Cataract surgery with an intraocular lens implant is one of the most common and thought to be the most effective surgical procedure in any field of medicine. Although aging is the most common cause, other factors are also known to be associated with cataract formation. Although cataracts are the domain of ophthalmology, primary care physicians are frequently the ones to whom patients present with vision complaints. Knowledge of cataract symptoms, how to evaluate them, and a basic understanding of the surgery to correct cataracts make primary care physicians an integral part of treating this leading cause of preventable blindness.
Objective Melanoma incidence and mortality are increasing among United States (U.S.) adults. Currently, routine skin cancer screening total body skin examinations (TBSEs) by a physician are not recommended by the United States Preventive Services Task Force (USPSTF); while organizations such as the American Cancer Society recommend screening. Currently, there are limited data on the prevalence, correlates, and trends of TBSE among U.S. adults. Methods We analyzed data by race/ethnicity, age, and skin cancer risk level, among other characteristics from three different National Health Interview Survey (NHIS) cancer control supplements conducted every five years since 2000 in random U.S. households. High-risk status and middle-risk status were defined based on the USPSTF criteria (age, race, sunburn, and family history). Results Prevalence of having at least one TBSE increased from 14.5 in 2000 to 16.5 in 2005 to 19.8 in 2010 (P = 0.0001). In 2010, screening rates were higher among the elderly, the fair-skinned, those reporting sunburn(s), and individuals with a family history of skin cancer. Approximately 104.7 million (51.1%) U.S. adults are at high-risk for developing melanoma, of which 24.0% had at least one TBSE. Conclusions TBSE rates have been increasing since 2000 both overall and among higher-risk groups. Data on screening trends could help tailor future prevention strategies.
Gynecologic cancer confers a large burden among women in the United States. Several evidence-based interventions are available to reduce the incidence, morbidity, and mortality from these cancers. The National Comprehensive Cancer Control Program (NCCCP) is uniquely positioned to implement these interventions in the US population. This review discusses progress and future directions for the NCCCP in preventing and controlling gynecologic cancer. Gynecologic Cancer in the United StatesA pproximately 84,000 new cases are diagnosed and about 28,000 deaths occur each year from gynecologic cancer among women in the United States.1 Five cancers account for the vast majority of gynecologic cancer cases: cervical, ovarian, uterine, vaginal, and vulvar. Uterine cancer diagnoses are common; uterine is the fourth highest incident cancer among women in the US after breast, lung, and colorectal cancers.1 Ovarian cancer is the eighth most common cancer diagnosed; however, it is the fifth leading cause of cancer death among US women. Cervical, vaginal, and vulvar cancers are relatively less common than uterine and ovarian cancers; however, diagnoses and deaths from these three cancers still number in the thousands each year.1 The economic burden of gynecologic cancer is substantial in the US. In a single state (California) during a 1-year period, cervical, ovarian, and uterine cancers accounted for $624 million in direct health care costs and lost productivity due to premature death.2 Ovarian cancer was the most costly ($292 million), followed by cervical cancer ($206 million) and uterine cancer ($126 million).
Introduction Centers for Disease Control and Prevention’s (CDC) National Comprehensive Cancer Control Program (NCCCP) funds states, the District of Columbia, tribal organizations, territories, and jurisdictions across the USA develop and implement jurisdiction-specific comprehensive cancer control (CCC) plans. The objective of this study was to analyze NCCCP action plan data for incorporation and appropriateness of cancer survivorship-specific goals and objectives. Methods In August 2013, NCCCP action plans maintained within CDC’s Chronic Disease Management Information System (CDMIS) from years 2010 to 2013 were reviewed to assess the inclusion of cancer survivorship objectives. We used the CDMIS search engine to identify “survivorship” within each plan and calculated the proportion of programs that incorporate cancer survivorship-related content during the study period and in each individual year. Cancer survivorship objectives were then categorized by compatibility with nationally accepted, recommended strategies from the report A National Action Plan for Cancer Survivorship: Advancing Public Health Strategies (NAP). Results From 2010 to 2013, 94 % (n=65) of NCCCP action plans contained survivorship content in at least 1 year during the time period and 38 % (n=26) of all NCCCP action plans addressed cancer survivorship every year during the study period. Nearly 64 % (n=44) of NCCCP action plans included cancer survivorship objectives recommended in NAP. Conclusion Nearly all NCCCP action plans addressed cancer survivorship from 2010 to 2013, and most programs implemented recommended cancer survivorship efforts during the time period. Implications for Cancer Survivors NCCCP grantees can improve cancer survivorship support by incorporating recommended efforts within each year of their plans.
Despite evidence that physical activity can reduce the cardiometabolic risk of patients with psoriasis, these patients may engage in less physical activity than those without psoriasis. The aim of this study was to examine the association of the extent of psoriatic skin lesions with the likelihood of participating in leisure-time moderate to vigorous physical activity (MVPA) and metabolic equivalent task (MET)-minutes of MVPA amongst those who participated. The National Health and Nutrition Examination Survey (NHANES) is a population-based survey among U.S. adults. A total of 6549 persons aged 20-59 years responded to the 2003-2006 NHANES dermatology questionnaires, which asked about participation in leisure-time MVPA and MET-minutes of MVPA amongst those who participated. Compared with individuals without psoriasis, those with psoriasis were less likely to have engaged in leisure MVPA in the past 30 days, although this association was not statistically significant. Amongst those who participated in leisure-time MVPA, MET-minutes of leisure-time MVPA were lower on average for patients currently having few to extensive cutaneous lesions (but not for those currently having little or no psoriatic patches), relative to individuals never diagnosed with psoriasis by approximately 30%. Clinicians should encourage patients with psoriasis, especially those with more severe disease, to be more physically active; they should help identify and address possible psychological and physical barriers to their patients' physical activity.
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