HEALTH MATTERS: Your health questions answeredQ. In your last column, you discussed the value of prevention. Are there any new developments regarding screening tests that might be germane?
By: Dr. Joshua Wynne, Grand Forks Herald
Q. In your last column, you discussed the value of prevention. Are there any new developments regarding screening tests that might be germane?
A. Three new practice guidelines have been released recently by the U.S. Preventive Services Task Force regarding the value of screening for testicular cancer, hearing loss and osteoporosis. The task force systematically reviews all the available clinical trials data on the benefits and harms of preventive care services, including screening tests, and then makes recommendations for doctors and patients to follow.
The three new task force recommendations can be helpful to all of us as we consider prudent measures we should take to try to preserve our health and well-being.
The first considers screening of adolescent or adult males for testicular cancer. Perhaps surprising to some people, the task force recommends against screenings by physicians, or patients through self-examination because there is no evidence that such screenings have any benefit. The good news is that testicular cancer, a relatively rare cancer, is responsive to treatment and many patients have a highly favorable outcome, even in advanced cases.
The second recommendation relates to screening for osteoporosis, a common cause of fractures in the elderly. The task force suggests that screening bone measurements are useful in women, but not in men, because postmenopausal women have almost a one in two chance of suffering an osteoporosis-related fracture.
The third task force recommendation concerns screening for hearing loss. Although still preliminary, it suggests that screening adults aged 50 years or older may help identify patients with such a problem and that simple tests that can be done in a primary care provider’s office are adequate for screening.
Q. I’ve read articles about the increasing obesity problem in children and teenagers. Does childhood obesity predispose someone to health problems as an adult?
A. A recently published study of nearly 38,000 apparently healthy young men gives an emphatic yes in answer to your question. The study followed young military recruits for an average of 17 years after their first evaluation at the time of induction at the age of 17.
Obesity was defined by the commonly used measure of Body Mass Index or BMI, which combines a subject’s height and weight into a convenient measure of obesity. The study found a strong correlation between adolescent obesity (as determined at age 17) and the subsequent risk of diabetes or coronary artery disease during the ensuing 17 years.
The risk of diabetes was about four times higher in the most obese subjects compared with the leanest ones, while the risk of coronary heart disease was nearly eight times higher.
One other depressing finding of the study was the progressive increase in BMI for most subjects as they aged. So the message is clear — childhood and adolescent obesity is a significant risk factor for subsequent disease and health problems in adulthood.
Wynne is vice president for health affairs at UND, dean of the School of Medicine and Health Sciences, and a professor of medicine. He is a cardiologist by training.
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