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Anchor lead: New recommendations have been released regarding colorectal cancer screening, Elizabeth Tracey reports

If you’ve reached the age of 45, it’s time to schedule your first screening for colorectal cancer. And you can choose which screening test to use. That’s according to the American Cancer Society in their recently released updated guidelines. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, provides a review.

Nelson: The formal recommendation would be that if you’re at so-called average risk, which means you don’t have any polyps so far, you don’t have a strong family history, you don’t have Crohn’s disease or ulcerative colitis, something like that, you haven’t had radiation to your stomach, you’re at average risk, that you should start at age 45 with colonoscopy or one of the stool tests, either the one that really focuses on blood or the multifeature ones.  :22

Nelson himself thinks colonoscopy is the most practical test, since if polyps are found they can be removed right away.

Nelson: Because when you find something colonoscopy isn’t just a screening tool it’s a screening and treatment tool.   :05

Nelson notes that a series of negative fecal tests is also quite reliable. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A genetic assay can help many with early breast cancer avoid chemotherapy, Elizabeth Tracey reports

A widely available 21-gene assay can help women with so-called intermediate risk breast cancer avoid chemotherapy and simply stick to endocrine therapy, a study reported recently in the New England Journal of Medicine found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, describes the results.

Nelson: The addition of chemotherapy did not help these women at all, followed all the way to nine years, suggesting that in that group, which is a very large group, that you might not need the chemotherapy. Using this gene panel you take the ones with the low score, they don’t need any therapy. The ones with this intermediate score they do well with the this endocrine therapy alone, and the ones with the high score are the ones who should get the chemotherapy.  :25

Nelson says genetic testing thus helps the majority of women with this type of breast cancer avoid chemotherapy, and that’s a great outcome. It should also result in huge cost savings as the number of women who need chemotherapy is vastly reduced. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: If you’re infected with HIV, you don’t have to transmit it to others, Elizabeth Tracey reports

People who are infected with HIV are essentially the same as those who aren’t as long as they’re taking the proper medications. That’s the take home from a new slogan being popularized by the Centers for Disease Control and prevention. Joseph Cofrancesco, an HIV expert at Johns Hopkins, explains.

Cofrancesco: If you are infected we have absolutely wonderful treatment that can control this and you can live a healthy life. The CDC has a new advertising plan: U=U. Undetectable equals uninfected. If you’re not infected, we have many different ways to help prevent you from getting infected, like knowing your partner’s status, like having your partner be controlled, because those who are controlled don’t spread the virus, like using condoms and even if need be adding PrEP. :31

Cofranscesco notes that everyone needs to know their HIV status, so everyone should be tested. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Recent free HIV testing underscores the need for all, Elizabeth Tracey reports

Do you know your HIV status? A recent day of free HIV testing provided to all comers by many  drugstores and clinics nationally brings awareness to the fact that everyone should be tested for HIV, even and perhaps especially those who don’t think they’re at risk for infection. Joseph Cofranscesco, an HIV expert at Johns Hopkins, comments.

Cofrancesco: The CDC has mentioned and all good practitioners have mentioned that basically everyone should be HIV tested. Certainly those at risk may know they’re at risk and are often regularly tested although fear sometimes prevents them. But there’s a whole group out there who don’t perceive to be at risk, who are. So basically everyone should get tested, this is the first part of what we call the treatment cascade. So first of all you need to know that you have an HIV infection.  :28

Distressingly, even in developed countries some groups are seeing an increased rate of HIV transmission, a development that threatens to undermine years of control and intervention in containing the virus. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What is the impact of high profile suicides? Elizabeth Tracey reports

Suicide can be contagious, research into rates of spates of suicide show. Karen Swartz, a psychiatrist and depression expert at Johns Hopkins, says when a prominent and well-known person chooses to end their life, the ripples can extend far and wide.

Swartz: When there are tragic deaths by suicide, of public figures, we have the risk of contagion. When someone who is feeling well hears that they think it’s sad, and they wonder oh my goodness why would this happen? If you are depressed, contemplating suicide and on the verge, and then you see an example of someone who has done this it does increase the risk that someone might act. It almost strips away one of the taboos, which is really dangerous. I saw many more accounts that included if you’re feeling depressed please seek help. And so I think we’re making some progress but I fear there’s not enough.   :34

Swartz hopes public awareness will also help identify those at risk so intervention is possible. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Women are increasingly using lethal means to commit suicide, Elizabeth Tracey reports

The Centers for Disease Control and Prevention has released disturbing data on the increasing rates of suicide nationally. Karen Swartz, a psychiatrist and depression expert at Johns Hopkins, says women are comprising more of this number.

Swartz: Related to the suicide change one of the concerning facts is that women are having higher rates. Women are tending to use more lethal means, are more likely to use firearms, or hanging or other lethal means which is very concerning. There was a long pattern where women attempted suicide more frequently but were more likely to take pills, and thankfully also didn’t know which pills would be fatal and so they would make an attempt, and survive. And now when they’re making an attempt they’re often dying, particularly if they’ve made these choices. :31

Swartz says it’s fairly easy to search the internet for information relative to how to commit suicide, but notes that the top hits are now occupied by suicide intervention groups offering help. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: What factors lead to suicide among older people? Elizabeth Tracey reports

Depression in older people is more difficult to treat and lasts longer than in younger people, a recent study reports. Karen Swartz, a psychiatrist and depression expert at Johns Hopkins, says the constellation of factors surrounding aging may be the culprit.

Swartz: As you become more frail, the work it takes to get out and see people is greater, and so unless you are lucky to have a wonderful social network isolation I think is something that most older individuals are fighting against or trying to figure out how to manage. That has a negative impact. We accumulate medical problems. Things just get harder and if you combine some hypertension and diabetes and some mobility problems with slight changes in your memory its very hard to get out and do things in the way that you used to.  :30

Swartz says recent reports of increasing suicidality among this age group are especially troubling, and notes that since older folks interact with primary care physicians most often, educating these clinicians in screening and management is key. At Johns Hopkins, I’m Elizabeth Tracey.

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