Posts Tagged ‘wiley’

U.S. has seen widespread adoption of robot-assisted cancer surgery to remove the prostate

In 2001, surgeons began using robotic technologies in operations to remove the prostate. To examine trends in the use of such robotic-assisted radical prostatectomy (RARP) procedures for prostate cancer patients, Steven Chang, MD, MS, of Harvard Medical School, the Dana-Farber Cancer Institute, and Brigham and Women’s Hospital, led a team that analyzed 489,369 men who underwent non-RARP (i.e., open or laparoscopic radical prostatectomy) or RARP in the United States from 2003 to 2010.

During the study period, RARP adoption (defined as performing more than 50 percent of annual radical prostatectomies with the robotic approach) increased from 0.7 percent to 42 percent of surgeons performing radical prostatectomies. Surgeons who performed at least 25 radical prostatectomies each year were more likely to adopt RARP. Also, from 2005 to 2007, adoption was more common among surgeons at teaching hospitals and at intermediate and large-sized hospitals. After 2007, adoption was more common among surgeons at urban hospitals. RARP was more costly, disproportionally contributing to the 40 percent increase in annual prostate cancer surgery expenditures; however, RARP costs generally decreased and plateaued at slightly over $10,000 while non-RARP costs increased to nearly $9,000 by the end of the study.

“Our findings give insights on the adoption of not just robotic technology but future surgical innovations in terms of the general pattern of early diffusion, the potential impact on costs of new and competing treatments, and the alternations in practices patterns such as centralization of care to higher volume providers,” said Dr. Chang.

source : http://www.sciencedaily.com/releases/2014/08/140826091041.htm

Medicaid reimbursements may affect cancer screening rates among beneficiaries

Although Medicaid is a joint state-federal government health insurance program, each state sets the policies for its own Medicaid program within requirements set by the federal government. This includes setting how much providers are paid for health care services and who is allowed to enroll in Medicaid. To determine whether state Medicaid eligibility and reimbursement policies affect receipt of breast, cervical, and colorectal cancer screening among Medicaid beneficiaries, Michael Halpern, MD, PhD, MPH, of RTI International, and his colleagues analyzed 2007 Medicaid data from 46 states and Washington DC.

“Few studies have examined how state-specific differences in Medicaid policies might affect use of preventive care services, particularly for early detection of cancer,” said Dr. Halpern. “Our study was able to compare differences in cancer screening for Medicaid beneficiaries in almost all states, providing a broad, national picture of the effects of state-level Medicaid policies on receipt of these critical medical care services among a large group of underserved individuals.”

The researchers found that in states with higher payments for office visits, Medicaid beneficiaries were more likely to receive recommended screenings for early detection of all three types of cancer. In contrast, higher payments for cancer screening tests (such as colonoscopy, mammography, and Pap tests) were not always linked with increased screenings among Medicaid beneficiaries. The team also found that Medicaid beneficiaries in states that had an “asset test” (which considers an individual’s savings, property, or other items of worth to determine whether he or she could enroll in Medicaid) were less likely to be screened for cancer.

The association between higher Medicaid reimbursements for office visits and increased likelihood of receiving cancer screenings may reflect barriers in access to primary care physicians and other providers for Medicaid enrollees in states with lower reimbursements. Increasing reimbursements for office visits may facilitate access to primary care among Medicaid beneficiaries, and thereby increase the likelihood of receiving appropriate cancer screening tests. On the other hand, raising reimbursement for the screening tests themselves may be a less effective policy tool for increasing use of recommended screenings. The results also indicate that eliminating asset tests may increase the likelihood of receiving cancer screenings by helping low-income individuals remain enrolled in Medicaid.

“Due to multiple factors, including Health Care Reform and decreased state budgets, many states are changing their Medicaid policies, including how much health care providers are paid and who is allowed to enroll,” said Dr. Halpern. “Our findings can help state health care decision makers and policy leaders to develop new Medicaid policies that aid low income individuals in receiving recommended cancer screenings.”

source : http://www.sciencedaily.com/releases/2014/08/140825084929.htm

Lifestyle choices may affect long-term heart health of childhood cancer survivors

Adults who had cancer as children are known to be at increased risk for the metabolic syndrome, a group of risk factors that increases the likelihood of developing heart disease and other health problems such as diabetes and stroke. People with the metabolic syndrome have some combination of factors including high blood pressure, abnormal cholesterol and glucose levels, and increased body fat.

Kirsten Ness, PT, PhD, of St. Jude Children’s Research Hospital in Memphis, and her colleagues looked to see if lifestyle habits might affect cancer survivors’ risk of developing the metabolic syndrome. The team studied 1598 childhood cancer survivors who were cancer-free for at least 10 years. Questionnaires and tests helped the researchers assess whether the participants followed healthy lifestyle recommendations issued by the World Cancer Research Fund and American Institute for Cancer Research. Those who met at least four of seven recommendations were classified as following the guidelines. “This study is unique because of the large, well characterized population of survivors of various diagnoses that we studied, many years from their original cancer diagnosis,” said Dr. Ness.

The metabolic syndrome was present in 31.8 percent of the participants, and 27.0 percent of participants followed the healthy lifestyle guidelines. Females who did not follow the guidelines were 2.4 and males were 2.2 times more likely to have the metabolic syndrome than those who followed the guidelines.

“These findings are important because they indicate that adults who were treated for cancer as children have the opportunity to influence their own health outcomes,” said Dr. Ness. “Cancer survivors should not smoke. In addition, adopting a lifestyle that includes maintaining a healthy body weight, regular physical activity, and a diet that includes fruits and vegetables and that limits refined sugars, excessive alcohol, red meat, and salt has potential to prevent development of the metabolic syndrome.”

source : http://www.sciencedaily.com/releases/2014/07/140728080436.htm