Screening for Cervical and Breast Cancer: Is Obesity an Unrecognized Barrier to Preventive Care?

Article Abstract:

Overweight and obese women are less likely to have Pap smears and mammography, even though they have a higher mortality rate than thinner women from breast cancer and cervical cancer, which indicates they should be screened at a higher rate. It is not determined if obesity itself decreases access to the screening tests. Of 11,435 women between 18 and 75 years of age who had not had a hysterectomy, overweight and obese women had fewer Pap smears in the previous three years than women of normal weight. The same proportion was found for mammography in women between 50 and 75.

Health aspects, Patient outcomes, Mortality, Demographic aspects, Cervical cancer, Obesity, Breast cancer, Mammography, Pap test

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Outcomes and cost-effectiveness of initiating dialysis and continuing aggressive care in seriously ill hospitalized adults

Article Abstract:

It may not be cost-effective to begin dialysis in many seriously ill patients who develop kidney failure. In a study of 490 seriously ill patients who developed kidney failure and were treated with dialysis, only 27% survived for 6 months. Overall, the estimated cost of providing dialysis to these patients was $128,000 per quality-adjusted life-year saved. The patients with the worst prognosis incurred $274,000 per quality-adjusted life-year while those with the best prognosis incurred $61,900. Many physicians believe that treatments that cost more than $50,000 per quality-adjusted life-year saved are not cost-effective.

Care and treatment, Economic aspects, Reports, Hospitalization, Cost benefit analysis, Critically ill, Chronic kidney failure, Hemodialysis

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Physician Counseling About Exercise

Article Abstract:

Many doctors are not advising their patients to get more exercise. More and more Americans are obese, and a sedentary lifestyle may be a factor. In a survey of 9,299 adults who had seen a doctor in the previous year, only 34% said their doctor had recommended exercise. Women were more likely to receive advice about exercise, as were older people, college graduates, people with high incomes, people with high levels of physical activity and those with heart disease. Young, healthy people are most likely to need this advice, including those from low socioeconomic groups.

Physician and patient, Physician-patient relations, Surveys, Exercise

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