In Chapter 6 of The Decision Tree, “Screening for Everything”, Thomas talks about the human papilloma virus (HPV), the virus that causes cervical cancer. Traditionally, doctors detected HPV by looking for irregular cells in the pap smear. But now, a cheap ($5) test can detect and analyze the DNA of the virus, determining if it is the high- or low-risk type, which can determine the likelihood of a patient developing cervical cancer.

One problem remains: you still have to get women into the clinic to be tested. However, a new study in the British Medical Journal shows that home testing is not only a reality, but it may actually boost compliance rates. Roughly 28% of women using the home testing kit, which consisted of a simple cervicovaginal lavage, effectively screened themselves, while only about 17% of women required to go into the doctor’s office for screening showed up.

The HPV DNA test is primarily looking for the high-risk virus serotype, and the authors of this study claim that home screening kits have the same sensitivity as the doctor’s protocol when specifically looking for the aggressive virus.

Special thanks to Lindsay Crouse for bringing this to my attention. In her email to me, she brilliantly summed up the significance of home HPV testing:

While screening has been tremendously successful in Western countries at reducing cervical cancer cases and deaths, the obstacle of reaching all women through screening remains. Currently, if a woman is to be screened for cervical cancer, she must visit a health care provider for a gynecological exam. If she is unable or reluctant to do that, whether due to transportation, cost, or comfort issues, she is less likely to get screened at all, and is consequently at increased risk for developing cervical cancer. More than half of such cancers are typically diagnosed in women who do not get screened regularly.

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We’ve all heard the mantra: keep LDL levels – the “bad” cholesterol – down, and the “good” HDL cholesterol up. But thanks in part to the ubiquity of statins, such as Lipitor, which allow us to simply pop a pill to limit LDL production in the body, we’ve recently adopted tunnel vision when thinking about managing cholesterol. LDL levels are all we seem to care about now, as we strive for lower and lower numbers at each visit to the doctor’s office.

However, I think we’re missing the bigger picture by focusing solely on LDL. First, it’s made us reliant on medication to solve a problem that can many times be addressed with changes in diet and exercise regimes. Once someone starts Lipitor treatment, they’ll be taking it for life, and if LDL levels don’t quite get as low as they should, it’s all too easy to solve the problem by increasing the dose. When patients first begin Lipitor treatment, physicians typically prescribe the lowest possible amount, 10mg. However, dosing can go as high as 80mg, which begs the question: Do higher doses of the drug really improve outcomes?

Read more…

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“The human body does enormously well healing itself,” Keas founder, and ex-Google Health lead, Adam Bosworth told Health 2.0 conference-goers shortly after stepping on stage.  On the heels of an article in the New York Times that touted the company’s beta launch, Bosworth walked the crowd through the way we’ll keep ourselves healthy in the future, using Keas’ platform.

Of all people, Bosworth understood the potential power of the internet on health, where the collective wisdom of the patient population could reach thousands, or millions, of other people.  So he wondered, if people were readily turning to the web for information when they got sick, could customized, preemptive web advice keep people from getting sick in the first place?

By personalizing the measures we can take to stave off certain predisposed conditions, Keas’ Care Plans should improve our health.  But the real promise of the company, wasn’t in what Bosworth delivered onstage, but rather, in something he simply mentioned in passing.  Bosworth alluded to the idea that not only will Keas’ platform let people track their own health, but it could also allow people to keep tabs on their family’s health as well.

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I saw this study in Science at the beginning of the month, and a summary was posted at The Scientist:

A bacterium that infects insects may provide a biological method for stunting the spread of a range of devastating human diseases. The bacteria may protect their hosts against disease-causing pathogens by hiking up the insects’ immune response, according to a study published online today (October 1) in Science.

Basically, mosquitoes were fed a certain bacteria, called “popcorn” Wolbachia, that did two things, 1.) boosted the immune system of the mosquitoes, which made them less likely carriers of diseases such as filarial nematodes (cause lymphatic filariasis), and 2.) cut the average lifespan of the mosquitoes in half.

Researchers are looking at the future possibilities of this promising treatment — a natural way to curb the dangerous infectious diseases spread by mosquitoes.  Questions remain whether the “popcorn” bacteria could also interfere with the mosquitoes’ ability to carry more dangerous diseases, such as malaria or the Dengue virus.

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