Showing papers by "Mona Saraiya published in 2005"

Total and percent free prostate-specific antigen levels among U.S. men, 2001-2002.

Abstract: Background: Because total prostate-specific antigen (PSA) and, more recently, the percent free PSA are used to screen men for prostate cancer, population-based, age- and race-specific distributions are needed of both PSA tests among American men to estimate the effect of lowering the PSA threshold or widespread introduction of the free PSA test as an additional screening test. Methods: We did PSA assays on serum samples from men of ages 40 years and older ( n = 1,320) who participated in the 2001-2002 National Health and Nutrition Examination Survey. Results: About 6.1% (95% confidence interval, 4.7-7.7%), corresponding to an estimated 3.4 million (range, 2.7-4.3 million) men nationwide, ages 40 years and older, had a total PSA of >4.0 ng/mL. Among men ages 50 to 69 years old, the age group for which PSA testing is most prevalent, 5.4% or an estimated 900,000 to 2 million men had a total PSA of >4.0 ng/mL. An equal number had a total PSA between 2.5 and 4.0 ng/mL and a percent free PSA of <25%. Approximately 27% of men in this age group, corresponding to a range of 5.7 to 8.1 million men, had a total PSA <2.5 ng/mL and a percent free PSA of <25%. Conclusion: The effect of lowering the total PSA threshold or introducing another screening test is significant. Provision of the number of U.S. men with certain total PSA and percent free PSA values may help guide prostate cancer public health policy and screening practices.

Report from the CDC. Pap test intervals used by physicians serving low-income women through the National Breast and Cervical Cancer Early Detection Program.

Abstract: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP), administered by the Centers for Disease Control and Prevention (CDC), provides breast and cervical cancer screening to low-income women who are uninsured or underinsured. For women with three consecutive annual Pap tests with normal findings, the NBCCEDP supports extending the screening interval to every 3 years. Thirteen telephone focus groups were conducted with physician providers in 17 states and the District of Columbia to investigate familiarity with NBCCEDP's triennial Pap test policy, the Pap test intervals actually used, and the factors influencing screening interval selection. No participants were familiar with NBCCEDP's triennial Pap test policy, and none reported routinely extending the screening interval after three consecutive annual Pap tests with normal findings. Two patterns of screening interval use were reported: annual screeners continued performing yearly Pap tests, and selective extended screeners offered an e...

Using evidence-based community and behavioral interventions to prevent skin cancer: opportunities and challenges for public health practice.

Abstract: Skin cancer is the most common cancer in the United States and is increasing in incidence (1). In 2004, more than 1 million people were expected to be diagnosed with squamous cell or basal cell carcinoma, and more than 2200 deaths were expected (2). Another 54,200 people were estimated to be diagnosed with melanoma, the most lethal of all skin cancers, and 7600 persons were expected to die from that disease during 2004. High levels of exposure to ultraviolet radiation (UVR) increase the risk of all three major forms of skin cancer, and approximately 65% to 90% of melanomas are caused by UVR exposure. Other risk factors for skin cancer include having fair skin, hair, and eyes; growing up closer to the equator; and having a large number of moles or nevi (3). Fortunately, skin cancer is one of the most preventable cancers. State and local health departments can play an important role in preventing skin cancer by developing population-based programs to prevent the disease; assuring sun-safe environments and policies; and regulating exposure where appropriate. Behaviors that reduce risk include limiting or minimizing exposure to the sun during midday hours; wearing protective clothing; and using a broad-spectrum sunscreen when outside (3). The Task Force on Community Preventive Services conducted an evidence-based review of the efficacy of interventions for sun protection in varied segments of the population across various settings (4,5). Reviewers examined the methodology of identified studies to see whether their design was suitable and their execution good enough to be included in the Task Force's review and also to inform the later determination of whether the evidence was sufficient to recommend a particular intervention (6,7). Given the increasing emphasis on basing policy and practice on evidence, public health leaders and practitioners should be familiar with this evidence review, its findings, and its implications for policy and practice. This paper summarizes the state of knowledge about the effectiveness of interventions to reduce UVR exposure among various groups to prevent skin cancer and suggests strategies and resources for translating the evidence into action to improve population health.