News in brief - Sept. 26, 2005

New cancer screening recommendations released - No link between accelerated approval process and drug safety - Respect may lead to better health outcomes - Cholesterol screening increases but has not met goals - Community-acquired staph tougher than hospital-acquired

New cancer screening recommendations released

Primary care doctors should not routinely refer all women for genetic counseling and DNA testing to detect the presence of specific BRCA1 and BRCA2 gene mutations that may be associated with breast or ovarian cancer, according to a new recommendation from the U.S. Preventive Services Task Force.

But if a woman has certain specific family history patterns that put her at risk for these gene mutations, her primary care physician should suggest counseling and possible DNA testing.

This was the first time the task force has addressed the issue of genetic counseling and DNA-based testing for any disease. The recommendations, along with a review of supporting evidence, appear in the Sept. 6 Annals of Internal Medicine.

Women who inherit mutations in one or both of the genes have a greater risk of developing breast and/or ovarian cancer, especially if family members have had one or both of the cancers. However, it is believed that in the general population, only about one out of every 300 to 500 women has this genetic mutation, according to the task force.

No link between accelerated approval process and drug safety

Faster approval of new drugs by the Food and Drug Administration has not increased the number of prescription drugs withdrawn for safety reasons in this country, says a recent analysis by the Tufts Center for the Study of Drug Development.

"Given rising public concern over drug safety, and assertions by FDA critics that drug safety in the United States has deteriorated since the adoption of user fees [which helped hasten drug review] in 1993, we wanted to investigate the matter," said Kenneth I. Kaitin, PhD, director of the center.

The center found that instead of more drugs being withdrawn from the market because of safety concerns, there have been fewer withdrawals since 2000. The Prescription Drug User Fee Act enabled the FDA to assess drug firms extra fees that could be used to hire more reviewers and improve the drug review process.

The center's analysis found that 3.2% of all drugs approved for sale in the United States in the 1980s were subsequently withdrawn. That rate increased slightly to 3.5% in the 1990s and since then has dropped to 1.6%.

Respect may lead to better health outcomes

Being treated with dignity was associated with a greater degree of satisfaction with health care and an increased likelihood of receiving preventive services, according to a study published in the July/August issue of Annals of Family Medicine.

Researchers analyzed data from more than 5,000 people who participated in the Commonwealth Fund's 2001 Health Care Quality Survey. Slightly more than three-quarters reported being treated with respect, and the impact was significant. For example, 78% of those treated respectfully planned to adhere to recommendations, while only 69% of those who were not treated quite as well could say the same.

The impact of varying types of respect, however, varied among racial and ethnic groups. Dignity was associated with increased adherence for racial and ethnic minorities, while being involved in decision-making was linked with compliance among Caucasian patients.

Cholesterol screening increases but has not met goals

Screening for high blood cholesterol has increased but still has not achieved Health People 2010 goals in most of the country, according to a paper in the Sept. 9 Morbidity and Mortality Weekly Report.

Researchers at the Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention analyzed data collected by the Behavioral Risk Factor Surveillance System. The national average for people being screened for cholesterol within the past five years increased from 68% to 73% between 1991 and 2003, with only Washington, D.C., and Massachusetts achieving the goal of having at least 80% of the population screened.

The number of people told they had high blood cholesterol also increased from 25% to 31%.

Authors of the paper said these data highlighted the need to increase awareness of the importance of monitoring cholesterol and taking steps to maintain or achieve healthy levels.

Community-acquired staph tougher than hospital-acquired

Drug-resistant Staphylococcus aureus caught in the community is more lethal and better at evading the immune system than its cousin, which is transmitted in the hospital setting, according to a paper published in the Sept. 15 Journal of Immunology.

Researchers at the National Institute of Allergy and Infectious Diseases' Rocky Mountain Laboratories in Hamilton, Mont., studied how various strains of the bacteria behaved in mice. The community-acquired version was more capable of evading the neutrophils that typically ingest harmful bacteria and make up 60% of a human's supply of white blood cells. Scientists also detected several genetic differences that could play a role in the virulence of this bug. The hope is that further understanding of these genes will lead to more effective medical treatments.

"There is a critical need to develop new treatments against late-stage disease caused by antibiotic-resistant strains, and this promising work offers several new approaches," said NIAID Director Anthony S. Fauci, MD.