Memorial Day Shorts: Follow-ups from recent posts
May 27, 2024
A) More evidence that HPV vaccine decreases rates of cervical cancer
Source: Falcaro, et al BMJ May 15, 2024 LINK
Researchers in England showed a dramatic decrease in the risk of invasive cervical cancer and CIN (Cervical Intraepithelial Neoplasia - a precursor to cancer) in young women who received HPV (Human Papilloma Virus) vaccines. The impact was largest when girls were younger at the time of vaccination and were larger for those who lived in areas of greater socioeconomic deprivation. This was reported in the journal BMJ. Here’s a link to a past post on this.
Employers can strongly advocate childhood vaccines - which can now prevent cancers as well as infections. These are covered without cost sharing by employer-sponsored health plans.
B) Measles death in Canada
Ontario reported the death of an unvaccinated child under 5 from measles. See this post written by my colleague Patricia Toro on the importance of measles vaccinations. Again, employers can strongly advocate for childhood vaccinations. In the US, one in four children with measles are hospitalized, and one in 1,000 die.
The US has had no measles deaths since 2000, although the number of cases of measles reported so far this year have been exceptionally high. Vaccination is highly effective at preventing cases of measles, but there are now enough unvaccinated people in many communities to have sustained transmission.
Sources: 1960s and 1970s: Rev of Inf Disease, 1981 LINK 2020s: CDC, 2024 LINK
C) Hispanic people are diagnosed later than White people for colorectal cancer
Source: Rajaseker, JAMA Surgery May 8, 2024 LINK
Researchers reported in JAMA Surgery on 12 years of data from the California Cancer Registry, which included data from over 40,000 people who had colectomy for colorectal cancer from 2010 to 2021. They found that Hispanic people were more likely to have Stage 3 disease (39.8% vs. 35.7% for White people). Stage 3 colorectal cancer has invaded lymph nodes but not distant organs. Hispanic people were less likely to have surgery in a timely manner (<=30 days from diagnosis) and were less likely to have at least 12 lymph nodes removed. Hispanic people were more likely to receive timely chemotherapy (120 days or less after surgery). The quality differences appear small, but because of the sample size they are statistically significant.
This demonstrates the importance of collecting and reporting on outcomes based on race and ethnicity. Many studies focus on the differences in screening and outcomes between Black and White non-Hispanic people, and these researchers focused their attention on Hispanic people.
Employers can be sure that education around cancer screening is available in multiple languages and is compelling to people of different races and cultures.
D) Industry payments to researchers continues to increase
Industry sponsored payment to researchers increased to about $7.6 billion in 2022. Most of these payments were to “noncovered entities,” so that it’s difficult to tell how much landed in the pockets of individual providers or researchers. Sunshine is good - here’s a post from last fall about research that shows that physicians who take more industry payments deliver more low value care.