British Medical Journal

Objectives
To determine the relationship between the reduction in salt intake that occurred in England, and blood pressure (BP), as well as mortality from stroke and ischaemic heart disease (IHD).

Design
Analysis of the data from the Health Survey for England.

Setting and participants
England, 2003 N=9183, 2006 N=8762, 2008 N=8974 and 2011 N=4753, aged ≥16 years.

Outcomes
BP, stroke and IHD mortality.

Results
From 2003 to 2011, there was a decrease in mortality from stroke by 42% (p<0.001) and IHD by 40% (p<0.001). In parallel, there was a fall in BP of 3.0±0.33/1.4±0.20 mm Hg (p<0.001/p<0.001), a decrease of 0.4±0.02 mmol/L (p<0.001) in cholesterol, a reduction in smoking prevalence from 19% to 14% (p<0.001), an increase in fruit and vegetable consumption (0.2±0.05 portion/day, p<0.001) and an increase in body mass index (BMI; 0.5±0.09 kg/m2, p<0.001). Salt intake, as measured by 24 h urinary sodium, decreased by 1.4 g/day (p<0.01). It is likely that all of these factors (with the exception of BMI), along with improvements in the treatments of BP, cholesterol and cardiovascular disease, contributed to the falls in stroke and IHD mortality. In individuals who were not on antihypertensive medication, there was a fall in BP of 2.7±0.34/1.1±0.23 mm Hg (p<0.001/p<0.001) after adjusting for age, sex, ethnic group, education, household income, alcohol consumption, fruit and vegetable intake and BMI. Although salt intake was not measured in these participants, the fact that the average salt intake in a random sample of the population fell by 15% during the same period suggests that the falls in BP would be largely attributable to the reduction in salt intake rather than antihypertensive medications.

Conclusions
The reduction in salt intake is likely to be an important contributor to the falls in BP from 2003 to 2011 in England. As a result, it would have contributed substantially to the decreases in stroke and IHD mortality.

CRS — What Is the Farm Bill? (updated)

April 22, 2014 Comments off

What Is the Farm Bill? (PDF)
Source: Congressional Research Service (via Federation of American Scientists)

The farm bill is an omnibus, multi-year piece of authorizing legislation that governs an array of agricultural and food programs. Titles in the most recent farm bill encompassed farm commodity price and income supports, farm credit, trade, agricultural conservation, research, rural development, bioenergy, foreign food aid, and domestic nutrition assistance. Although agricultural policies sometimes are created and changed by freestanding legislation or as part of other major laws, the farm bill provides a predictable opportunity for policy makers to comprehensively and periodically address agricultural and food issues. The farm bill is renewed about every five years.

FDA discourages use of laparoscopic power morcellation for removal of uterus or uterine fibroids

April 18, 2014 Comments off

FDA discourages use of laparoscopic power morcellation for removal of uterus or uterine fibroids
Source: U.S. Food and Drug Administration

In a safety communication notice issued today, the U.S. Food and Drug Administration discouraged the use of laparoscopic power morcellation for the removal of the uterus (hysterectomy) or uterine fibroids (myomectomy) in women because, based on an analysis of currently available data, it poses a risk of spreading unsuspected cancerous tissue, notably uterine sarcomas, beyond the uterus.

Laparoscopic power morcellation is one of several available treatments for fibroids. It is a procedure that uses a medical device to divide the uterine tissue into smaller pieces or fragments so it can be removed through a small incision in the abdomen, such as during laparoscopy.

Uterine fibroids are non-cancerous growths that originate from the smooth muscle tissue in the wall of the uterus. According to the National Institutes of Health, most women will develop uterine fibroids at some point in their lives. While most uterine fibroids do not cause problems, they can cause symptoms, such as heavy or prolonged menstrual bleeding, pelvic pressure or pain, and frequent urination, sometimes requiring medical or surgical therapy.

Based on an analysis of currently available data, the FDA has determined that approximately 1 in 350 women who are undergoing hysterectomy or myomectomy for fibroids have an unsuspected type of uterine cancer called uterine sarcoma. If laparoscopic power morcellation is performed in these women, there is a risk that the procedure will spread the cancerous tissue within the abdomen and pelvis, significantly worsening the patient’s likelihood of long-term survival.

Optimal Schedules of Light Exposure for Rapidly Correcting Circadian Misalignment

April 18, 2014 Comments off

Optimal Schedules of Light Exposure for Rapidly Correcting Circadian Misalignment
Source: PLoS Computational Biology

Jet lag arises from a misalignment of circadian biological timing with the timing of human activity, and is caused by rapid transmeridian travel. Jet lag’s symptoms, such as depressed cognitive alertness, also arise from work and social schedules misaligned with the timing of the circadian clock. Using experimentally validated mathematical models, we develop a new methodology to find mathematically optimal schedules of light exposure and avoidance for rapidly re-entraining the human circadian system. In simulations, our schedules are found to significantly outperform other recently proposed schedules. Moreover, our schedules appear to be significantly more robust to both noise in light and to inter-individual variations in endogenous circadian period than other proposed schedules. By comparing the optimal schedules for thousands of different situations, and by using general mathematical arguments, we are also able to translate our findings into general principles of optimal circadian re-entrainment. These principles include: 1) a class of schedules where circadian amplitude is only slightly perturbed, optimal for dim light and for small shifts 2) another class of schedules where shifting occurs along the shortest path in phase-space, optimal for bright light and for large shifts 3) the determination that short light pulses are less effective than sustained light if the goal is to re-entrain quickly, and 4) the determination that length of daytime should be significantly shorter when delaying the clock than when advancing it.

See: Using mathematics to beat jetlag effectively (Science Daily)

The Five Most Costly Children’s Conditions, 2011: Estimates for U.S. Civilian Noninstitutionalized Children, Ages 0-17

April 17, 2014 Comments off

The Five Most Costly Children’s Conditions, 2011: Estimates for U.S. Civilian Noninstitutionalized Children, Ages 0-17
Source: Agency for Healthcare Research and Quality

This Statistical Brief presents data from the Household Component of the Medical Expenditure Panel Survey (MEPS-HC) regarding medical expenditures associated with the top five most costly conditions for children in 2011. These top five conditions–mental disorders; asthma/chronic obstructive pulmonary disease (COPD); trauma-related disorders; acute bronchitis and upper respiratory infections (URI); and otitis media (ear infections)–were determined by totaling and ranking the expenses for all medical care delivered in 2011.

Hooked on Smartphones: An Exploratory Study on Smartphone Overuse among College Students

April 16, 2014 Comments off

Hooked on Smartphones: An Exploratory Study on Smartphone Overuse among College Students (PDF)
Source: Association for Computing Machinery

The negative aspects of smartphone overuse on young adults, such as sleep deprivation and attention deficits, are being increasingly recognized recently. This emerging issue motivated us to analyze the usage patterns related to smartphone overuse. We investigate smartphone usage for 95 college students using surveys, logged data, and interviews. We first divide the participants into risk and non-risk groups based on self-reported rating scale for smartphone overuse. We then analyze the usage data to identify between-group usage differences, which ranged from the overall usage patterns to appspecific usage patterns. Compared with the non-risk group, our results show that the risk group has longer usage time per day and different diurnal usage patterns. Also, the risk group users are more susceptible to push notifications, and tend to consume more online content. We characterize the overall relationship between usage features and smartphone overuse using analytic modeling and provide detailed illustrations of problematic usage behaviors based on interview data.

Daytime sleepiness: associations with alcohol use and sleep duration in americans

April 15, 2014 Comments off

Daytime sleepiness: associations with alcohol use and sleep duration in americans
Source: Sleep Disorders

The aim of the current analysis was to investigate the relationship of daytime sleepiness with alcohol consumption and sleep duration using a population sample of adult Americans. Data was analyzed from adult respondents of the National Health and Nutritional Examination Survey (NHANES) 2007-2008 (N = 2919) using self-reported variables for sleepiness, sleep duration, and alcohol consumption (quantity and frequency of alcohol use). A heavy drinking episode was defined as the consumption of ≥5 standard alcoholic beverages in a day. Logistic regression models adjusted for sociodemographic variables and insomnia covariates were used to evaluate the relationship between daytime sleepiness and an interaction of alcohol consumption variables with sleep duration. The results showed that daytime sleepiness was reported by 15.07% of the subjects. In univariate analyses adjusted for covariates, an increased probability of daytime sleepiness was predicted by decreased log drinks per day [OR = 0.74 (95% CI, 0.58–0.95)], a decreased log drinking frequency [0.90 (95% CI, 0.83–0.98)], and lower sleep duration [OR = 0.75 (95% CI, 0.67–0.84)]. An interaction between decreased sleep duration and an increased log heavy drinking frequency predicted increased daytime sleepiness (P = 0.004). Thus, the effect of sleep duration should be considered when evaluating the relationship between daytime sleepiness and heavy drinking.

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System

April 14, 2014 Comments off

Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral Risk Factor Surveillance System
Source: PLoS ONE

Background
With increased life expectancy for HIV-infected persons, there is concern regarding comorbid depression because of its common occurrence and association with behaviors that may facilitate HIV transmission. Our objectives were to estimate the prevalence of current depression among HIV-infected persons receiving care and assess the burden of major depression, relative to that in the general population.

Methods and Findings
We used data from the Medical Monitoring Project (MMP) and the Behavioral Risk Factors Surveillance System (BRFSS). The eight-item Patient Health Questionnaire was used to identify depression. To assess the burden of major depression among HIV-infected persons receiving care, we compared the prevalence of current major depression between the MMP and BRFSS populations using stratified analyses that simultaneously controlled for gender and, in turn, each of the potentially confounding demographic factors of age, race/ethnicity, education, and income. Each unadjusted comparison was summarized as a prevalence ratio (PR), and each of the adjusted comparisons was summarized as a standardized prevalence ratio (SPR). Among HIV-infected persons receiving care, the prevalence of a current episode of major depression and other depression, respectively, was 12.4% (95% CI: 11.2, 13.7) and 13.2% (95% CI: 12.0%, 14.4%). Overall, the PR comparing the prevalence of current major depression between HIV-infected persons receiving care and the general population was 3.1. When controlling for gender and each of the factors age, race/ethnicity, and education, the SPR (3.3, 3.0, and 2.9, respectively) was similar to the PR. However, when controlling for gender and annual household income, the SPR decreased to 1.5.

Conclusions
Depression remains a common comorbidity among HIV-infected persons. The overall excess burden among HIV-infected persons receiving care is about three-times that among the general population and is associated with differences in annual household income between the two populations. Relevant efforts are needed to reduce this burden.

Lost and Found: Understanding Technologies Used to Locate Missing Persons with Alzheimer’s or Dementia

April 14, 2014 Comments off

Lost and Found: Understanding Technologies Used to Locate Missing Persons with Alzheimer’s or Dementia (PDF)
Source: Bureau of Justice Assistance

Alzheimer’s disease and other forms of dementia affect not only those who are living with the disease; these afflictions also impact the caregivers, law enforcement, and even neighbors. As the disease progresses, physical and mental capabilities are negatively impacted, short-term memory loss increases, and a person with Alzheimer’s might begin living in the past. As the person attempts to return to former places of employment or residences, they often get lost and need assistance returning to where they are currently residing. It is never possible to predict if or when a person with Alzheimer’s will wander or be unable to navigate familiar routes. Initiating a search for a person with Alzheimer’s can never be delayed, and conducting such searches can prove to be costly and consume extreme amounts of agency resources. It is crucial for law enforcement officers and other first responders to be familiar with and understand the signs of dementia and be aware of passive identification products used to identify persons with Alzheimer’s. In addition to passive identification techniques, there are technologies and products available that can be used to actively locate an individual who is lost.

Cellular location techniques and Global Positioning System devices are examples of proven methods for aiding law enforcement in a search for a missing person with dementia. This document will provide a technical description of these technologies and outline some of the advantages and disadvantages when employing these products. It will also provide comprehensive lists of locating devices that are currently available. Provided in each section is a short technical description of the technology and its advantages and the disadvantages. Appendix I and Appendix II provide a list of passive and active locating devices currently available.

Timing and Intensity of Light Correlate with Body Weight in Adults

April 9, 2014 Comments off

Timing and Intensity of Light Correlate with Body Weight in Adults
Source: PLoS ONE

Light exposure can influence sleep and circadian timing, both of which have been shown to influence weight regulation. The goal of this study was to evaluate the relationship between ambient light, sleep and body mass index. Participants included 54 individuals (26 males, mean age 30.6, SD = 11.7 years). Light levels, sleep midpoint and duration were measured with wrist actigraphy (Actiwatch-L) for 7 days. BMI was derived from self-reported height and weight. Caloric intake was determined from 7 days of food logs. For each participant, light and activity data were output in 2 minute epochs, smoothed using a 5 point (10 minute) moving average and then aggregated over 24 hours. The mean light timing above 500 lux (MLiT500) was defined as the average clock time of all aggregated data points above 500 lux. MLiT500 was positively correlated with BMI (r = 0.51, p<0.001), and midpoint of sleep (r = 0.47, p<0.01). In a multivariable linear regression model including MLiT500 and midpoint of sleep, MLiT500 was a significant predictor of BMI (B = 1.26 SE = 0.34, β = 0.53 p = 0.001, r2Δ = 0.22). Adjusting for covariates, MLiT500 remained an independent predictor of BMI (B = 1.28 SE = 0.36, β = 0.54, p = 0.002, r2Δ = 0.20). The full model accounted for 34.7% of the variance in BMI (p = 0.01). Exposure to moderate levels of light at biologically appropriate times can influence weight, independent of sleep timing and duration.

Diabetes Spending Dips in States: NCSL Report

April 9, 2014 Comments off

Diabetes Spending Dips in States: NCSL Report
Source: National Conference of State Legislatures

State and federal spending to combat diabetes decreased slightly in 2013 compared to the previous year, according to a new report from the National Conference of State Legislatures (NCSL). The report, “States Address the Costs of Diabetes: A 50-State Budget Survey for Fiscal Year 2013,” tracks the funds specifically appropriated by state legislatures for diabetes in FY 2013. It also reviews the funding provided by the Centers for Disease Control and Prevention (CDC) to states in FY 2012 for Diabetes Prevention and Control Programs (DPCPs), as well as changes in grant funds received from the CDC.

The total of state and federal funding appropriated by state legislatures specifically for diabetes prevention and control was $11,347,038 in FY 2013, compared to $11,947,129 in FY 2012, a difference of about 5 percent. Those figures, however, do not represent total spending by states on diabetes. The CDC also supports state efforts through grant programs, providing roughly $27 million per year.

Unpopular, Overweight, and Socially Inept: Reconsidering the Stereotype of Online Gamers

April 9, 2014 Comments off

Unpopular, Overweight, and Socially Inept: Reconsidering the Stereotype of Online Gamers
Source: Cyberpsychology, Behavior, and Social Networking

Online gaming has become an activity associated with a highly specific, caricatured, and often negative image. This “stereotype” has permeated the collective consciousness, as online gamers have become common caricatures in popular media. A lack of comprehensive demographic inquiries into the online gaming population has made it difficult to dispute these stereotypical characteristics and led to rising concerns about the validity of these stereotypes. The current study aims to clarify the basis of these negative characterizations, and determine whether online video game players display the social, physical, and psychological shortcomings stereotypically attributed them. Sampling and recruiting was conducted using a two-stage approach. First, a representative sample of 50,000 individuals aged 14 and older who were asked about their gaming behavior in an omnibus telephone survey. From this sample, 4,500 video game players were called for a second telephone interview, from which the current data were collected. Only those participants who completed all of the questions relating to video game play were retained for the current analysis (n=2,550). Between- and within-group analyses were enlisted to uncover differences between online, offline, and nongame playing communities across varying degrees of involvement. The results indicate that the stereotype of online gamers is not fully supported empirically. However, a majority of the stereotypical attributes was found to hold a stronger relationship with more involved online players than video game players as a whole, indicating an empirical foundation for the unique stereotypes that have emerged for this particular subgroup of video game players.

NCCAM Clinical Digest: Chronic Low-Back Pain and Complementary Health Approaches

April 4, 2014 Comments off

NCCAM Clinical Digest: Chronic Low-Back Pain and Complementary Health Approaches
Source: National Center for Complementary and Alternative Medicine

This issue of the digest summarizes current scientific evidence about spinal manipulation, acupuncture, massage, and yoga, the complementary approaches most often used by people for chronic low back pain.

Fact Sheet: Hunger by the Numbers in the African-American Community: Employment, Wages, and Fairness

April 4, 2014 Comments off

Fact Sheet: Hunger by the Numbers in the African-American Community: Employment, Wages, and Fairness (PDF)
Source: Bread for the World

Ending hunger in America is possible. However, the return of income inequality on a scale that hasn’t been witnessed since the Great Depression—and the high poverty and hunger rates that accompany it—indicates that it’s time for the U.S. government to step up.

In 2012, the average incomes of the top 1 percent of households rose by 19.6 percent, while the incomes of the other 99 percent grew by just 1 percent. Economic inequality manifests itself in disproportionate rates of hunger and poverty among communities of color and children in particular. Following is an analysis of hunger and poverty within the African-American community and the connection to employment, wages, and fairness.

Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012

April 4, 2014 Comments off

Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012
Source: Journal of Infectious Diseases

Background. 
No studies have examined the effectiveness of influenza vaccine against ICU admission associated with influenza virus infection among children.

Methods. 
In 2010-11 and 2011-12, children aged 6 months to 17 years admitted to 21 US pediatric intensive care units (PICUs) with acute severe respiratory illness and testing positive for influenza were enrolled as cases; children who tested negative were PICU controls. Community controls were children without an influenza-related hospitalization, matched to cases by comorbidities and geographic region. Vaccine effectiveness was estimated with logistic regression models.

Results. 
We analyzed data from 44 cases, 172 PICU controls, and 93 community controls. Eighteen percent of cases, 31% of PICU controls, and 51% of community controls were fully vaccinated. Compared to unvaccinated children, children who were fully vaccinated were 74% (95% CI, 19 to 91%) or 82% (95% CI, 23 to 96%) less likely to be admitted to a PICU for influenza compared to PICU controls or community controls, respectively. Receipt of one dose of vaccine among children for whom two doses were recommended was not protective.

Conclusion. 
During the 2010-11 and 2011-12 US influenza seasons, influenza vaccination was associated with a three-quarters reduction in the risk of life-threatening influenza illness in children.

Where America is sprawling and what it means

April 2, 2014 Comments off

Where America is sprawling and what it means (PDF)
Source: Smart Growth America

People in compact, connected metropolitan regions are more likely to move up the economic ladder, have lower household costs, enjoy more transportation choices and lead longer, safer, healthier lives according to a new report out today by Smart Growth America and the University of Utah’s Metropolitan Research Center.

Measuring Sprawl 2014 evaluates development in 221 major metropolitan areas in the United States, and ranks these areas based on how sprawling or compact they are. The report also examines how sprawl relates to life in those communities, based on factors like economic mobility, the cost of housing and transportation, life expectancy, obesity, chronic disease and safety.

Invasive Cancer Incidence — United States, 2010

March 31, 2014 Comments off

Invasive Cancer Incidence — United States, 2010
Source: Morbidity and Mortality Weekly Report

Cancer has many causes, some of which can, at least in part, be avoided through interventions known to reduce cancer risk (1). Healthy People 2020 objectives call for reducing colorectal cancer incidence to 38.6 per 100,000 persons, reducing late-stage breast cancer incidence to 41.0 per 100,000 women, and reducing cervical cancer incidence to 7.1 per 100,000 women (2). To assess progress toward reaching these Healthy People 2020 targets, CDC analyzed data from U.S. Cancer Statistics (USCS) for 2010. USCS includes incidence data from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program and mortality data from the National Vital Statistics System (3). In 2010, a total of 1,456,496 invasive cancers were reported to cancer registries in the United States (excluding Arkansas and Minnesota), an annual incidence rate of 446 cases per 100,000 persons, compared with 459 in 2009 (4). Cancer incidence rates were higher among men (503) than women (405), highest among blacks (455), and ranged by state from 380 to 511 per 100,000 persons. Many factors, including tobacco use, obesity, insufficient physical activity, and human papilloma virus (HPV) infection, contribute to the risk for developing cancer, and differences in cancer incidence indicate differences in the prevalence of these risk factors. These differences can be reduced through policy approaches such as the Affordable Care Act,* which could increase access for millions of persons to appropriate and timely cancer preventive services, including help with smoking cessation, cancer screening, and vaccination against HPV (5).

Invasive cancers include all cancers except in situ cancers (other than in the urinary bladder) and basal and squamous cell skin cancers.

Colorectal cancer statistics, 2014

March 27, 2014 Comments off

Colorectal cancer statistics, 2014
Source: CA: A Cancer Journal for Clinicians

Colorectal cancer is the third most common cancer and the third leading cause of cancer death in men and women in the United States. This article provides an overview of colorectal cancer statistics, including the most current data on incidence, survival, and mortality rates and trends. Incidence data were provided by the National Cancer Institute’s Surveillance, Epidemiology, and End Results program and the North American Association of Central Cancer Registries. Mortality data were provided by the National Center for Health Statistics. In 2014, an estimated 71,830 men and 65,000 women will be diagnosed with colorectal cancer and 26,270 men and 24,040 women will die of the disease. Greater than one-third of all deaths (29% in men and 43% in women) will occur in individuals aged 80 years and older. There is substantial variation in tumor location by age. For example, 26% of colorectal cancers in women aged younger than 50 years occur in the proximal colon, compared with 56% of cases in women aged 80 years and older. Incidence and death rates are highest in blacks and lowest in Asians/Pacific Islanders; among males during 2006 through 2010, death rates in blacks (29.4 per 100,000 population) were more than double those in Asians/Pacific Islanders (13.1) and 50% higher than those in non-Hispanic whites (19.2). Overall, incidence rates decreased by approximately 3% per year during the past decade (2001–2010). Notably, the largest drops occurred in adults aged 65 and older. For instance, rates for tumors located in the distal colon decreased by more than 5% per year. In contrast, rates increased during this time period among adults younger than 50 years. Colorectal cancer death rates declined by approximately 2% per year during the 1990s and by approximately 3% per year during the past decade. Progress in reducing colorectal cancer death rates can be accelerated by improving access to and use of screening and standard treatment in all populations.

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