Podcasts about us preventative services task force

A 72-year-old woman with a 20-year history of hypertension and dyslipidemia-- both at EBP goals with appropriate drug therapy, as well as a remote history of peptic ulcer disease-- presents for follow up. She is a nonsmoker, drinks about 1- 2 glasses of wine per week and denies the use of other substances. Her daily routine includes a 2- 3 mile walk and she denies history of acute coronary syndrome or other ASCVD related conditions. She mentions that one of her friends takes an aspirin a day to “prevent a heart attack or a stroke”, and further states, “I live alone, and I need to maintain my independence.” According to the latest recommendations from US Preventative Services Task Force, which of the following is the most appropriate advice regarding low dose aspirin use in this patient?A. Start low dose aspirin therapy 81 mg daily as the vascular benefits outweigh the risk.B. Best evidence for primary prevention of ASCBT event is with higher dose aspirin at 325 mg a day.C. The risks associated with aspirin therapy in this patient outweigh the potential benefits.D. Start aspirin therapy only if the patient has a family history of heart disease and 1st degree relatives.---YouTube: https://www.youtube.com/watch?v=9uK3CINTFOg&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=91Visit fhea.com to learn more!

Today's Headlines: In a Manhattan court, Stormy Daniels provided testimony about her sexual encounter with Donald Trump, with much of the cross-examination focusing on the details of the encounter itself rather than the hush money payment. Her lack of knowledge about Trump's business records became a notable point, highlighting the broader context of the trial, which concerns the payment made to cover up their liaison. Following Daniels, Donald's former assistant, Madeleine Westerhout, testified about communications with Michael Cohen regarding the reimbursement of the $130,000 hush money payment to Stormy. These communications led to the Trump Organization sending checks to Cohen, labeled as "legal expenses'' under a "retainer agreement" that lacks recorded documentation. Despite Donald's attorney's attempts for a mistrial, Judge Juan Merchan denied the motion, and Marjorie Taylor Greene's motion to remove Speaker Mike Johnson from office also failed. Meanwhile, recent data shows that medical school graduates are avoiding states with abortion bans for residency positions, and the US Preventative Services Task Force recommended that mammograms for breast cancer screening should start at age 40. Lastly, the Inspector General at the Office of Veterans Affairs reported nearly $11 million in improperly paid bonuses to senior executives, and Hunter Biden's federal gun charges trial is set to proceed next month alongside separate federal tax charges in California. Resources/Articles mentioned in this episode: WA Post: Checks, not sex, and other takeaways from Trump's New York hush money trial Axios: Trump denied second mistrial request, gag order change in hush money case  AP News: House Speaker Mike Johnson survived a motion to vacate. Here's why his job is far from safe NPR: Medical residents are starting to avoid states with abortion bans, data shows AP News: Breast cancer is on the rise in women in their 40s. An earlier mammogram may help catch it sooner WA Post: VA improperly approved nearly $11 million in bonuses for execs, watchdog finds  Axios: Hunter Biden's federal gun charges to go to trial after appeal dismissed Morning Announcements is produced by Sami Sage alongside Bridget Schwartz and edited by Grace Hernandez-Johnson Learn more about your ad choices. Visit megaphone.fm/adchoices

CardioNerds (Drs. Amit Goyal, Jason Feinman, and Tiffany Dong) discuss Beyond the Boards: Diseases of the Peripheral Arteries with Dr. Amy Pollak. We review common presentations of peripheral vascular disease, ranging from aortic disease to the more distal vessels in an engaging case-based discussion. Dr. Pollack talks us through these cases, including the diagnosis and management of peripheral vascular diseases. Show notes were drafted by Dr. Matt Delfiner and episode audio was edited by student doctor Tina Reddy. The CardioNerds Beyond the Boards Series was inspired by the Mayo Clinic Cardiovascular Board Review Course and designed in collaboration with the course directors Dr. Amy Pollak, Dr. Jeffrey Geske, and Dr. Michael Cullen. CardioNerds Beyond the Boards SeriesCardioNerds Episode PageCardioNerds AcademyCardionerds Healy Honor Roll CardioNerds Journal ClubSubscribe to The Heartbeat Newsletter!Check out CardioNerds SWAG!Become a CardioNerds Patron! Pearls and Quotes - Disease of the Peripheral Arteries Risk factors for abdominal aortic aneurysm include traditional atherosclerotic risk factors such as age, hypertension, hyperlipidemia, and tobacco use. Screening for AAA should be for men over the age of 65 years with a history of tobacco use. If present, medical management includes blood pressure and lipid lowering therapies to decrease the risk of expansion. Decision for surgical intervention relies on size and rate of growth of AAA, with clear indications if it grows> 10 mm in a year or diameter of 5.5 cm in men and 5.0 cm in women. When diagnosis of PAD is not straightforward (presence of symptoms but ABI is normal), an exercise ankle-brachial index (ABI) test can be useful. An exercise-induced decrease in ABI by 20% or in ankle pressure by 30 mmHg is consistent with PAD. For PAD, treatment with low dose rivaroxaban and aspirin yields lower event rates than with antiplatelet therapy alone. This in combination with lifestyle therapies (diet + exercise) and risk factor management (hypertension and hyperlipidemia) are the cornerstones of therapy. Revascularization is indicated for continued PAD symptoms despite conservative therapy. Acute limb ischemia is an “acute leg attack” and is a life-threatening emergency. Common symptoms include pain, pallor, pulselesess, parasthesias, cold temperature (poikilothermia), and paralysis. Restoration of blood flow is paramount, and emergent or urgent revascularization is the first line therapy for those with symptoms < 2 weeks. Notes - Disease of the Peripheral Arteries Learning Objectives: Describe screening and therapeutic strategy for AAA management. Understand the risk factors and diagnosis of peripheral arterial disease. Compare different management approaches for PAD. Be able to recognize acute limb ischemia. Describe the overall treatment strategy for acute limb ischemia. Abdominal Aortic Aneurysms Abdominal aortic aneurysms are a source of high morbidity and mortality. The US Preventative Services Task Force recommends one time screening ultrasound for AAA in men older than 65 years of age with a tobacco use history. Risk factors include age, hypertension, hyperlipidemia, and tobacco use. Patients with AAA between 3-3.9 mm should be monitored every 2-3 years. Sizes 4-5 cm should be re-imaged every 6-12 months.  Additional screening can be done for individuals < 65 years who have a first degree relative with AAA. Women are more likely to have aortic dissection at smaller diameters than men, which is why intervention (open vs endovascular repair) is recommended at 5 cm diameter for women versus at 5.5 cm for men. Additionally, repair is also warranted if a AAA grows more than 5 mm in 6 months or 10 mm in one year. Risk factor management is key with AAA, including blood pressure, glucose, and lipid targeting.  The presence of an AAA should be treated as secondary ASCVD prevention like coronary a...

Recently, the US Preventative Services Task Force changed the breast cancer screening guidelines to recommend starting screening at 40 years old instead of 50 years old. In this episode of Prescribed Listening, Host Tessa Lackey discusses the latest breast cancer screening guidelines and how they apply to you with Dr. Danae Hamouda from UTMC oncology and Hematology.We also discuss genetic testing and if it's right for you, how to know the risks of breast cancer and how to reduce your overall risk.If you would like to schedule an appointment with Dr. Hamouda or a mammogram, you can call the Eleanor N. Dana Cancer center at 419.383.6644. 

The public comment period has opened for the US Preventative Services Task Force's massively ill-advised draft research plan “Weight Loss to Prevent Ob*sity*-Related Morbidity and Mortality in Adults: Interventions”Here is the link to the plan text.Here is the link to comment (you can also go to the link above and click “leave a comment” in the last line of the yellow box at the top of the page)We have until June 14th to comment, please feel free to use anything I've written here for your comments. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

Our healthcare system is always evolving and changing—which means that doctor's recommendations are too. It's important to stay on top of these to keep our body in tip top shape, particularly as we get older.Dr. Michael Berry is the Vice Chair of the US Preventative Services Task Force and a leading authority on health and aging. He is a board-certified family and preventive medicine physician, with training in integrative medicine, and specializes in primary care. Dr. Berry has dedicated his career to helping people understand how to improve their health and wellbeing through preventive measures. He has been a guest lecturer at medical conferences, a featured speaker on podcasts, and a contributing author to medical publications. Dr. Berry has an extensive background in preventive services, with a particular focus on the latest health recommendations for aging. He has been a part of the US Preventive Services Task Force since 2008, and currently serves as its Vice Chair. He is passionate about helping people practice preventive medicine and live longer, healthier lives. On today's episode, Dr. Berry explains the importance of aspirin for people between the ages of 40 and 59 (and why those over the age of 60 should not start taking it), he explains the importance of lung cancer screening, colon cancer screening and much more.What's Next?What are your views, comments or questions on changing medical recommendations?  Share them with us at info@seniorityauthority.org!  Stay ConnectedGet in touch with our host Cathleen Toomey on LinkedInYou can also find Seniority Authority on Facebook, on Instagram, or you can connect with us on our website!Subscribe to our show on Apple Podcasts, Spotify, or anywhere you get your podcasts.

There is a mental and behavioral health crisis in King County schools, prompting the expansion of a program designed to address counseling and care for students in need. "It could not be more clear that we have a crisis in behavioral health, mental health in our youth. It shows up routinely. It shows up in many ways, it shows up in things as terrible as kids taking their own lives. It shows up in what we are hearing from staff at school districts, what they see every day, and we need to act," said Leo Flor, the King County Department of Community and Human Services director. His office points to data from the CDC and US Preventative Services Task Force, which points to a spike in suicide rates and anxiety among teens.LIKE & SUBSCRIBE for new videos everyday. https://bit.ly/3KBUDSK

September is Prostate Cancer Awareness Month! So, to support the effort to get the word out, we are re-airing our 2nd episode with prostate cancer expert, Dr. Judd Moul. Dr. Judd Moul, is from Duke University, and he's here today talking about the importance of the PSA, or the Prostate Specific Antigen, which is like a check-engine light for men's prostate health. Dr. Moul joined the Duke faculty in 2004, after a career in the US Army Medical Corps, where he was mainly at the Walter Reed National Military Medical Center. Dr. Moul, who served as the editor for Prostate Cancer and Prostate Disease Journal, has authored and co-authored over 275 scientific manuscripts and book chapters. He is a retired colonel, and also a noted researcher and clinician in the area of prostate cancer. He is also a popular speaker and lecturer, having been a visiting professor and keynote speaker throughout America and the world.  Be sure to listen in today, to hear what Dr. Moul has to share about the importance of the PSA. And in honor of Prostate Cancer Awareness Month, schedule an appointment for your screening today! Disclaimer: The Prostate Health Podcast is for informational purposes only. Nothing in this podcast should be construed as medical advice. By listening to the podcast, no physician-patient relationship has been formed. For more information and counseling, you must contact your personal physician or urologist with questions about your unique situation. Show Highlights: Dr. Moul explains what a PSA is. What is measured in the PSA test. The PSA test first came out in the late '80s. Initially, several companies were making the test, and there were no national standards at the time, so the results could vary, depending on where the test was done. Dr. Thomas Stamey, a famous Stanford urologist, came up with a standard for PSA testing. Dr. Moul explains how doctors checked men's prostates in the years before the PSA tests became available. The problem with doctors prescribing antibiotics for suspected prostate infections. A digital rectal prostate exam is still very important, even in combination with the PSA. The guidelines that Dr. Moul prefers to refer to, with regards to using the PSA for prostate cancer screening. There was an unsettling trend, in around 2012, that resulted in millions of American men not getting PSA or prostate cancer screening. Today, urologists are doing a very good job of determining who needs to go for an evaluation for elevated PSA. There are some very important things that The US Preventative Services Task Force needs to recognize around the cutting-off of PSA testing for certain men.   Links and resources: Follow Dr. Pohlman on Twitter and Instagram - @gpohlmanmd  Get your free What To Expect Guide (or find the link here, on our podcast website)   Join our Facebook group  Follow Dr. Pohlman on Twitter and Instagram  Go to the Prostate Health Academy to sign up for the wait-list for our bonus video content.   

Today, we're very happy to have Dr. Judd Moul, an international prostate cancer expert from Duke University, joining us on the podcast. In today's episode, Dr. Moul will be talking about the importance of the PSA, or the Prostate Specific Antigen, which is like a check-engine light for men's prostate health. Dr. Moul joined the Duke faculty in 2004, after a career in the US Army Medical Corps, where he was mainly at the Walter Reed National Military Medical Center. Dr. Moul, who served as the editor for Prostate Cancer and Prostate Disease Journal, has authored and co-authored over 275 scientific manuscripts and book chapters. He is a retired colonel, and also a noted researcher and clinician in the area of prostate cancer. He is also a popular speaker and lecturer, having been a visiting professor and keynote speaker throughout America and the world.  Be sure to listen in today, to hear what Dr. Moul has to share about the importance of the PSA. Disclaimer: The Prostate Health Podcast is for informational purposes only. Nothing in this podcast should be construed as medical advice. By listening to the podcast, no physician-patient relationship has been formed. For more information and counseling, you must contact your personal physician or urologist with questions about your unique situation. Show Highlights: Dr. Moul explains what a PSA is. What is measured in the PSA test. The PSA test first came out in the late '80s. Initially, several companies were making the test, and there were no national standards at the time, so the results could vary, depending on where the test was done. Dr. Thomas Stamey, a famous Stanford urologist, came up with a standard for PSA testing. Dr. Moul explains how doctors checked men's prostates in the years before the PSA tests became available. The problem with doctors prescribing antibiotics for suspected prostate infections. A digital rectal prostate exam is still very important, even in combination with the PSA. The guidelines that Dr. Moul prefers to refer to, with regards to using the PSA for prostate cancer screening. There was an unsettling trend, in around 2012, that resulted in millions of American men not getting PSA or prostate cancer screening. Today, urologists are doing a very good job of determining who needs to go for an evaluation for elevated PSA. There are some very important things that The US Preventative Services Task Force needs to recognize around the cutting-off of PSA testing for certain men.   Links and resources: Prostate Health Podcast - www.prostatehealthpodcast.com To receive your free guide, go to www.prostatehealthpodcast.com/clinic or find the link on our podcast website

Episode Summary:This episode tackles the following question— is taking a multivitamin essential for health or essentially a waste of money?Topics discussed are the following:Multivitamin—the iconic supplementScientific research regarding the efficacy of a multivitaminTakeaways from the researchSummary and recommendationEpisode References:See here for a historical review on how the term vitamin came about: https://www.acs.org/content/acs/en/education/whatischemistry/landmarks/vitamin-b-complex.html List of Nobel prizes related to vitamin research: https://www.nobelprize.org/prizes/themes/the-nobel-prize-and-the-discovery-of-vitamins-2/ 2009 multivitamin study on 161,808 postmenopausal women: https://www.ncbi.nlm.nih.gov/pubmed/192042212013 multivitamin study on 27,658 participants: https://www.ncbi.nlm.nih.gov/pubmed/192042212013 multivitamin study on 5,947 male physicians: https://www.ncbi.nlm.nih.gov/pubmed/244902652014 multivitamin paper by the US Preventative Services Task Force: https://www.ncbi.nlm.nih.gov/pubmed/245664742014 editorial on multivitamin use: http://annals.org/aim/fullarticle/1789253/enough-enough-stop-wasting-money-vitamin-mineral-supplements

Health organizations’ guidelines about PSA screening for prostate cancer can be confusing. Dr. Ross Krasnow discusses how he advises men about the test.   TRANSCRIPT Introduction: MedStar Washington Hospital Center presents Medical Intel, where our healthcare team shares health and wellness insights, and gives you the inside story on advances in medicine. Host: Welcome, everybody, and thanks for joining us today. We’re talking to Dr. Ross Krasnow. He is a urologic oncologist at MedStar Washington Hospital Center. Welcome, Dr. Krasnow. Dr. Krasnow: Thank you for having me. Host: So, we’re going to talk about PSA testing for prostate cancer. In 2016, Ben Stiller, the actor, made waves with a blog post titled, “The Prostate Cancer Test That Saved My Life,” in which he encouraged men to learn more about PSA testing, and it was something that he had gone through personally. And, the article also renewed a debate between medical professionals and organizations about the effectiveness of this test. Please explain to us a little bit more about what PSA testing is. Why is there so much debate surrounding this test? Dr. Krasnow: PSA stands for prostate specific antigen. It is a substance that the prostate actually secretes into the ejaculate. The prostate is a sexual organ. It’s not really supposed to be in the bloodstream, but it does leak into the bloodstream in small amounts. When a patient has prostate cancer, PSA will be secreted into the bloodstream at a higher level. Because of how PSA can be elevated in the bloodstream, it can be used as a screening test for prostate cancer, and it has been used successfully as a screening test for prostate cancer. Unfortunately, some of the data that demonstrates the efficacy, or lack thereof, of PSA testing for prostate cancer, is controversial. Specifically, in 2012 the US Preventative Task Force gave PSA testing a grade D recommendation. What that means is that they thought that the benefits of testing did not outweigh the harm, and they did not recommend PSA testing in men. In May of 2017, the US PTF, the US Preventative Task Force, revised their recommendation, and upgraded the recommendation to a grade C recommendation in men between the ages of 55 and 69. What this grade C recommendation means is that the test should be offered based on the professional judgment of the clinician and patient preference. Prostate cancer screening works when used properly, but there are harms. That’s why the Preventative Task Force came out with their recommendation in 2012. And those harms are a false positive rate of 15 percent. That means that 15 percent of men with an elevated PSA may not have prostate cancer at all and undergo unnecessary testing. When I say unnecessary testing, that primarily means a prostate biopsy, and a prostate biopsy can have complications. Also, there is a real risk of overtreatment. Most of the prostate cancer that’s diagnosed with the prostate biopsy ends up being low-grade prostate cancer, also what we call indolent prostate cancer. Yes, under the microscope, the cells are abnormal, and it’s technically called prostate cancer, but it’s unlikely to negatively impact that man’s life in any way. Also, there’s a risk of over-detection of prostate cancer in men who are older with a lower life expectancy. Prostate cancer is a very slow-growing cancer, and it takes 10 to 15 years for it to progress, and maybe even longer for it to cause death. So there’s not a lot of utility in screening and treating older gentlemen. Host:  So, what do current screening guidelines say about PSA tests then? So, for example, like the US Preventative Services Task Force or American Cancer Society? Dr. Krasnow: As I mentioned, the updated recommendations from the US Preventative Task Force give it a grade C recommendation for men between the ages of 55 and 69. This means that a conversation needs to take place between the physician or advanced practice provider ordering the PSA test and the patient to understand the risks and benefits associated with PSA screening. And really, the American Cancer Society and American Urological Association guidelines have a similar emphasis on shared decision-making. The American Cancer Society updated their recommendations in 2016. They recommended that screening should start at the age of 50 after a conversation using shared decision-making takes place. They also recommend screening, specifically African-American men, starting at the age of 45, and they recommend screening patients with a family history of prostate cancer at the age of 40. The American Urologic Association has similar recommendations. They recommend starting screening a little bit later at the age of 55, but again they emphasize the importance of the patient understanding the benefits and harms of screening before undergoing PSA testing. The American Association of Family Physicians hasn’t revised their recommendations in some time, but they do not recommend screening at this time. Host: As a younger male, how is a man supposed to know which guidelines to follow? Dr. Krasnow: There really is no right or wrong guideline to follow. The key is that the patient themselves has to engage in the decision-making process with their provider to decide whether they should undergo PSA testing or not. They need to understand the benefits of PSA testing, that PSA testing can lead to a decrease in the risk of a prostate cancer mortality, but they also need to understand that you have to screen a lot of patients before you save even one person, and the treatment for prostate cancer has its own risks associated with it. One person may feel that they don’t want to undergo that type of test for what they find to be minimal benefit. Another person may say, “You know what? I want to know if I have cancer, and if I have it, I want to treat it, because I don’t want to face the long-term consequences of having a cancer down the line.” The other thing to mention is that the detection of prostate cancer with PSA testing may not impact survival as much as we would expect, but there is a lot of benefit to preventing patients from having progressive prostate cancer that either invades into local structures or becomes metastatic. I’ve certainly seen patients in my practice who have advanced prostate cancer that spreads to other organs and they feel that, had they had testing at an earlier stage, an intervention could have been offered sooner. Host: That makes me wonder, you know, have you seen patients like Ben Stiller, who is a younger male than I guess what is presented in those guidelines to follow, in which this test found the cancer really at the really early stage of their lives, or have you seen patients who went through a biopsy and it turned out that the test was false positive? Dr. Krasnow: I’ve definitely seen both of these types of scenarios. I have a specific patient in mind that I treated. He was a very young gentleman. He was less than 50 years old, who ended up getting a PSA test because he had some urinary symptoms. In reality, based on the strict screening guidelines, he may not have needed a PSA test at all because he was less than 50, but it was warranted because he had some urinary symptoms. His PSA was very, very high. At that point, we did a prostate biopsy on him and it showed only a very small focus of low-risk cancer, but something didn’t make sense. His PSA should not have been that high for having such a low, small focus of cancer on the biopsy. So we had a long discussion about what the next step should be. Should we continue PSA testing? Should we treat? Should we do an MRI? We ended up doing an MRI, which showed an area that was of concern for a higher-risk cancer. We then discussed the potential treatment options, and he elected to undergo a radical prostatectomy using the robotic platform. And at the end of the day, his final pathology was a very high-grade cancer that left unchecked would likely have led to a lethal prostate cancer, so I was very relieved that he had had that PSA test and that we had intervened. On the other side of the spectrum, I’m often referred patients in their 70s, mid-70s or patients who have a lot of medical, what we call comorbidities. That means they have a lot of other medical problems—heart problems, lung problems, vascular problems, and they end up being referred to me for elevated PSA and for a biopsy. And when I meet with them, I say, “You know what? We should not biopsy you because we’re likely to find prostate cancer or likely to find an indolent prostate cancer, but it’s unlikely to ever affect you in your lifetime. So, I feel that I have avoided overtreatment in many patients as well. I think the key is to be smarter about testing, being more selective. Host: How do you advise men regarding prostate cancer screening and do you find the test valuable, or do you think more men are harmed than helped because of false positives? Dr. Krasnow: Let’s not forget that prostate cancer is by far the most common cancer in men. Over 160,000 men are diagnosed with prostate cancer each year, and it’s the number 2 cause of cancer death in men with 26,000 men dying of prostate cancer each year. This number is really comparable to breast cancer in women. Since the inception of PSA testing, there has been a sharp decrease in prostate cancer mortality. Approximately 1 out of 7 men in the US will be diagnosed with prostate cancer during their lifetime, and nearly 2.8 percent of men will die from the disease. We’ve discussed how PSA testing can decrease prostate cancer mortality and that treatment is associated with better survival over just watching it, so yes, I think that we definitely can help patients through PSA testing, but we can cause harm if we test the wrong patients. So, we really need to engage in smarter PSA screening. I think an important key is the shared decision-making so that patients really understand the benefits and risks associated with testing. I think we need to be smarter about screening patients who are at an increased risk of prostate cancer, such as African-American and those who have had a close family member with prostate cancer. I think that it’s reasonable to start screening even at an earlier age, such as 50 or below, and I think that there is now data that suggests that a low PSA at the age of 50 may suggest that you don’t need any further testing, and so I think that is something that’s coming down the line. It’s important that we don’t test patients who have a life expectancy of less than 10 years because they’re really unlikely to derive any benefit from the testing and any further workup or treatment could definitely result in harm. I really advocate for stopping screening at the age of 70, except in only rare situations where someone is extremely healthy for their age, has a long life expectancy and, for whatever reason, is extremely burdened about the health of their prostate. I think it’s important that we check PSA in men with urinary symptoms, especially before procedures or treatment of benign prostatic hyperplasia, like the young gentleman I told you about earlier. Host: Dr. Krasnow, are there certain men who are at risk for prostate cancer and should be screened earlier or more frequently? Dr. Krasnow: Absolutely. There are populations of men who are at increased risk of prostate cancer. Race is strongly correlated with prostate cancer mortality. African-Americans have at least double the incidence of prostate cancer compared to white men. And it’s not only that the incidence is higher. They have an increased risk of high-risk prostate cancer and they have a 2 to 3 times increased risk of dying from prostate cancer, so not only is this a population that’s underrepresented in the medical literature, but they’re at increased risk of having an adverse outcome from prostate cancer, so it’s more important that we screen in that population. Another important population that I talked about earlier is men with a family history of prostate cancer, and when I say family history I specifically mean those who have a father or a brother with prostate cancer. They have a much higher risk of developing prostate cancer, and again, more importantly, a higher risk of dying from prostate cancer. And studies suggest that screening in those patients with a family history may decrease prostate cancer death by 50 percent. We are also developing a better understanding of those who may have an increased genetic predisposition to prostate cancer. For example, one of the most common causes of breast cancer is a gene mutation called the BRCA gene, associated with breast and ovarian cancer in women. And what we’re learning now is that men who have this mutation also have an increased risk of prostate cancer and an increase in lethal prostate cancer. Now we know that men who have a family history of breast cancer in the women in their family should also be more aggressively screened for prostate cancer. Host: So, to me it sounds like the PSA test and the screening, it’s effective. What’s the future for prostate cancer screening? Are there better methods coming down the pipe? Dr. Krasnow: I definitely think that PSA testing is effective when used in a smart fashion in patients who are younger and in patients who are more likely to die from prostate cancer. But the test could definitely be improved. Also, we’re understanding that just because a man has a diagnosis of prostate cancer doesn’t mean that we have to treat them for prostate cancer. We can effectively prevent prostate cancer death by watching the cancer closely. But, there are better methods coming down the pipeline. There’s a lot of interest in earlier screening for prostate cancer, but not yearly screening. There was recently a publication by my colleague, Mark Preston, in the Journal of Clinical Oncology that showed that by essentially screening with a single PSA test at a younger age, if your PSA value is below a certain cutoff, you may never need PSA screening again for the rest of your life, and I think that’s a very exciting proposition to say, OK, at the age of 45 we are going to do one PSA test. If it looks OK, we never have to do it again. That would certainly prevent screening in a large amount of patients, but we’re not there yet. Also, we’re better integrating advanced imaging into the diagnosis of prostate cancer. Specifically, I mean MRI for prostate cancer—magnetic resonance imaging. This type of imaging has increasingly been used in men who had an elevated PSA and have had a negative biopsy, but a scary high-level PSA, and it can be used to see prostate cancer that you can’t see on the ultrasound and detect by routine biopsy. Now there is data that suggests that we may be able to push the MRI into an earlier phase and use it in the screening process, so instead of the process being an elevated PSA leading to a negative biopsy, leading to an MRI, leading to another biopsy, maybe a smarter way to do it is an elevated PSA, leads to an MRI, and then if there is something suspicious on the MRI, then we do the biopsy. This is new because up until recently the MRIs haven’t had a high enough resolution to really see prostate cancer. There’s also better biomarkers for prostate cancer. One is called the 4K score. It uses not just PSA, but PSA that’s found in the blood and PSA that’s further broken down by the body, and it may also be useful in screening patients who have an elevated PSA prior to biopsy to better detect those who may just have a lethal prostate cancer. And, in fact, MRI and these new biomarkers, like the 4K score, have recently been integrated into the NCCN guidelines. So, we’ve made a lot of progress in how to intelligently use PSA testing for the screening of prostate cancer. I think that we have more work to do, but it’s looking even more promising, and I’m hopeful that we can further reduce the burden of screening and the harms of screening through these new technologies. Host:  That is really great news. I especially liked the part where you were telling us about how we can do it just one time at the age of 45 or so, and then never have to do it again. Hopefully, that time will come soon. Dr. Krasnow: I hope so. It’s early data now, but it’s looking like that may be promising. Host: Thank you very much for joining us today. Dr. Krasnow: It was my pleasure. Conclusion: Thanks for listening to Medical Intel with MedStar Washington Hospital Center. Find more podcasts from our healthcare team by visiting medstarwashington.org/podcast or subscribing in iTunes or iHeartRadio.

Interview with Seth Landefeld, MD, member of the US Preventative Services Task Force, on  Screening for Atrial Fibrillation With Electrocardiography: US Preventive Services Task Force Recommendation Statement

Matt Asner talks about the shocking failure of the US Preventative Services Task Force to recommend Autism screenings for all children under the age of three. On the Spectrum with Matt Asner is a collaborate effort between Autism Live and Autism Speaks. For more information on Autism Speaks visit www.AutismSpeaks.org Autism Live is a production of the Center for Autism and Related Disorders (CARD), headquartered in Woodland Hills, California, and with offices throughout, the United States and around the globe. For more information on therapy for autism and other related disorders, visit the CARD website at http://centerforautism.com

This week, you may have heard that there are new mammogram guidelines from the US Preventative Services Task Force which is a federal government panel. Debate in the medical community has been fierce. I'll review the guidelines and I'll break down the arguments both for and against the USPSTF guidelines.