World AIDS Day Tues Dec 1 – Free HIV Testing in Nashville

Tuesday, December 1 is World AIDS Day. To mark the day in Nashville, Planned Parenthood of Middle and East Tennessee is offering free HIV screening at their D.B. Todd Blvd location. Details here. An event is also being held at The Belcourt, described as “a multimedia journey through HIV/AIDS.”

At Our Bodies Our Blog: Prempro Lawsuits, Cosmetic Surgery, & the Fabulous Judy Norsigian

At Our Bodies Our Blog today, I have a bit about the outcomes of some recent lawsuits related to Prempro (estrogen+progestin HRT) and breast cancer. Earlier this week, I pointed to a recent issue of the journal “Clinical Risk” which is focused on cosmetic surgery risks and regulations. Christine has posted about a Time magazine article on a sex drive drug for women in which OBOS co-founder and director Judy Norsigian is quoted; Judy is also featured in the current issue of Vanderbilt University Medical Center newsletter The Reporter, following her visit to Nashville and talk at Vanderbilt’s School of Nursing.

Weekly News Round-Up – 11/22

Assorted things of interest from the previous week.
It’s not nearly as controversial as the USPSTF’s breast cancer screening recommendations, but ACOG released a new practice bulletin on cervical cancer screening. The New York Times has coverage of the change, which is basically that women can wait until up to 21 years of age to start getting Pap tests, and then can get Paps every 2-3 years instead of every year once they’ve had a few normal tests. This is not entirely new – the USPSTF’s 2003 recommendations are very, very similar. (so, 6 years from now, we’ll be cool w/ the breast cancer recs?)

Some lots of Vick’s Sinex nasal spray are being recalled due to bacterial contamination.

The FDA has tips on holiday food safety.

Presented without comment: Highest Rates of Obesity, Diabetes in the South, Appalachia, and Some Tribal Lands [w/ the exception of a request to think about what that might mean in conjunction with the frequent framing of obesity as a moral failing of individuals]

SisterSong has posted a new issue of its Collective Voices newsletter [PDF]; this issue has a reproductive justice theme. You can follow SisterSong on Twitter.

The Kaiser Family Foundation issued a brief on how health reform might affect health disparities experienced by racial/ethnic minorities.

Nov 20 was the Transgender Day of Remembrance, set aside to memorialize those who were killed due to anti-transgender hatred or prejudice. Learn more here, and see the any of a number of blog posts observing the day.

The Voices Against Violence Zine is “A small zine-diy style, with work from people of color, indigenous folks, trans people & queer survivors of domestic violence, sexual violence and sexual assault. Included topics can be: healing from trauma, transformative words used as a healing mechanism, enabling healing, life after trauma, self-help guides/resources, self-healing, dancing as means to healing, healing through narration, forgiveness (do we need it?), & collective trauma.” It will be accepting submissions for the next issue through Nov 30. Learn more at Hermana, Resist.

The 60th Disability Blog Carnival has been posted at FWD/Forward.

The CDC updated their 2009 H1N1 Flu Information for People with Disabilities and Their Caregivers or Personal Assistants.

Renee at Womanist Musings talks about people making class assumptions about her based on her scooter use.

Good for them: the Ames Public Library in Iowa carries Sex, Etc. magazine, which is written by teens for teens to provide accurate sex education information. There was a petition to have it removed from the library. It’s going to stay. I have a librarian happy.

More Writing On and Coverage of the Mammography Controversy

I’ve been reading a lot and paying attention to other media this week on the U.S. Preventive Services Task Force’s recommendations on breast cancer screening. The following are some pieces that I thought were well-done and/or raised interesting points:

Three posts by Orac of Respectful Insolence at ScienceBlogs -
1) Really rethinking breast cancer screening; 2) “Obama’s fixin’ death panels for your mama,” the misogyny gambit, and other idiotic responses to the updated USPSTF mammography recommendations; 3) “Obama’s fixin’ death panels for your mama”: The USPSTF recommendations for mammography used as a political weapon. I’m not in love with some of the post titles, but Orac nicely covers some of the controversial aspects; also good discussion in the comments of all three posts.

The Balance of Screening Tests by Mark Chu-Carroll of Good Math, Bad Math at ScienceBlogs. A bit about the mathematical considerations of screening.

Between the various ScienceBlogs posts there is some good discussion of the problem of finding an optimal cut-off point for screening.

Mammography News: You Heard It Here First … and It’s Still an Outrage! from the National Women’s Health Network, on how it’s actually been known for a while that current screening (mammography) is not so effective for younger women, but nothing much has changed since that started to become known. Short version: be angry screening tech hasn’t gotten better in response to the evidence, not angry about the evidence itself.

Does Mammography Screening Save Lives? Let’s Talk About It from Breast Cancer Action. Argues that the messaging about breast cancer and early detection has been oversimplified for far too long. Provides a decent summary of the recommendations and risks.

New Mammogram Recommendations Patronize Women from Feminist Law Professors. Makes the argument that the “anxiety” of a mammogram is not so much and the new recommendations are kind of “don’t worry your pretty little head” patronizing of women. I have to disagree, but I could see why people think the recommendations are focused that way, based on the media coverage. Psychosocial harms *are* mentioned in the actual recommendations, but what seems to be missing in coverage of “anxiety” as a basis for the recs are the other harms described in the original report such as radiation exposure, invasive biopsies, cost, unnecessary treatment, and the like. If the reason not to routinely do screening mammography for women 40-49 of average risk was actually given as just potential anxiety (ignoring the real functional problem anxiety can be for many people), then yes, that would be completely patronizing and innapropriate. That’s not how I read the recs at all.

I have seen a number of posts and pieces and comments asking a legitimate question – what about black women? For example: Dear USPSTF: What About Mammograms for Black Women? by Nordette Adams at Whose Shoes are These Anyway? We know – although white women are more likely to get breast cancer – that black women are more likely to die of breast cancer, more likely to have it at a younger age, more likely to have a more advanced cancer when diagnosed. To me, this would make black women not in the “average risk” group the USPSTF recommendations say can make individualized decisions about mammography instead of doing routine screening starting at age 40, which I didn’t hear any news stories explicitly point out. The USPSTF documents for the recommendations actually note as a limitation that the models they used do not “capture differences in outcomes among certain risk subgroups, such as women with BRCA1 or BRCA2 genetic susceptibility mutations, women who are healthier or sicker than average, or black women who seem to have more disease at younger ages than white women” but I’d be surprised if anybody heard mention of that in the media coverage of the recommendations.

Statement from the National Cancer Institute. “The take-away message is that each woman needs to consider her individual benefits and risks and discuss them with her health care provider before making a decision on when to start screening mammography and how often to get one.” The national cancer agency also says it’s “too early” for them to make any decisions related to the recommendations.

Making Sense of New Mammography Recommendations – from the Komen folks. I’m not a huge Komen fan, but they take a pretty balanced approach.

American Cancer Society Responds to Changes to USPSTF Mammography Guidelines. Short version: we’re not changing our position right now. Neither is the cancer center at my larger workplace, apparently.

NPR had a ton of stories on the topic. Seriously. That link is to a search and there currently about 3 pages of results linking to various stories and aspects of the news.

At Our Bodies Our Blog: CDC Reverses HPV Vaccine Requirement for Immigration

At Our Bodies Our Blog this week, I cover the CDC’s new vaccination criteria for U.S. immigration, which removed HPV and zoster (chicken pox) from the required vaccines. I also have a bit about why the HPV vaccine requirement was problematic, links to previous related posts, and links to organizations for women of color that issued a statement applauding the change.

Meanwhile, C’s post on the new mammogram recommendations has useful explanation of the change and a lively comments section.

Direct Link to the Breast Cancer Screening Recommendations That Have Been in the News

U.S. Preventive Services Task Force
Screening for Breast Cancer
Release Date: November 2009

The following bullet points are copy/pasted from the page, but more explanation of the recommendations and how “strong” they each are is available in the supporting documents.

Summary of Recommendations

• The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take patient context into account, including the patient’s values regarding specific benefits and harms.
  
• The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.
  
• The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.
  
• The USPSTF recommends against teaching breast self-examination (BSE).
  
• The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of clinical breast examination (CBE) beyond screening mammography in women 40 years or older.
  
• The USPSTF concludes that the current evidence is insufficient to assess the additional benefits and harms of either digital mammography or magnetic resonance imaging (MRI) instead of film mammography as screening modalities for breast cancer.

I haven’t had time to read all of the supporting documents yet myself. I believe Christine is going to have something on this for Our Bodies Our Blog; will post the link when it’s available.

Added: Here’s C’s post at Our Bodies Our Blog, which I think she did a rather good job of.

Judy from OBOS in Nashville, on Liberadio(!)

As I mention in today’s post at Our Bodies Our Blog, OBOS co-founder and Executive Director Judy Norsigian was in Nashville, and was featured today on local political talk radio show Liberadio(!). More about her trip and a link to the show archive are in the post.

Thanks to the locals who hosted a house party for OBOS last night – it was a great event and – in addition to hearing Judy speak – I was so glad to meet so many interesting folks!

Sunday News Round-Up – 11/15

Lots of good stuff at Our Bodies Our Blog as usual, including a new post from OBOS intern Meg Young on Reebok’s ridiculous new sneaker ad.

The FDA is looking into caffeinated alcoholic beverages and considering whether they are safe and/or legal (via NPR).

On Stupak, NPR has a good explanation of the red tape barriers to abortion that would be created by the amendment.

RaceWire launched a LGBT Racial Equity Toolkit with the note “Though this website was developed especially to inform philanthropic efforts and mobilize support for LBGTQ communities of color, there’s a lot here that could benefit the wider community involved in all kinds of social justice efforts.” The “Perspectives” section can be browsed by topic – some of them touch on aging, HIV/AIDS, and health generally.

I only just saw this blog this week, I’m Here. I’m Queer. What the Hell Do I Read? Libraryland folks may be interested in the most recent post, on some folks boycotting Scholastic book fairs because they have a book which includes lesbian parents. Ugh.

RH Reality Check has a piece on some of the potential absurd outcomes of fetal personhood laws.

Scarleteen – the excellent sex-ed resource – needs support.

CBS Evening News covered the rape kit backlog. The New York Times has an editorial on the problem.

The NY Times also has a piece on contraception in Afghanistan and the barriers women may experience in trying to use contraception.

Maame-Mensima Horne at On the Issues takes on the “black genocide” anti-abortion argument.

A bunch of photos have been posted to the Vessel (film project on Women on Waves) Facebook page.

The National Cancer Institute offers cancer information via their free cancer hotline in both English and Spanish. Here’s the info for Spanish-speaking callers:

Information in Spanish / información en español
El Servicio de Información sobre el Cáncer del NCI ofrece servicio telefónico en español. En Estados Unidos y sus territorios, llame al 1-800-422-6237 (1-800-4-CANCER), de lunes a viernes, de las nueve de la mañana a las cuatro treinta de la tarde hora local.
O, usted puede enviar un mensaje electrónico a nciespanol@mail.nih.gov. Si su mensaje requiere una respuesta, puede esperar recibirla en 7 días laborables.

The CDC has updated their Information for Pregnant Women Working in Education, Child Care, and Health Care Settings Concerning 2009 H1N1 Influenza Virus.

Physicians for Reproductive Choice and Health is sharing stories of the reproductive health consequences of being uninsured.

CNN’s website ran a Health.com piece, What doctors don’t tell you about C-section. It addresses some potential reasons c-sections have increased, but totally fails to address the evidence behind those “reasons.” For example, it cites continuous fetal monitoring in the following passage:

“If there’s a hint of trouble, they’re more likely to play it safe and do a Caesarean, Macones says. “Continuous recording of the fetal heart rate came into being in the 1970s and is likely a big contributor to the increase in C-sections,” he says. “Doctors today are more inclined to do a C-section if there is anything of concern.”

but fails to address the serious lack of evidence to support continuous fetal monitoring for most of its assumed benefits in the first place. So…nice start, not thorough or nuanced. Big surprise.

The American Journal of Public Health has a supplement issue on environmental justice. Unfortunately you need a subscription (or check with your library) to get access.

I needed to remind myself to revisit the FWD/Forward discussions on the words “idiot” and “cretin” this week. This post on reading rights and disabilities also caught my attention.

Things I Have: Geographic Tongue

The New England Journal of Medicine has posted a new “Images in Clinical Medicine” image, and this time it’s geographic tongue (and it’s freely available without a subscription to the journal). And that happens to be something I experience, so I thought I’d link to the info.

Basically, some of the bumpy parts of the tongue flatten out, making patterns kind of like continents/maps (hence the “geographic” moniker). Sometimes it kind of hurts. Sometimes it kind of itches. The patches are differently shaped and located over time. MedlinePlus and eMedicine both provide more info.

It’s not harmful, just odd, and can draw comments/reactions from people who see it and don’t know what it is. The NEJM piece explains that “Geographic tongue (benign migratory glossitis) is a benign inflammatory condition that affects approximately 2% of the world’s population.”

2%, huh? I wonder what percent have *both* geographic tongue *and* Asian flush…

[Thanks to Becky for pointing me to the NEJM piece]
[Note: I initially used the word "afflicted" in the post title, but I decided I didn't like the suffering that implied. So I changed it.]

Reminder: OBOS House Party This Weekend

As I mentioned in a previous post, I’m looking forward to seeing Judy Norsigian, executive director and co-founder of Our Bodies Ourselves, in Nashville this weekend. If you are interested in attending the fundraising house party and meeting Judy while she’s here, let me know.

Judy is also on the board of PRIM&R, Public Responsibility in Medicine and Research, which is having their conference here in town staring today. Wish I was going to that! Let me know in the comments if you’re attending (and if there’s a Twitter hashtag I can follow!).