Kaiser Permanente Northern California’s Colorectal Cancer Screening Program Saves Lives

Kaiser Permanente members in Northern California are 52 percent less likely to die from colorectal cancer since the health care system launched a comprehensive, organized screening program, according to a new study in the specialty’s top journal, Gastroenterology.

“Since we launched our screening program we have seen a remarkable decline in the number of cases of colorectal cancer and related deaths across a large, diverse population,” said gastroenterologist and co-lead author Theodore R. Levin, MD, clinical lead for Kaiser Permanente’s colorectal cancer screening in Northern California.

Theodore R. Levin, MD

Theodore R. Levin, MD

The study, “Effects of Organized Colorectal Cancer Screening on Cancer Incidence and Mortality in a Large, Community-based Population,” confirms that since Kaiser Permanente Norther California’s screening program for colorectal cancer was rolled out between 2006 and 2008, screening completion as recommended by the U.S. Preventive Services Task Force increased to 83 percent among those eligible (adults 50 to 75 years old) by 2015, compared to 66 percent nationally. In that same timeframe, new cases of colorectal cancer in the United States dropped 26 percent.

Colorectal cancer is the 2nd leading cause of cancer deaths in the U.S.

View ADA text version of this infographic or download a pdf. »

Researchers compared the periods before and after the organized Kaiser Permanente screening program was rolled out between 2006 and 2008. The study found that mortality from colorectal cancer decreased 52.4 percent from approximately 31 deaths to 15 deaths per 100,000 people; and the incidence fell 25.5 percent from approximately 96 cases to 71 cases per 100,000 people.

“This most recent study is the culmination of more than two decades of groundbreaking Kaiser Permanente research and clinical care initiatives. It provides evidence for dramatic improvements to colorectal cancer screening by having an organized approach to making sure people get screened,” said The Permanente Medical Group gastroenterologist and co-lead author Douglas A. Corley, MD, PhD.

Screening saves lives

Douglas A. Corley, MD, PhD

Douglas A. Corley, MD, PhD

Colorectal cancer is the second-leading cause of cancer deaths in the United States. The American Cancer Society estimates more than 140,000 new cases will be diagnosed in the U.S. this year, and it’s expected to cause more than 50,000 deaths during 2018.

Fortunately, regular screening allows for the early detection of colorectal cancers and polyps that can become colorectal cancer. Cancer detected early is more likely to be cured and removing polyps early can prevent the development of colorectal cancer.

  • Fecal testing (such as with the fecal immunochemical test or “FIT”), every year
  • Flexible sigmoidoscopy every 5 years, and/or
  • Colonoscopy every 10 years

After a positive fecal test or sigmoidoscopy, physicians order a colonoscopy, the procedure that examines the full colon and can remove polyps.

Drs. Levin and Corley, both research scientists with the Kaiser Permanente Northern California Division of Research, noted that Kaiser Permanente has conducted, and continues to conduct, critical research on all three of these methods, with important studies dating back to the 1980s.

“Colonoscopy has long been an effective screening tool for colorectal cancer, but it can be expensive and time-consuming to deliver in large populations, and many people are unwilling to undergo the test,” Dr. Levin said. “We have found that Kaiser Permanente members are more than willing to be screened with the FIT kit, which has greatly contributed to our high screening rates.”

An initial Kaiser Permanente research goal — led by James Allison, MD, FACP, an emeritus research scientist in the Division of Research — was to generate evidence that the guaiac-based fecal occult blood test and/or sigmoidoscopy conducted in large, average-risk populations could save lives and decrease the incidence of colorectal cancer.

The Division of Research conducted landmark studies on the use of flexible sigmoidoscopy, which began at Kaiser Permanente facilities in the mid-1990s; these studies formed the basis for U.S. Preventive Services Task Force guideline recommendations.

In 1996, Kaiser Permanente conducted the first U.S. study showing that FIT kits had superior performance characteristics to the fecal occult blood test. A 2007 study provided evidence used by the U.S. Preventive Services Task Force to recommend FITs as a screening option in their guidelines. And a recent multicenter study within Kaiser Permanente was the first large U.S. study to estimate the effectiveness of colonoscopy for reducing deaths from colorectal cancer. (Although colonoscopy is commonly used, it has not been studied in large, randomized trials.)

Model screening program

Within a few years of initiating its population-based screening program, Kaiser Permanente was able to dramatically increase its screening rates by mailing FIT kits to the homes of its Northern California members of recommended screening age, 50 to 75 years old; systematically reminding members when they are due for screening; and quickly processing a large volume of FITs — upwards of 3,000 per day — that are mailed directly to a Kaiser Permanente laboratory.

“Kaiser Permanente’s screening program for colorectal cancer in Northern California is a perfect example of how a large health care system can expertly use technology and data to create a program that promotes health, prevents illness and saves the lives of its members on an unprecedented scale,” said Yi-Fen Chen, MD, associate executive director for quality and research of The Permanente Medical Group.

In 2014, the National Colorectal Cancer Roundtable set a national goal of screening at least 80 percent of those eligible by 2018. Kaiser Permanente Northern California achieved the 80 percent screening rate by 2011. The Kaiser Permanente FIT-based outreach program, combined with colonoscopy, has become a model for similar programs to maximize the number of people screened in the United States, the Veteran’s Administration and internationally.

Dr. Corley now also leads the National Cancer Institute’s Population-based Research Optimizing Screening through Personalized Regimens (or PROSPR) consortium, a multisite effort to evaluate and improve cancer screening processes, including colorectal cancer. The consortium’s research has included important studies on the quality and effectiveness of colonoscopies and adenoma detection rates.

“Screening markedly decreases deaths from colorectal cancer and enables people to live healthier lives,” Dr. Corley said. “The future of colorectal cancer research and care is furthering proven ways to increase screening rates; better understand the best ages to start, repeat and stop screening; and continue to improve the ease and effectiveness of the tests themselves.”

Infographic text

Colorectal cancer is the 2nd leading cause of cancer deaths in the US.
83% of Kaiser Permanente members* are now screened for colorectal cancer
From 2000 to 2015
26% fewer CASES of colorectal cancer (down arrow)
52% fewer DEATHS from colorectal cancer (down arrow)

*N Cal region; screened by fecal immunochemical test (FIT), colonoscopy or sigmoidoscopy, compared with two-thirds nationally (CDC); Levin and Corley et al., Gastroenterology, July 2018. Division of Research Northern California – Kaiser Permanente

The post Kaiser Permanente Northern California’s Colorectal Cancer Screening Program Saves Lives appeared first on Kaiser Permanente.

Main RSS Feed – Kaiser Permanente

NEW PARENT ESSENTIAL UPDATE:

Community Health Centers Can Help Boost Rates of Colorectal Cancer Screening, Kaiser Permanente Study Shows

PORTLAND, Ore. — An innovative program in community health centers to mail free colorectal cancer screening tests to patients’ homes led to a nearly 4 percentage point increase in CRC screening, compared to clinics without the program, according to a Kaiser Permanente study published today in JAMA Internal Medicine.

According to the National Association of Community Health Centers, approximately 24 million people in the United States receive care at federally qualified health centers, often called community health or safety net clinics. These underserved patients historically have low rates of CRC screening compared to the general population.

“With such a large number of individuals receiving care in the safety-net setting, an improvement in CRC screening rates of even a few percentage points can have a major impact in terms of cancers detected and lives saved,” said lead author Gloria Coronado, PhD, an investigator at the Kaiser Permanente Center for Health Research in Portland, Oregon.

The study, “Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC),” took place in 26 clinics representing eight health centers in Oregon and California. More than 41,000 adults aged 50-64 met the study criteria of being due for CRC screening between February 2014 and February 2015.

Half of the clinics were randomized to implement the program after receiving training and support, and the other half continued to deliver usual care without the program. For clinics implementing the program, the process began with customization of their electronic health record systems to identify patients who were due for CRC screening. The clinics then mailed an introductory letter to these patients, explaining they would soon be receiving a screening test in the mail.

Next, clinics mailed the screening tests to eligible patients’ homes. The clinics used the fecal immunochemical test (or FIT), a simple test that detects small amounts of blood in the stool and can be done easily at home. Individuals with a positive FIT result were encouraged to get a follow-up colonoscopy to look for cancer or pre-cancerous polyps. Finally, as the last step of the program, clinics mailed a reminder letter to patients’ homes, encouraging them to complete and return their FIT kits.

Compared to the control group clinics, clinics that delivered the intervention had a significantly higher proportion of patients who were screened for CRC. The percentage of patients who completed a FIT kit was 3.4 points higher, and the percentage of patients who received any type of CRC screening was 3.8 points higher in intervention clinics compared to control clinics.

The clinical effectiveness of mailing FIT kits to patients’ homes had already been established in previous research, including a pilot study by Coronado and her team. But this new, much larger study showed the program can also work well when clinic staff — not researchers — are responsible for implementing it.

“This was a real-world, pragmatic trial, which is quite a bit different from a carefully controlled research environment,” explained Coronado. “Our team provided clinics with the EHR tools needed to identify and contact patients who were due for screening; we trained clinic staff to use the tools; we provided letter templates, pictographic instructions and other materials; and we used a collaborative learning model to offer ongoing support. But ultimately, clinic staff were responsible for integrating the intervention into their care processes.”

The study team observed significant variation across health centers in successful implementation of the program. The proportion of eligible patients who were mailed a FIT kit ranged from 6.5 percent to 68.2 percent. Of eligible patients who did receive a FIT kit in the mail, reminder letters had a major impact on return rates. Clinics that consistently sent out reminder letters after sending FIT kits had a return rate of 25 percent, compared to clinics that did so inconsistently (14 percent) or not at all (6 percent).

“Community health centers are very busy places with many competing priorities,” said senior author Beverly Green, MD, MPH, of the Kaiser Permanente Washington Health Research Institute. “Our study showed that while FIT outreach programs can be a great way to increase colorectal cancer screening rates in this underserved population, we need to identify additional strategies to support program implementation in health centers with limited resources.”

Coronado and her team are building on this research with a new study, “Participatory Research to Advance Colon Cancer Prevention.” The researchers are working with community advisors to adapt and spread a direct-mail FIT kit and reminder program, with the ultimate goal of increasing the effectiveness of reminders by ensuring they meet the specific needs of diverse population subgroups.

The STOP CRC study was funded by grants from the National Institutes of Health (UH2AT007782 and 4UH3CA18864002). In addition to principal investigator and lead author Coronado,  authors include Amanda Petrik, MS, William Vollmer, PhD, and Erin Keast, MPH, from the Kaiser Permanente Center for Health Research in Portland; Stephen Taplin, MD, MPH, from the National Cancer Institute’s Center for Global Health; Scott Fields, MD, from OCHIN; and Dr. Green, from the Kaiser Permanente Washington Health Research Institute in Seattle.


About the Kaiser Permanente Center for Health Research
The Kaiser Permanente Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Oregon, and Honolulu. Visit kpchr.org for more information. 

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 12.2 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

The post Community Health Centers Can Help Boost Rates of Colorectal Cancer Screening, Kaiser Permanente Study Shows appeared first on Kaiser Permanente Share.

rss-feed – Kaiser Permanente Share

NEW PARENT ESSENTIAL UPDATE:

Mobile app for autism screening yields useful data

A new study of an iPhone app to screen young children for signs of autism has found the app easy to use, welcomed by caregivers and good at producing reliable scientific data. The app first administers caregiver consent forms and survey questions and then uses the phone’s ‘selfie’ camera to collect videos of young children’s reactions while they watch movies designed to elicit emotion and attention on the device’s screen.
Child Development News — ScienceDaily

SPECIAL DISCOUNT DEAL UPDATE:

WATCH: New recommendations for prostate cancer screening

Men ages 55 to 69 should have a conversation with their doctor about the test.
ABC News: Health

SPECIAL NEWS BULLETIN:

http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

BEST DEAL UPDATE BY AMERICAN CONSULTANTS RX:

Click today to request your free ACRX discount prescription card and save up to 80% off of your medicine!

SPECIAL DONATION REQUEST UPDATE:

Please help American Consultants Rx achieve it’s biggest goal yet of donating over 30 million discount prescription cards to over 50k organizations in an effort to assist millions of Americans in need. Please click here to donate today!

Photo Flash: Sara Bareilles and Brandon Victor Dixon Host JESUS CHRIST SUPERSTAR LIVE! Screening and Q&A

Jesus Christ Superstar Live in Concert stars Sara Bareilles and Brandon Victor Dixon hosted a screening and QampA as part of the SAG-AFTRA Foundation’s Conversations series on Wednesday, April 18 at the Robin Williams Center for Entertainment and Media in New York City. The QampA was moderated by BroadwayWorld’s Richard Ridge. Check out photos from the event below
BroadwayWorld.com Featured Content

BEST DEAL UPDATE:

Kaiser Permanente Cancer Screening and Prevention Fair Provides Free Exams and Education

HONOLULU — Kaiser Permanente welcomed over 300 attendees and provided more than 150 free cancer screenings at its annual Cancer Screening and Prevention Fair, held this morning at Waipio Medical Office.

Kaiser Permanente otolaryngologists (ear, nose and throat specialists) provided short physical exams to screen for cancers of the head and neck, which often appear as lesions or spots in the mouth, nose or throat. Risk factors for head and neck cancer include tobacco and alcohol use, so those who smoke and drink are encouraged to participate in regular screenings.

Kaiser Permanente dermatologists examined attendees for evidence of melanoma — the fifth most common cancer in Hawaii — and other types of skin cancer. According to the American Cancer Society, an estimated 490 cases of melanoma will be diagnosed in Hawaii this year. Like head and neck cancer, melanoma is highly curable in its earliest stages, with a five-year survival rate of 99 percent for localized melanoma.

In addition to screening exams, attendees had a chance to speak with tobacco cessation counselors and members of Kaiser Permanente’s prevention and education department, to receive tips on quitting smoking, improving nutrition, sun protection and living an overall healthy lifestyle.

“Some types of cancers, including those of the head, neck and skin, can be prevented by reducing risk factors such as smoking, drinking or heavy exposure to sunlight. Education, lifestyle changes and early detection through screenings help save lives,” said Susan Amina, APRN, cancer care coordinator at Kaiser Permanente Hawaii. “We’re glad to see so many attendees taking steps toward better health, which includes taking part in preventive care and screenings like mammograms, fecal occult testing and Pap smears.”

The American Cancer Society estimates that Hawaii will see 6,280 new cancer diagnoses and 2,580 cancer-related deaths in 2018; breast, lung, colorectal and prostate cancer are the most common types in the state. Regular screenings, education and an awareness of risk factors all contribute toward detecting cancer in its early stages, when survival rates are often significantly higher.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 11.8 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share. cancerSusan Amina, APRN,

The post Kaiser Permanente Cancer Screening and Prevention Fair Provides Free Exams and Education appeared first on Kaiser Permanente Share.

rss-feed – Kaiser Permanente Share

NEW PARENT ESSENTIAL UPDATE:

Screening for Colorectal Cancer Can Save Lives

Colorectal cancer is the second-leading cause of cancer death in the United States, yet only two in three adults in the United States is adequately screened. With appropriate screening, however, colorectal cancer is one of the most preventable forms of cancer. Men and women at average risk should begin screening at age 50.

In observance of Colorectal Cancer Awareness Month, we interviewed Karl Kwok, MD, an interventional gastroenterologist at the Kaiser Permanente Los Angeles Medical Center, about the importance of screening tests and what we can do to lower our risk of cancer.

Why is colorectal cancer screening so important?

Colon cancer is the third most commonly diagnosed cancer in the United States. However, it’s also one of the most treatable cancers. When colorectal cancer is found at an early stage, the five-year relative survival rate is approximately 90 percent. In fact, regular screenings can help detect advanced polyps, which are precancerous, and allow us to remove them using advanced techniques that do not require surgery. This returns your colon-cancer risk back to baseline.

What methods are used to screen people for colorectal cancer?

Kaiser Permanente, in line with the United States Preventive Services Task Force, encourages its members age 50 and above to either undergo a yearly at-home fecal immunochemical test, also known as a FIT test; an average-risk sigmoidoscopy every five years; or an average-risk colonoscopy every 10 years.

People with a higher risk for colorectal cancer, such as those with a strong family history of colorectal cancer, may need to start routine testing before age 50 and have it more often.

To figure out which screening test is best for you, have a conversation with your primary care provider. Each has its advantages and disadvantages, but one thing is certain: Regular colorectal cancer screenings can save lives.

Can colorectal cancer be prevented?

To a large extent, YES! Most cases of colorectal cancer are due to sporadic development of precancerous polyps that do not cause symptoms for a long period of time. This is why screening is critical — the earlier we detect and remove these polyps, the less likely they can grow into an advanced polyp and ultimately turn into cancer. Multiple studies have shown that precancerous colon polyp removal is protective against subsequent development of colon cancer.

What risk factors increase a person’s chance of developing colorectal polyps or colorectal cancer?

Some of the known risk factors for developing colon cancer include:

  • Having a diet heavy in red meats and processed meats
  • Having a sedentary lifestyle
  • Being overweight or obese
  • Smoking and heavy alcohol use
  • Having a family history of colon cancer, especially a first degree relative (mother, father, sibling or child)
  • Having a personal history of colorectal polyps or a personal history of inflammatory bowel disease, including Crohn’s disease or ulcerative colitis (a condition which causes chronic inflammation of the colon)
  • Your racial and ethnic background or your personal health history. For example, African Americans have the highest colorectal cancer incidence. People with a history of kidney transplants and people with type 2 diabetes also have an increased risk of colorectal cancer.

To learn more about colorectal cancer and the screening process, visit www.kp.org.

Get Screened!

On Thursday, March 22, all Kaiser Permanente Southern California Medical Centers will host a colorectal cancer screening day. Be part of this life saving event. Please drop off your completed screening kit (FIT kit) at your nearest Kaiser Permanente medical center. If you haven’t received one, call your doctor or visit your customized online Personalized Action Plan on KP.org and request a FIT kit.

Need help? This video shows a simple step-by-step process to use the home screening kit.

The post Screening for Colorectal Cancer Can Save Lives appeared first on Kaiser Permanente Share.

rss-feed – Kaiser Permanente Share

NEW PARENT ESSENTIAL UPDATE:

Havana Moon Special Screening!

Revive at Studio 5 in association with The Rolling Stones, Eagle Rock Entertainment & House Of Toam present an immersive Cinema Experience like no other!

2 Years to the date, RELIVE the ground-breaking Havana Moon concert at Maidstone Studios, Kent, UK. Streamed in Ultra HD with Cuban themed set design, actors, food & drink as well as full concert production….Bringing the concert back to life!

Saturday, 24th March, Maidstone Studios, Tickets On Sale Now here.

The Rolling Stones

BEST DEAL UPDATE:

Research Shows Importance of Second Pediatric Blood Pressure Screening

PASADENA, Calif. — Nearly one-quarter of children and teens who had their blood pressure screened at a primary care appointment showed a reading in the hypertensive range, but less than half of those readings could be confirmed after the blood pressure was repeated, according to a new Kaiser Permanente study released today in The Journal of Clinical Hypertension. The research shows the importance of taking a second blood pressure reading for those ages 3 to 17 years when the first reading is elevated.

“Pediatricians don’t diagnose hypertension in children very often, but if it is there, we want to find it,” said Robert James Riewerts, MD, regional chief of Pediatrics for the Southern California Permanente Medical Group. “This study is important because it demonstrates the best path to accurately diagnose hypertension in a child or teen. Taking a second blood pressure reading is something all clinicians must consider when the initial reading is elevated.”

Blood pressure in youth varies considerably and can be affected by factors such as a child’s anxiety. Also, determining high blood pressure in children or teens is more difficult to do than in adults because what is considered high varies based on age, gender and height.

Since this study was conducted, Kaiser Permanente in Southern California has put alerts on its electronic health records to alert clinicians when a second blood pressure reading is recommended. Also, decision-support tools were added to help clinicians determine when further evaluation is recommended.

Researchers found that for patients ages 3 to 17 years:

  • 7 percent had at least one blood pressure reading in the hypertensive range.
  • Fewer than half of the children who had their blood pressure screened would be correctly classified based solely on their first blood pressure reading of the appointment.
  • 3 percent of youth have sustained hypertension over time.
Corinna Koebnick, PhD, MSc

Corinna Koebnick, PhD, MSc

“Because an elevated first blood pressure in youth is common, correct identification of truly elevated blood pressure may be a first step to improve the recognition of hypertension in pediatric care,” said Corinna Koebnick, PhD, MSc, of the Kaiser Permanente Southern California Department of Research & Evaluation. “If hypertension is missed, children and teens may not receive the counseling they need for lifestyle changes or medication.”

This study is based on the Kaiser Permanente Southern California Children’s Health Study, which includes all children and adolescents ages 2 to 19 years in Southern California who are Kaiser Permanente members. The cohort follow-up was conducted through passive surveillance of clinical care information using the electronic health record system.

The final cohort of 755,795 youths was followed during a four-year study period, January 2012 through December 2015.

Dr. Koebnick suggested that instead of calculating the average of blood pressure readings, using the lower blood pressure reading may be more efficient for most clinicians.

This study adds to previous Kaiser Permanente research aimed at improving hypertension care, including a study that found children who have a first elevated blood pressure at the doctor’s office are not likely to receive the recommended follow-up blood pressure readings. Another study found that expanding blood pressure screenings to non-primary care settings can help identify more adult patients with high blood pressure.

Other authors on the paper include Yasmina D. Mohan, MPH, and Xia Li, MSc, with the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena, California; Amy H. Porter, MD, Kaiser Permanente Los Angeles Medical Center, Los Angeles; Matthew F. Daley, MD, Kaiser Permanente Institute for Health Research, Denver; Gang Luo, PhD, Department of Biomedical Informatics and Medical Education, University of Washington, Seattle; and Beatriz D. Kuizon, MD, Department of Biomedical Informatics and Medical Education, University of Washington, Seattle.

The study was supported by funds from the Kaiser Permanente Community Benefit Fund and internal operational funding from Kaiser Permanente Southern California.

About the Kaiser Permanente Southern California Department of Research & Evaluation

The Department of Research & Evaluation conducts high-quality, innovative research into disease etiology, prevention, treatment and care delivery. Investigators conduct epidemiologic research, health services research, biostatistics research and behavioral research as well as clinical trials. Major areas of study include chronic disease, infectious disease, cancer, drug safety and effectiveness and maternal and child health. Headquartered in Pasadena, California, the department focuses on translating research to practice quickly to benefit the health and lives of Kaiser Permanente Southern California members and the general public. Visit kp.org/research.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 11.7 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: kp.org/share.

The post Research Shows Importance of Second Pediatric Blood Pressure Screening appeared first on Kaiser Permanente Share.

rss-feed – Kaiser Permanente Share

NEW PARENT ESSENTIAL UPDATE:

Your Questions About Breast Cancer Screening Answered

Confused about breast cancer screening and mammograms? You are not alone, says Susan Kutner, MD, general surgeon and chair of Kaiser Permanente’s Northern California Breast Care Task Force. As new research emerges, mammography guidelines shift. Still, Dr. Kutner stresses that mammography is the best screening tool for breast cancer right now.

“The purpose of a mammogram is to detect cancer early. If we detect cancer in its earliest stage and treat it immediately, side effects are less intense and survival rates are higher,” she says.

Dr. Kutner recently shared the top questions she receives from patients, as well as the information and advice she frequently provides.

When should women start getting mammograms and how often should they get them?

Overall, it is important to look at each individual woman’s risk. What we’re learning is that we can’t just say “a mammogram every year is good for everyone” – it’s too much for some. We rigorously review all evidence every two years. It’s important to have a conversation with your primary care provider about your risk factors, which include previous biopsy results, previous cancers, your personal history and your family history. You should only get a mammogram if it is going to be beneficial to you and your health.

photo of Susan Kutner, MD

Susan Kutner, MD

There is a lot of controversy surrounding women who fall into the 40-50 age group. Our evidence has shown that, as a group, not all women need to start getting mammograms at age 40. Talk to your primary care provider about the benefits and risks, specific to you. In the 50-74 age group, we see the greatest incidence of breast cancer and the greatest benefit of mammography. Typically, women in this age group have a mammogram every one-two years. For women over the age of 75, the risk of developing breast cancer continues, but they may be more at risk of developing other diseases that get in the way of early cancer detection.

Are mammograms safe?

Mammography is an X-ray. There is a very low level of radiation exposure during each mammogram. However, X-ray exposure is a cumulative process over a lifetime. Therefore, each mammogram you do get should serve a purpose to you and your health.

In addition to screenings, how can women be proactive about decreasing their risk of developing breast cancer?

Even before age 40, women should learn about and know their individual risks of developing breast cancer, and discuss with their primary care physician to tailor a screening plan specific to them. Women who have an immediate family history (mothers, sisters and aunts) of breast and ovarian cancer, especially below the age of 40, should be offered an evaluation by a genetic counselor to see if they need to start screening at an earlier age. The next step in being proactive involves making healthy lifestyle choices. These include getting regular exercise (30 minutes of aerobic exercise a day, five times a week), managing weight, avoiding smoking and excessive alcohol consumption, and maintaining a healthy diet as much as possible.

What does the future of breast cancer screenings look like?

It’s possible that breast cancer screenings in the future will not be imaging tests. Since breast tissue is so variable, we may need to look at other ways to screen for breast cancer that have not been fully addressed before, such as a blood test for cancer markers. Overall, in the next phase of intervention and research, we will continue to improve — we’ve already gone from analog images to digital, and 3D is now emerging. It takes 10-20 years to see what works and to test equipment, and we want the next step to be valuable.

We need to be careful about what we’re doing, continue to reevaluate, and ultimately ask, “how can we detect cancer early?” We don’t want to over-diagnose or over-treat cancers. We are routinely looking at research to answer, “what are the recommendations?” and “how do screenings impact women at different ages?”

For example, some ask why self-exams have gone out of favor and why we don’t stress that like we used to. With self-exams, it is difficult to detect cancer early because cancer usually starts a little deeper in the breast, which makes it harder to feel it. This doesn’t mean we should ignore our bodies and subtle signs or that self-exams don’t have value.

Breast cancer dramatically affects women and their families. We need to continue to get better at treating it. We also need to keep in mind that whatever we do to improve breast cancer risk and decrease the likelihood of dying from it, we must invest in a woman’s ability to get the information she needs to make a personal plan for her care.

The post Your Questions About Breast Cancer Screening Answered appeared first on Kaiser Permanente Share.

rss-feed – Kaiser Permanente Share

NEW PARENT ESSENTIAL UPDATE:

Live Phone Calls Better Than Text Messages and Letters to Remind People About Colon Cancer Screening

PORTLAND, Ore. — Live phone calls significantly outperform text messages and letters as a way to remind patients to complete and return at-home screening tests for colon cancer, according to new research in the Journal of General Internal Medicine.

The study included more than 2,700 patients who receive care in safety-net clinics and who were overdue for colon cancer screening. Colon cancer screening is recommended for everyone ages 50-75.

The patients were sent test kits by mail, and 10 percent mailed back their completed tests within three weeks. Those who did not return the kits within that period were assigned to one of seven reminder interventions. These included a phone call from a clinic outreach worker (live call), two automated calls, two text messages, a single reminder letter, or a combination of these strategies.

The live phone call intervention was most effective, resulting in 32 percent of patients in this group completing and returning their test kit within six months. The text message intervention was the least effective — only 17 percent of patients in this group completed and mailed back their test.

“We knew that these patients are not as text savvy as younger patients, but we didn’t expect text messaging to do so poorly, compared to the other strategies,” said Gloria Coronado, PhD, lead author and cancer disparities researcher with the Kaiser Permanente Center for Health Research. “Text messaging is a relatively inexpensive way to send patient reminders, but for this group it was also relatively ineffective.”

Patients received the various reminders in their preferred language. Phone calls were the most effective strategy for all patients, but English speakers were more likely to resond to live phone calls, while Spanish speakers were more likely to respond to the combination of a live call and two automated calls.

People assigned to receive the live call and the automated calls had more contacts with the health care system. It appears that Spanish speakers appreciated this additional contact, while English speakers may have been more likely to disregard the additional automated calls, said Coronado.

“The phone calls may help to build trust or confianza, which is an important value and motivator for care-seeking among Hispanics,” added Ricardo Jimenez, MD, co-author and medical director of Sea Mar Community Health Centers in Seattle, where the study took place.

“Our study shows that one reminder intervention doesn’t necessarily work for all patients. We need to design interventions tailored to the patient’s language and cultural preference,” explained Coronado.

Initially, at-home fecal screening tests were sent to 2,722 patients who received their health care in the Sea Mar system and who were overdue for colon cancer screening. Some of the tests were returned by the U.S. Postal Service because patients no longer lived at the address on file. After excluding these patients and the patients who mailed their test kits back within three weeks, there were 2,010 assigned to one of the seven reminder interventions.

The authors believe it is the first study to rigorously test the effectiveness of reminder strategies in a safety net system among patients with different language preferences.

Study strengths include its large, diverse sample size and ability to capture the patients’ demographic and medical information in the medical record. The study also has some limitations. Researchers could determine whether the text messages were sent to active cell numbers, but not whether patients received the text messages. They also don’t know whether patients listened to the automated phone messages or read the postcards.

The study was funded by a grant from the National Institutes of Health Common Fund and the National Cancer Institute, and is part of the larger STOP Colon Cancer pragmatic trial that aims to improve colorectal cancer screening in community health clinics in Oregon, California and Washington (UH2AT007782) (4UH3CA188640-02).

In addition to Coronado and Dr. Jimenez, other authors include Jennifer Rivelli, MA, Morgan Fuoco, MA, William Vollmer, PhD, Amanda Petrik, MS, Erin Keast, MPH, from the Kaiser Permanente Center for Health Research in Portland, Oregon, and Sara Barker, MPH, and Emily Topalanchik from Sea Mar Community Health Center in Seattle..

About the Kaiser Permanente Center for Health Research
The Kaiser Permanente Center for Health Research, founded in 1964, is a nonprofit research institution dedicated to advancing knowledge to improve health. It has research sites in Portland, Oregon and Honolulu, Hawaii. Visit kpchr.org for more information.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, Kaiser Permanente has a mission to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 11.8 million members in eight states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal Permanente Medical Group physicians, specialists and caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to share.kaiserpermanente.org.

 

The post Live Phone Calls Better Than Text Messages and Letters to Remind People About Colon Cancer Screening appeared first on Kaiser Permanente Share.

rss-feed – Kaiser Permanente Share

NEW PARENT ESSENTIAL UPDATE:

8 Screening Questions for Potential Tenants (and Some You Can’t Ask)

screening-questions-for-tenants

The application and screening process for tenants is important for landlords because it allows them to find ideal renters. An ideal tenant is typically someone who has a steady income, pays rent on time, and is respectful of the property and other tenants. The last thing a landlord needs is a tenant who causes trouble in one way or another.

One of the best ways to screen tenants is to have them fill out a Rental Application. This can act as a preliminary qualifier before you interview them. It should be noted that you are not required to formally interview tenants. You can accept their application, show them the property, and allow them to move in if they meet all your requirements. However, landlords can benefit from being more thorough.

In this post, we’ll discuss questions you can ask that will allow you to weed out unsuitable tenants, as well as questions that could get you into some legal hot water.

Good Questions to Ask Prospective Tenants

Regardless of how many stages are in your vetting process, these are some questions that you can ask on a Rental Application or in an interview with potential tenants:

  1. Why are you leaving your current residence?
  2. When do you plan on moving in?
  3. What is your monthly income?
  4. Can you pay move-in costs once you’ve signed the lease?
  5. Can you provide references from your employer/previous landlord(s)?
  6. Will you agree to a background and credit check?
  7. How many people will be living in the unit?
  8. Do you have pets? Do you want them in the future?

These questions cover the applicant’s income, ability to pay rent, and some basic information, and they also give you access to other vetting avenues. For instance, the reference check from employers or past landlords will likely give you the most insight into what kind of person the applicant is.

Other great avenues for you as a landlord are the credit and background checks, which will show you if the tenant is good at paying bills and if they’ve ever been convicted of a crime. Keep in mind, you can’t ban a tenant from housing based on them being convicted of a crime, except for sex offenses, arson, and the manufacturing and/or distribution of illegal drugs.

Questions You Can’t Ask Potential Tenants

It’s also important to discuss the kinds of question you can’t ask potential tenants. These are mostly questions that discriminate against specific people. It’s a good idea to review them because the last thing you want is a fair housing violation that leads to a lawsuit.

Essentially you can’t ask anything that violates the Fair Housing Act (FHA). This act keeps protected classes from discrimination when it comes to housing, which means you can’t bar a prospective tenant’s application based on certain characteristics.

These characteristics include:

  • Race
  • National origin
  • Skin color
  • Religion
  • Sex
  • Familial status (e.g. married or single tenants, tenants with or without children)
  • Disability

You might have noticed that sexual orientation and gender are not part of these characteristics. This is because technically sexual orientation and gender are not protected under the FHA. However, in 2012, the U.S. Department of Housing and Urban Development (HUD) issued the Equal Access Rule which expanded protections for these two categories under the law’s “sex” protections. The rule frames the protection under discrimination based on gender nonconformity and discrimination in the form of sexual harassment.

Some states, cities, and counties have laws that include gender identity and sexual orientation as protected classes, so it’s best to review the laws specific to your property’s location. Additional information can also be found on HUD’s LBGT Housing Discrimination page.

Fair Housing and Fair Screening

As a landlord, you want the best tenants, and the best way to find them is to use the exact same screening process for every single tenant you’re in contact with. What tends to get landlords in trouble is changing up their processes and questions for particular people; that opens them up to liability and fair housing violations.

If you can stick to the same list of questions for everyone and avoid questions that violate fair housing protections, you should have no trouble finding upstanding tenants while ensuring you aren’t asking anything that could be considered discriminatory.

Do you always ask potential tenants the same questions?

The post 8 Screening Questions for Potential Tenants (and Some You Can’t Ask) appeared first on LawDepot Blog.

LawDepot Blog

BEST DEAL UPDATE:

Travis Scott’s Birthday Treat For Kylie Jenner Revealed: A Private Screening, Close Friends & More

Travis Scott had something lovely in mind when he planned out Kylie Jenner’s 20th birthday. An insider told HollywoodLife.com EXCLUSIVELY about the magical birthday treats Travis sprung on Ky on her B-day!


Hollywood Life

BEST DEAL UPDATE:

Save Up to 50% Off ROXY Sale Styles!

Study boosts hope of ‘liquid biopsies’ for cancer screening

Scientists have the first major evidence that blood tests called liquid biopsies hold promise for screening people for cancer. Hong Kong doctors tried it for a type of head and neck cancer, and boosted early detection and one measure of survival.
Health Headlines

SPECIAL NEWS BULLETIN:

http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News

CHARITY UPDATE:

Click today to request your free ACRX discount prescription card and save up to 80% off of your medicine!

SPECIAL DONATION REQUEST UPDATE:

Please help American Consultants Rx achieve it’s biggest goal yet of donating over 30 million discount prescription cards to over 50k organizations in an effort to assist millions of Americans in need. Please click here to donate today!

Study boosts hope of ‘liquid biopsies’ for cancer screening

Scientists have the first major evidence that blood tests called liquid biopsies hold promise for screening people for cancer. Hong Kong doctors tried it for a type of head and neck cancer, and boosted early detection and one measure of survival.
U.S. Headlines

BEST DEAL UPDATE:

The Best Science Game For Kids! Play Free!

Too Many Women Who Need Bone Screening Aren’t Getting It

California study found that patients at highest risk for fractures often miss out on tests
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

Save up to 50% at Walgreens

Screening Test Finds Drugs That Show Promise Against Ebola

Researchers uncover 53 potential treatments; all are already FDA approved but need more study for this use
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

Save up to 50% at Walgreens

Too Few Americans Undergo Dementia Screening

More than half of people with the condition never had a thinking/memory test, study found
healthfinder.gov Daily News
SPECIAL NEWS BULLETIN!-http://www.acrx.org -As millions of Americans strive to deal with the economic downturn,loss of jobs,foreclosures,high cost of gas,and the rising cost of prescription drug cost. Charles Myrick ,the President of American Consultants Rx, announced the re-release of the American Consultants Rx community service project which consist of millions of free discount prescription cards being donated to thousands of not for profits,hospitals,schools,churches,etc. in an effort to assist the uninsured,under insured,and seniors deal with the high cost of prescription drugs.-American Consultants Rx -Pharmacy Discount Network News-
HEALTH SPECIALS!!-

Save up to 50% at Walgreens