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"content": "\u003cp>Back in the 1960s, the U.S. started vaccinating kids for measles. As expected, children stopped getting measles.\u003c/p>\n\u003cp>But something else happened.\u003c/p>\n\u003cp>Childhood deaths from all infectious diseases plummeted. Even deaths from diseases like pneumonia and diarrhea were cut by half.\u003c/p>\n\u003cp>Scientists saw the same phenomenon when the vaccine came to England and parts of Europe. And they see it today when developing countries introduce the vaccine.\u003c/p>\n\u003cp>\"In some developing countries, where infectious diseases are very high, the reduction in mortality has been up to 80 percent,\" says Michael Mina, a postdoc in biology at Princeton University and a medical student at Emory University.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"So it's really been a mystery,\" he says. \"Why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine?\"\u003c/p>\n\u003cp>Mina and his colleagues think they now might have an explanation. And they \u003ca title=\"http://www.sciencemag.org/content/348/6235/694.abstract\" href=\"http://www.sciencemag.org/content/348/6235/694.abstract\" target=\"_blank\">published their evidence \u003c/a>recently in the journal Science.\u003c/p>\n\u003cp>There's an obvious answer to the mystery: Children who get the measles vaccine are probably more likely to get better health care in general — maybe more antibiotics and other vaccines. And it's true that health care in the U.S. has improved since the 1960s.\u003c/p>\n\u003cp>But Mina and his colleagues have found there's more going on than that simple answer.\u003c/p>\n\u003cp>The team obtained epidemiological data from the U.S., Denmark, Wales and England dating back to the 1940s. Using computer models, they found that the number of measles cases in these countries predicted the number of deaths from other infections two to three years later.\u003c/p>\n\u003cp>\"We found measles predisposes children to all other infectious diseases for up to a few years,\" Mina says.\u003c/p>\n\u003cp>And the virus seems to do it in a sneaky way.\u003c/p>\n\u003cp>Like many viruses, measles is known to suppress the immune system for a few weeks after an infection. But previous studies in monkeys have suggested that measles takes this suppression to a whole new level: It erases immune protection to other diseases, Mina says.\u003c/p>\n\u003cp>So what does that mean? Well, say you get the chicken pox when you're 4 years old. Your immune system figures out how to fight it. So you don't get it again. But if you get measles when you're 5 years old, it could wipe out the memory of how to beat back the chicken pox. It's like the immune system has amnesia, Mina says.\u003c/p>\n\u003cp>\"The immune system kind of comes back. The only problem is that it has forgotten what it once knew,\" he says.\u003c/p>\n\u003cp>So after an infection, a child's immune system has to almost start over, rebuilding its immune protection against diseases it has already seen before.\u003c/p>\n\u003cp>This idea of \"immune amnesia\" is still just a hypothesis and needs more testing, says epidemiologist William Moss, who has studied the measles vaccine for more than a decade at Johns Hopkins University.\u003c/p>\n\u003cp>But the new study, he says, provides \"compelling evidence\" that measles affects the immune system for two to three years. That's much longer than previously thought.\u003c/p>\n\u003cp>\"Hence the reduction in overall child mortality that follows measles vaccination is much greater than previously believed,\" says Moss, who wasn't involved in the study.\u003c/p>\n\u003cp>That finding should give parents more motivation to vaccinate their kids, he says. \"I think this paper will provide additional evidence — if it's needed — of the public health benefits of measles vaccine,\" Moss says. \"That's an important message in the U.S. right now and in countries continuing to see measles outbreaks.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because if the world can eliminate measles, it will help protect kids from many other infections, too.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Back in the 1960s, the U.S. started vaccinating kids for measles. As expected, children stopped getting measles.\u003c/p>\n\u003cp>But something else happened.\u003c/p>\n\u003cp>Childhood deaths from all infectious diseases plummeted. Even deaths from diseases like pneumonia and diarrhea were cut by half.\u003c/p>\n\u003cp>Scientists saw the same phenomenon when the vaccine came to England and parts of Europe. And they see it today when developing countries introduce the vaccine.\u003c/p>\n\u003cp>\"In some developing countries, where infectious diseases are very high, the reduction in mortality has been up to 80 percent,\" says Michael Mina, a postdoc in biology at Princeton University and a medical student at Emory University.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"So it's really been a mystery,\" he says. \"Why do children stop dying at such high rates from all these different infections following introduction of the measles vaccine?\"\u003c/p>\n\u003cp>Mina and his colleagues think they now might have an explanation. And they \u003ca title=\"http://www.sciencemag.org/content/348/6235/694.abstract\" href=\"http://www.sciencemag.org/content/348/6235/694.abstract\" target=\"_blank\">published their evidence \u003c/a>recently in the journal Science.\u003c/p>\n\u003cp>There's an obvious answer to the mystery: Children who get the measles vaccine are probably more likely to get better health care in general — maybe more antibiotics and other vaccines. And it's true that health care in the U.S. has improved since the 1960s.\u003c/p>\n\u003cp>But Mina and his colleagues have found there's more going on than that simple answer.\u003c/p>\n\u003cp>The team obtained epidemiological data from the U.S., Denmark, Wales and England dating back to the 1940s. Using computer models, they found that the number of measles cases in these countries predicted the number of deaths from other infections two to three years later.\u003c/p>\n\u003cp>\"We found measles predisposes children to all other infectious diseases for up to a few years,\" Mina says.\u003c/p>\n\u003cp>And the virus seems to do it in a sneaky way.\u003c/p>\n\u003cp>Like many viruses, measles is known to suppress the immune system for a few weeks after an infection. But previous studies in monkeys have suggested that measles takes this suppression to a whole new level: It erases immune protection to other diseases, Mina says.\u003c/p>\n\u003cp>So what does that mean? Well, say you get the chicken pox when you're 4 years old. Your immune system figures out how to fight it. So you don't get it again. But if you get measles when you're 5 years old, it could wipe out the memory of how to beat back the chicken pox. It's like the immune system has amnesia, Mina says.\u003c/p>\n\u003cp>\"The immune system kind of comes back. The only problem is that it has forgotten what it once knew,\" he says.\u003c/p>\n\u003cp>So after an infection, a child's immune system has to almost start over, rebuilding its immune protection against diseases it has already seen before.\u003c/p>\n\u003cp>This idea of \"immune amnesia\" is still just a hypothesis and needs more testing, says epidemiologist William Moss, who has studied the measles vaccine for more than a decade at Johns Hopkins University.\u003c/p>\n\u003cp>But the new study, he says, provides \"compelling evidence\" that measles affects the immune system for two to three years. That's much longer than previously thought.\u003c/p>\n\u003cp>\"Hence the reduction in overall child mortality that follows measles vaccination is much greater than previously believed,\" says Moss, who wasn't involved in the study.\u003c/p>\n\u003cp>That finding should give parents more motivation to vaccinate their kids, he says. \"I think this paper will provide additional evidence — if it's needed — of the public health benefits of measles vaccine,\" Moss says. \"That's an important message in the U.S. right now and in countries continuing to see measles outbreaks.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Because if the world can eliminate measles, it will help protect kids from many other infections, too.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Whooping Cough Vaccine Effectiveness Fades -- and Fast",
"title": "Whooping Cough Vaccine Effectiveness Fades -- and Fast",
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"content": "\u003cp>Lately, Californians have been focused on a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">significant measles outbreak\u003c/a> that just ended. But in the last five years, state health officials have declared an epidemic of whooping cough (also known as pertussis) twice -- in 2010 and in 2014, when \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" target=\"_blank\">11,000 people were sickened\u003c/a> and three infants died.\u003c/p>\n\u003cp>Now an analysis from a recent whooping cough epidemic in Washington state shows that the effectiveness of the Tdap vaccine used to fight whooping cough waned significantly. For adolescents who received all their shots, effectiveness within one year of the final booster was 73 percent. That rate plummeted to 34 percent within two to four years.\u003c/p>\n\u003cp>\"(T)his waning is likely contributing to the increase in pertussis among adolescents,\" the authors wrote.\u003c/p>\n\u003cp>Tdap protects against three diseases: tetanus, diphtheria and pertussis. The pertussis protection is from the acellular pertussis vaccine. It was introduced in 1997 to replace the whole-cell vaccine, which caused more side effects. Monday's report\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" target=\"_blank\"> confirms an earlier analysis\u003c/a> that the acellular pertussis may be safer, but less effective, than the old one.\u003c/p>\n\u003cp>\u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" target=\"_blank\">The study\u003c/a> was published Monday in the journal Pediatrics.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The take-home message is that the waning is there,\" said Dr. Art Reingold, a UC Berkeley professor of public health. \"You're protected initially but it wanes over time.\"\u003c/p>\n\u003cp>It doesn't mean anyone should skip the vaccine. Someone who is vaccinated, but becomes sick with whooping cough, should have a less severe course of illness.\u003c/p>\n\u003cp>The authors said that new vaccines are \"likely needed to reduce the burden of pertussis disease.\" But Reingold, who leads the CDC's Advisory Committee on Immunization Practices (ACIP) group on pertussis, said he doesn't know of any pertussis vaccine development in the pipeline.\u003c/p>\n\u003cp>He also said that adding another dose of the vaccine at a later age would not help much, based on research that was presented to the ACIP group. \"(An additional dose) would have very little impact on pertussis,\" he said, \"in terms of cases prevented.\"\u003c/p>\n\u003cp>The most severe cases are in very young infants, Reingold said. Babies cannot be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" target=\"_blank\">until they are 2 months old\u003c/a>. To protect newborns before they can be vaccinated, the CDC recommends that women be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" target=\"_blank\">during the last trimester of every pregnancy\u003c/a> -- even if they received a vaccine before they became pregnant.\u003c/p>\n\u003cp>\"Babies will be born with circulating antibodies,\" Reingold said, \"and there's pretty good evidence that that will reduce the risk of hospitalization and death in babies.\"\u003c/p>\n\u003cp>In an \u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" target=\"_blank\">accompanying commentary\u003c/a>, Dr. James Cherry at UCLA said the findings about Tdap effectiveness were \"disappointing,\" but he also pointed to other drivers of recent pertussis outbreaks, including increased awareness and better, more sensitive, testing.\u003c/p>\n\u003cp>Previous reports have shown that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">vaccine refusal\u003c/a> played a role in the 2010 whooping cough epidemic in California.\u003c/p>\n\u003cp>Reingold also drew an interesting distinction between measles and pertussis having to do with herd immunity. If a great enough percentage of the population is immunized against measles, both individuals and the broader community are protected against outbreak. That's because the measles vaccine protects people against the virus that actually causes the measles illness.\u003c/p>\n\u003cp>But in pertussis, the disease is caused by toxins that are released by bacteria. The pertussis vaccine protects people against those toxins, but may not prevent you from spreading the bacteria to others -- and causing illness in them.\u003c/p>\n\u003cp>The outbreak of measles earlier this year was likely caused by someone who brought the disease back from abroad. Measles was eliminated in the United States in 2000.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Pertussis is not going to go away with the current vaccine,\" Reingold said.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lately, Californians have been focused on a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/16/disneyland-measles-outbreak-to-be-declared-over/\" target=\"_blank\">significant measles outbreak\u003c/a> that just ended. But in the last five years, state health officials have declared an epidemic of whooping cough (also known as pertussis) twice -- in 2010 and in 2014, when \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis%20report%204-20-2015.pdf\" target=\"_blank\">11,000 people were sickened\u003c/a> and three infants died.\u003c/p>\n\u003cp>Now an analysis from a recent whooping cough epidemic in Washington state shows that the effectiveness of the Tdap vaccine used to fight whooping cough waned significantly. For adolescents who received all their shots, effectiveness within one year of the final booster was 73 percent. That rate plummeted to 34 percent within two to four years.\u003c/p>\n\u003cp>\"(T)his waning is likely contributing to the increase in pertussis among adolescents,\" the authors wrote.\u003c/p>\n\u003cp>Tdap protects against three diseases: tetanus, diphtheria and pertussis. The pertussis protection is from the acellular pertussis vaccine. It was introduced in 1997 to replace the whole-cell vaccine, which caused more side effects. Monday's report\u003ca title=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" href=\"http://ww2.kqed.org/stateofhealth/2012/08/03/todays-whooping-cough-vaccine-may-be-safer-but-less-effective-than-the-old-one/\" target=\"_blank\"> confirms an earlier analysis\u003c/a> that the acellular pertussis may be safer, but less effective, than the old one.\u003c/p>\n\u003cp>\u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-3358d.abstract\" target=\"_blank\">The study\u003c/a> was published Monday in the journal Pediatrics.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The take-home message is that the waning is there,\" said Dr. Art Reingold, a UC Berkeley professor of public health. \"You're protected initially but it wanes over time.\"\u003c/p>\n\u003cp>It doesn't mean anyone should skip the vaccine. Someone who is vaccinated, but becomes sick with whooping cough, should have a less severe course of illness.\u003c/p>\n\u003cp>The authors said that new vaccines are \"likely needed to reduce the burden of pertussis disease.\" But Reingold, who leads the CDC's Advisory Committee on Immunization Practices (ACIP) group on pertussis, said he doesn't know of any pertussis vaccine development in the pipeline.\u003c/p>\n\u003cp>He also said that adding another dose of the vaccine at a later age would not help much, based on research that was presented to the ACIP group. \"(An additional dose) would have very little impact on pertussis,\" he said, \"in terms of cases prevented.\"\u003c/p>\n\u003cp>The most severe cases are in very young infants, Reingold said. Babies cannot be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/vaccinate-baby.html\" target=\"_blank\">until they are 2 months old\u003c/a>. To protect newborns before they can be vaccinated, the CDC recommends that women be vaccinated \u003ca title=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" href=\"http://www.cdc.gov/pertussis/pregnant/mom/get-vaccinated.html\" target=\"_blank\">during the last trimester of every pregnancy\u003c/a> -- even if they received a vaccine before they became pregnant.\u003c/p>\n\u003cp>\"Babies will be born with circulating antibodies,\" Reingold said, \"and there's pretty good evidence that that will reduce the risk of hospitalization and death in babies.\"\u003c/p>\n\u003cp>In an \u003ca title=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" href=\"http://pediatrics.aappublications.org/content/early/2015/04/28/peds.2014-4118.full.pdf+html\" target=\"_blank\">accompanying commentary\u003c/a>, Dr. James Cherry at UCLA said the findings about Tdap effectiveness were \"disappointing,\" but he also pointed to other drivers of recent pertussis outbreaks, including increased awareness and better, more sensitive, testing.\u003c/p>\n\u003cp>Previous reports have shown that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">vaccine refusal\u003c/a> played a role in the 2010 whooping cough epidemic in California.\u003c/p>\n\u003cp>Reingold also drew an interesting distinction between measles and pertussis having to do with herd immunity. If a great enough percentage of the population is immunized against measles, both individuals and the broader community are protected against outbreak. That's because the measles vaccine protects people against the virus that actually causes the measles illness.\u003c/p>\n\u003cp>But in pertussis, the disease is caused by toxins that are released by bacteria. The pertussis vaccine protects people against those toxins, but may not prevent you from spreading the bacteria to others -- and causing illness in them.\u003c/p>\n\u003cp>The outbreak of measles earlier this year was likely caused by someone who brought the disease back from abroad. Measles was eliminated in the United States in 2000.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Pertussis is not going to go away with the current vaccine,\" Reingold said.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_25163\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2127061197_7321f7ac3c_o-e1430254712327.jpg\">\u003cimg class=\"size-large wp-image-25163\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2127061197_7321f7ac3c_o-640x426.jpg\" alt=\"(Ozgur Poyrazoglu via Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ozgur Poyrazoglu via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In a small study, women who had been diagnosed with breast cancer were 30 percent less likely to see a return of the disease if they had a history of breast-feeding. While previous research has found a \u003ca title=\"http://www.cancer.org/cancer/news/expertvoices/post/2013/05/07/can-breastfeeding-lower-breast-cancer-risk.aspx\" href=\"http://www.cancer.org/cancer/news/expertvoices/post/2013/05/07/can-breastfeeding-lower-breast-cancer-risk.aspx\" target=\"_blank\">small protective effect \u003c/a>of breast-feeding and breast cancer risk, researchers from Kaiser Permanente's Division of Research believe this is the first study to explore an association between nursing and a recurrence of cancer.\u003c/p>\n\u003cp>In the study, researchers asked 1,636 women who had breast cancer, mostly Kaiser patients, to fill out a questionnaire that included their history of breast-feeding. \"We followed them for over nine years, and we identified the women who had a recurrence and also those who died of breast cancer,\" said lead author Marilyn Kwan, Ph.D., with Kaiser. \"And we (found) this dramatic reduction in risk of recurrence.\"\u003c/p>\n\u003cp>In addition to the reduced risk of recurrence, the researchers found a 28 percent reduced risk of dying from the disease among women who breast-fed.\u003c!--more-->\u003c/p>\n\u003cp>They study also looked at specific types of tumors. They found that women who had breast-fed were more likely to develop a more common -- and more easily treatable -- kind of tumor, known as luminal A subtype, which includes estrogen-receptor positive tumors.\u003c/p>\n\u003cp>\"These tumors are less likely to spread, to metastasize, and they're treatable with hormonal therapy such as tamoxifen,\" Kwan said. \"Because of this, they have better prognosis. Women who have luminal A tumors are more likely to survive.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The study was published in the \u003ca title=\"http://jnci.oxfordjournals.org/content/107/7/djv087.abstract?sid=d7434ffc-ae03-423d-b438-80acfd8f2a12\" href=\"http://jnci.oxfordjournals.org/content/107/7/djv087.abstract?sid=d7434ffc-ae03-423d-b438-80acfd8f2a12\" target=\"_blank\">Journal of the National Cancer Institute\u003c/a> and was funded by the National Institutes of Health.\u003c/p>\n\u003cp>Kwan said that breast-feeding \"can increase the maturation of the cells in the breast.\" She theorized that it may set up a \"molecular environment that makes a tumor more responsive to therapy, so women, in the end, are less likely to have a recurrence or die from their disease.\"\u003c/p>\n\u003cp>Experts not affiliated with the study called it interesting, but noted that it was conducted among a fairly small sample of women. Of the 1,600 women in the study, 383 had a recurrence of cancer during the nine-year study period, and 290 women died of the disease. More than 200,000 women in the U.S. are \u003ca title=\"http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics\" href=\"http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics\" target=\"_blank\">projected to be diagnosed with breast cancer\u003c/a> in 2015.\u003c/p>\n\u003cp>\"It's a hypothesis that supports doing more research,\" said Dr. Otis Brawley, chief medical officer with the American Cancer Society. \"We can't take this study and tell women, 'Breast-feed, and you are more likely to get the easier-to-treat breast cancer.' \"\u003c/p>\n\u003cp>\u003cstrong>Intriguing Questions for African-American Women\u003c/strong>\u003c/p>\n\u003cp>Brawley also theorized that this study could have implications for African-American women who have higher rates of diagnosis of basal-type tumors, also called \"triple negative,\" which are more aggressive. Women with these types of tumors face a poorer prognosis.\u003c/p>\n\u003cp>Thirty percent of African-American women are diagnosed with these basal-type tumors, but only 20 percent of Caucasian women are. African-American women have a higher mortality rate from breast cancer overall. And, Brawley noted, African-American women have lower rates of breast-feeding.\u003c/p>\n\u003cp>\"Maybe breast-feeding, or lack thereof, is part of the reason for that difference,\" Brawley said of the breast cancer disparity. \"I can only say maybe.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Karuna Jaggar, executive director of Breast Cancer Action, a San Francisco-based advocacy group, said that overall the study adds to our understanding of breast cancer. \"(This research) underscores that breast cancer is a life course disease,\" she said. \"Exposures and activities that happen earlier in life impact breast cancer risk and mortality,\" both positively and negatively.\u003c/p>\n\n",
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"excerpt": "In a Kaiser study, women who had breast-fed had a 30 percent reduced risk of recurrence of breast cancer.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_25163\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2127061197_7321f7ac3c_o-e1430254712327.jpg\">\u003cimg class=\"size-large wp-image-25163\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/2127061197_7321f7ac3c_o-640x426.jpg\" alt=\"(Ozgur Poyrazoglu via Flickr) \" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Ozgur Poyrazoglu via Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In a small study, women who had been diagnosed with breast cancer were 30 percent less likely to see a return of the disease if they had a history of breast-feeding. While previous research has found a \u003ca title=\"http://www.cancer.org/cancer/news/expertvoices/post/2013/05/07/can-breastfeeding-lower-breast-cancer-risk.aspx\" href=\"http://www.cancer.org/cancer/news/expertvoices/post/2013/05/07/can-breastfeeding-lower-breast-cancer-risk.aspx\" target=\"_blank\">small protective effect \u003c/a>of breast-feeding and breast cancer risk, researchers from Kaiser Permanente's Division of Research believe this is the first study to explore an association between nursing and a recurrence of cancer.\u003c/p>\n\u003cp>In the study, researchers asked 1,636 women who had breast cancer, mostly Kaiser patients, to fill out a questionnaire that included their history of breast-feeding. \"We followed them for over nine years, and we identified the women who had a recurrence and also those who died of breast cancer,\" said lead author Marilyn Kwan, Ph.D., with Kaiser. \"And we (found) this dramatic reduction in risk of recurrence.\"\u003c/p>\n\u003cp>In addition to the reduced risk of recurrence, the researchers found a 28 percent reduced risk of dying from the disease among women who breast-fed.\u003c!--more-->\u003c/p>\n\u003cp>They study also looked at specific types of tumors. They found that women who had breast-fed were more likely to develop a more common -- and more easily treatable -- kind of tumor, known as luminal A subtype, which includes estrogen-receptor positive tumors.\u003c/p>\n\u003cp>\"These tumors are less likely to spread, to metastasize, and they're treatable with hormonal therapy such as tamoxifen,\" Kwan said. \"Because of this, they have better prognosis. Women who have luminal A tumors are more likely to survive.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The study was published in the \u003ca title=\"http://jnci.oxfordjournals.org/content/107/7/djv087.abstract?sid=d7434ffc-ae03-423d-b438-80acfd8f2a12\" href=\"http://jnci.oxfordjournals.org/content/107/7/djv087.abstract?sid=d7434ffc-ae03-423d-b438-80acfd8f2a12\" target=\"_blank\">Journal of the National Cancer Institute\u003c/a> and was funded by the National Institutes of Health.\u003c/p>\n\u003cp>Kwan said that breast-feeding \"can increase the maturation of the cells in the breast.\" She theorized that it may set up a \"molecular environment that makes a tumor more responsive to therapy, so women, in the end, are less likely to have a recurrence or die from their disease.\"\u003c/p>\n\u003cp>Experts not affiliated with the study called it interesting, but noted that it was conducted among a fairly small sample of women. Of the 1,600 women in the study, 383 had a recurrence of cancer during the nine-year study period, and 290 women died of the disease. More than 200,000 women in the U.S. are \u003ca title=\"http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics\" href=\"http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-key-statistics\" target=\"_blank\">projected to be diagnosed with breast cancer\u003c/a> in 2015.\u003c/p>\n\u003cp>\"It's a hypothesis that supports doing more research,\" said Dr. Otis Brawley, chief medical officer with the American Cancer Society. \"We can't take this study and tell women, 'Breast-feed, and you are more likely to get the easier-to-treat breast cancer.' \"\u003c/p>\n\u003cp>\u003cstrong>Intriguing Questions for African-American Women\u003c/strong>\u003c/p>\n\u003cp>Brawley also theorized that this study could have implications for African-American women who have higher rates of diagnosis of basal-type tumors, also called \"triple negative,\" which are more aggressive. Women with these types of tumors face a poorer prognosis.\u003c/p>\n\u003cp>Thirty percent of African-American women are diagnosed with these basal-type tumors, but only 20 percent of Caucasian women are. African-American women have a higher mortality rate from breast cancer overall. And, Brawley noted, African-American women have lower rates of breast-feeding.\u003c/p>\n\u003cp>\"Maybe breast-feeding, or lack thereof, is part of the reason for that difference,\" Brawley said of the breast cancer disparity. \"I can only say maybe.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Karuna Jaggar, executive director of Breast Cancer Action, a San Francisco-based advocacy group, said that overall the study adds to our understanding of breast cancer. \"(This research) underscores that breast cancer is a life course disease,\" she said. \"Exposures and activities that happen earlier in life impact breast cancer risk and mortality,\" both positively and negatively.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Vaccine Bill Approved in Key Hearing",
"title": "California Vaccine Bill Approved in Key Hearing",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_25005\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-e1429575505514.jpg\">\u003cimg class=\"size-large wp-image-25005\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED) \u003ccite>(Craig Miller/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A controversial bill that would require vaccination for nearly all California children to attend school -- both public and private -- cleared the Senate Education Committee on Wednesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The bill \"has a long way to go.\" \u003c/aside>\n\u003cp>The committee voted 7-2 on the bill, co-authored by Sens. Richard Pan (D-Sacramento) and Ben Allen (D-Santa Monica). Both Democrats and Republicans supported the bill.\u003c/p>\n\u003cp>\"It's a strong sign that people want to be sure that we protect our kids, protect our schools and protect our communities from these preventable diseases,\" Pan said of Wednesday's vote.\u003c!--more-->\u003c/p>\n\u003cp>It was the bill's second hearing in a week by the committee. Last Wednesday, hundreds of people voiced their opposition to the bill, and it looked like the committee would kill it. Instead, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" target=\"_blank\">Pan and Allen asked to hold the bill\u003c/a> and crafted amendments letting families that opt out of vaccines homeschool their children together and allowing students seek independent study.\u003c/p>\n\u003cp>While the committee backed the bill's advance, chairwoman Sen. Carol Liu (D-Glendale) noted the bill \"still has a long way to go\" and hinted that she wasn't completely swayed that the proposed amendments are sufficient.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"In terms of public health, it's necessary,\" she said in reference to the bill, \"but I am concerned about the rights of our parents.\"\u003c/p>\n\u003cp>Opponents vowed to continue their fight. The bill now heads to the Senate Judiciary Committee for a hearing next week as part of a long legislative process. \u003ca title=\"http://www.vaccinatecalifornia.org/endorsements2\" href=\"http://www.vaccinatecalifornia.org/endorsements2\" target=\"_blank\">A long list\u003c/a> of health groups and school districts back the bill.\u003c/p>\n\u003cp>\"We will continue to show our strength, and we will continue to educate lawmakers and the public about why this is a bad bill,\" said Jean Keese, a spokeswoman for the California Coalition for Health Choice.\u003c/p>\n\u003cp>The proposal was among several drafted across the nation in the wake of a measles outbreak that started at Disneyland and sickened more than 100 people in the U.S. and Mexico.\u003c/p>\n\u003cp>It would eliminate California's personal-belief and religious exemptions so unvaccinated children would not be able to attend public or private schools. Medical waivers would only be available for children who have health problems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n",
"disqusIdentifier": "25040 http://blogs.kqed.org/stateofhealth/?p=25040",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_25005\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-e1429575505514.jpg\">\u003cimg class=\"size-large wp-image-25005\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED) \u003ccite>(Craig Miller/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A controversial bill that would require vaccination for nearly all California children to attend school -- both public and private -- cleared the Senate Education Committee on Wednesday.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The bill \"has a long way to go.\" \u003c/aside>\n\u003cp>The committee voted 7-2 on the bill, co-authored by Sens. Richard Pan (D-Sacramento) and Ben Allen (D-Santa Monica). Both Democrats and Republicans supported the bill.\u003c/p>\n\u003cp>\"It's a strong sign that people want to be sure that we protect our kids, protect our schools and protect our communities from these preventable diseases,\" Pan said of Wednesday's vote.\u003c!--more-->\u003c/p>\n\u003cp>It was the bill's second hearing in a week by the committee. Last Wednesday, hundreds of people voiced their opposition to the bill, and it looked like the committee would kill it. Instead, \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" target=\"_blank\">Pan and Allen asked to hold the bill\u003c/a> and crafted amendments letting families that opt out of vaccines homeschool their children together and allowing students seek independent study.\u003c/p>\n\u003cp>While the committee backed the bill's advance, chairwoman Sen. Carol Liu (D-Glendale) noted the bill \"still has a long way to go\" and hinted that she wasn't completely swayed that the proposed amendments are sufficient.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"In terms of public health, it's necessary,\" she said in reference to the bill, \"but I am concerned about the rights of our parents.\"\u003c/p>\n\u003cp>Opponents vowed to continue their fight. The bill now heads to the Senate Judiciary Committee for a hearing next week as part of a long legislative process. \u003ca title=\"http://www.vaccinatecalifornia.org/endorsements2\" href=\"http://www.vaccinatecalifornia.org/endorsements2\" target=\"_blank\">A long list\u003c/a> of health groups and school districts back the bill.\u003c/p>\n\u003cp>\"We will continue to show our strength, and we will continue to educate lawmakers and the public about why this is a bad bill,\" said Jean Keese, a spokeswoman for the California Coalition for Health Choice.\u003c/p>\n\u003cp>The proposal was among several drafted across the nation in the wake of a measles outbreak that started at Disneyland and sickened more than 100 people in the U.S. and Mexico.\u003c/p>\n\u003cp>It would eliminate California's personal-belief and religious exemptions so unvaccinated children would not be able to attend public or private schools. Medical waivers would only be available for children who have health problems.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>The Associated Press contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Mammogram in Your 40s Still a Personal Decision, Task Force Says",
"title": "Mammogram in Your 40s Still a Personal Decision, Task Force Says",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_25011\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324.jpg\">\u003cimg class=\"size-large wp-image-25011\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Katherine Hobson,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" href=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" target=\"_blank\">NPR \u003c/a>\u003c/p>\n\u003cp>In 2009, I was among the scrum of reporters covering the controversial advice from the U.S. Preventive Services Task Force that women in their 40s think twice about regular mammograms. The task force pointed out that the net benefits in younger women were small and said women should weigh the pros and cons of screening before making a decision.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The suggested changes to the updated mammography guidelines are small ones. \u003c/aside>\n\u003cp>Those guidelines kicked off a heated debate about the benefits and harms of mammography that is rekindled with every new study.\u003c/p>\n\u003cp>I wasn't yet 40 back then, but what I learned about mammograms stuck with me: I haven't yet had the test. I took to heart the warnings of the task force and of many other physicians that mammography has minuses as well as pluses. I wasn't so worried about a false positive result. But I was very concerned about overdiagnosis, or being diagnosed with and treated for a cancer that would never have caused me any harm.\u003c/p>\n\u003cp>\u003c!--more-->I'm now 43 and am thinking that I should get a mammogram. So when I found out the USPSTF was doing a routine update of its breast cancer screening recommendations, I hoped it would help me decide.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>As it turns out, the suggested changes to the recommendations — which are in draft form and may be altered after a \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">public comment\u003c/a> period — are small ones.\u003c/p>\n\u003cp>What is new? For the first time, the task force looked at the evidence behind 3-D mammography, also known as tomosynthesis. The USPSTF said there's \u003ca href=\"http://www.npr.org/blogs/health/2014/06/24/325216641/3-d-mammography-finds-more-tumors-but-questions-remain\" target=\"_blank\">not enough evidence\u003c/a> to make a recommendation for or against using the technology to screen women. It also said there was \u003ca href=\"http://www.npr.org/blogs/health/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\">insufficient evidence\u003c/a> to say whether women with dense breasts should have screening with MRI, ultrasound or other methods in addition to mammography.\u003c/p>\n\u003cp>\u003cstrong>2009 Advice Unchanged\u003c/strong>\u003c/p>\n\u003cp>But the task force's basic advice has not changed:\u003c/p>\n\u003cul>\n\u003cli>The group recommends that \u003cstrong>women ages 50-74\u003c/strong> get a screening mammogram every two years.\u003c/li>\n\u003cli>And\u003cstrong> women between ages 40 and 49\u003c/strong> should make their own decision, in consultation with their doctors, based on \"health history, preferences and how they value the different potential benefits and harms of screening.\" (Women with a family history of breast cancer may benefit more from screening in their 40s, the task force says.)\u003c/li>\n\u003cli>The task force reiterates that there isn't enough evidence to say whether or not women \u003cstrong>75 and older\u003c/strong> should be routinely screened.\u003c/li>\n\u003c/ul>\n\u003cp>Screening mammography means looking for potential cancer in women who are healthy and who don't have any symptoms. People with symptoms should be seen by a doctor, no matter their age. And these recommendations don't apply to women who have previously been diagnosed with the disease or who are at higher risk because of a genetic mutation or other condition.\u003c/p>\n\u003cp>\"We want to reaffirm the importance of mammography to help prevent death from breast cancer,\" \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Biography/Kirsten-Bibbins-Domingo\">Kirsten Bibbins-Domingo\u003c/a>, a physician at UC San Francisco and vice chairwoman of the USPSTF, said.\u003c/p>\n\u003cp>And mammograms do save lives in women between 40 and 49 — it's just that there's a disproportionate level of harm.\u003c/p>\n\u003cp>The USPSTF's draft includes statistical models estimating the lifetime consequences of screening women from ages 50-74 and also from 40-74. For every 1,000 women screened, the model finds that screening women in their 40s means an estimated one additional breast cancer death averted (from eight to seven), but with 576 additional false positive tests (1,529 vs. 953), 58 unnecessary biopsies (204 vs. 146) and two additional overdiagnosed tumors (20 vs. 18).\u003c/p>\n\u003cp>The draft recommendations also repeat the USPSTF's earlier advice that women be screened every other year rather than annually, said Bibbins-Domingo. That time frame provides \"most of the benefits while minimizing the harm,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Other Groups' Guidelines Differ\u003c/strong>\u003c/p>\n\u003cp>Guidelines from medical groups differ on when a woman should start regular screening.\u003c/p>\n\u003cp>The American Cancer Society, for example, \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\">recommends\u003c/a> yearly mammograms starting at age 40. Richard Wender, chief cancer control officer of the ACS, says there's much common ground between the guidelines, however. \"The task force reconfirmed its conclusion that mammography reduced breast cancer deaths for women in their 40s,\" he said. The ACS is reviewing its own breast cancer screening guidelines this year.\u003c/p>\n\u003cp>As for my fear of overdiagnosis? Wender said it's an issue, but the exact extent of the problem is unknown. And, he added, much of overdiagnosis happens in women with \u003ca href=\"http://www.npr.org/blogs/health/2013/08/05/208239545/when-treating-abnormal-breast-cells-sometimes-less-is-more\" target=\"_blank\">ductal carcinoma in situ\u003c/a>, which is Stage 0 cancer that hasn't yet become invasive.\u003c/p>\n\u003cp>In the not-so-far future, molecular tools may help physicians give those women a more accurate prognosis, Wender says, so those at lower risk can opt for less aggressive treatments — or simply watchful waiting. \"The next 10 years are going to be good news for helping women really make decisions about treatment, not just about screening,\" he said.\u003c/p>\n\u003cp>So why am I planning to get a mammogram this year? In part, simply because I'm a few years older. The 50-year cutoff isn't a clear line in the sand, and as Bibbins-Domingo told me, the value of the test increases with age.\u003c/p>\n\u003cp>But to be honest, the main change has little to do with the numbers. I now have a young daughter, and my fear of dying prematurely has become far, far stronger than my fear of getting chemo or even a mastectomy I might not need. I understand the statistics, but I'd feel like a total jerk if I didn't get screened and that unlucky statistic were me.\u003c/p>\n\u003cp>And on the flip side, if my mammogram did show breast cancer and I was treated successfully, I'd probably be grateful I'd been screened, even if there was no way to know whether the treatment was necessary.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, then and now, I weighed the benefits and the risks and made my own decision, which is exactly what the USPSTF suggests.\u003c/p>\n\n",
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"excerpt": "Federal panel's 2009 recommendations ignited a firestorm. But the group is staying the course.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_25011\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324.jpg\">\u003cimg class=\"size-large wp-image-25011\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS8553_128959324-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Katherine Hobson,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" href=\"http://www.npr.org/blogs/health/2015/04/20/401006116/federal-panel-revisits-contested-recommendation-on-mammograms\" target=\"_blank\">NPR \u003c/a>\u003c/p>\n\u003cp>In 2009, I was among the scrum of reporters covering the controversial advice from the U.S. Preventive Services Task Force that women in their 40s think twice about regular mammograms. The task force pointed out that the net benefits in younger women were small and said women should weigh the pros and cons of screening before making a decision.\u003c/p>\n\u003caside class=\"pullquote alignleft\">The suggested changes to the updated mammography guidelines are small ones. \u003c/aside>\n\u003cp>Those guidelines kicked off a heated debate about the benefits and harms of mammography that is rekindled with every new study.\u003c/p>\n\u003cp>I wasn't yet 40 back then, but what I learned about mammograms stuck with me: I haven't yet had the test. I took to heart the warnings of the task force and of many other physicians that mammography has minuses as well as pluses. I wasn't so worried about a false positive result. But I was very concerned about overdiagnosis, or being diagnosed with and treated for a cancer that would never have caused me any harm.\u003c/p>\n\u003cp>\u003c!--more-->I'm now 43 and am thinking that I should get a mammogram. So when I found out the USPSTF was doing a routine update of its breast cancer screening recommendations, I hoped it would help me decide.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>As it turns out, the suggested changes to the recommendations — which are in draft form and may be altered after a \u003ca href=\"http://screeningforbreastcancer.org/\" target=\"_blank\">public comment\u003c/a> period — are small ones.\u003c/p>\n\u003cp>What is new? For the first time, the task force looked at the evidence behind 3-D mammography, also known as tomosynthesis. The USPSTF said there's \u003ca href=\"http://www.npr.org/blogs/health/2014/06/24/325216641/3-d-mammography-finds-more-tumors-but-questions-remain\" target=\"_blank\">not enough evidence\u003c/a> to make a recommendation for or against using the technology to screen women. It also said there was \u003ca href=\"http://www.npr.org/blogs/health/2015/04/16/399946509/letters-about-dense-breasts-can-lead-to-more-questions-than-answers\">insufficient evidence\u003c/a> to say whether women with dense breasts should have screening with MRI, ultrasound or other methods in addition to mammography.\u003c/p>\n\u003cp>\u003cstrong>2009 Advice Unchanged\u003c/strong>\u003c/p>\n\u003cp>But the task force's basic advice has not changed:\u003c/p>\n\u003cul>\n\u003cli>The group recommends that \u003cstrong>women ages 50-74\u003c/strong> get a screening mammogram every two years.\u003c/li>\n\u003cli>And\u003cstrong> women between ages 40 and 49\u003c/strong> should make their own decision, in consultation with their doctors, based on \"health history, preferences and how they value the different potential benefits and harms of screening.\" (Women with a family history of breast cancer may benefit more from screening in their 40s, the task force says.)\u003c/li>\n\u003cli>The task force reiterates that there isn't enough evidence to say whether or not women \u003cstrong>75 and older\u003c/strong> should be routinely screened.\u003c/li>\n\u003c/ul>\n\u003cp>Screening mammography means looking for potential cancer in women who are healthy and who don't have any symptoms. People with symptoms should be seen by a doctor, no matter their age. And these recommendations don't apply to women who have previously been diagnosed with the disease or who are at higher risk because of a genetic mutation or other condition.\u003c/p>\n\u003cp>\"We want to reaffirm the importance of mammography to help prevent death from breast cancer,\" \u003ca href=\"http://www.uspreventiveservicestaskforce.org/Page/Biography/Kirsten-Bibbins-Domingo\">Kirsten Bibbins-Domingo\u003c/a>, a physician at UC San Francisco and vice chairwoman of the USPSTF, said.\u003c/p>\n\u003cp>And mammograms do save lives in women between 40 and 49 — it's just that there's a disproportionate level of harm.\u003c/p>\n\u003cp>The USPSTF's draft includes statistical models estimating the lifetime consequences of screening women from ages 50-74 and also from 40-74. For every 1,000 women screened, the model finds that screening women in their 40s means an estimated one additional breast cancer death averted (from eight to seven), but with 576 additional false positive tests (1,529 vs. 953), 58 unnecessary biopsies (204 vs. 146) and two additional overdiagnosed tumors (20 vs. 18).\u003c/p>\n\u003cp>The draft recommendations also repeat the USPSTF's earlier advice that women be screened every other year rather than annually, said Bibbins-Domingo. That time frame provides \"most of the benefits while minimizing the harm,\" she said.\u003c/p>\n\u003cp>\u003cstrong>Other Groups' Guidelines Differ\u003c/strong>\u003c/p>\n\u003cp>Guidelines from medical groups differ on when a woman should start regular screening.\u003c/p>\n\u003cp>The American Cancer Society, for example, \u003ca href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\">recommends\u003c/a> yearly mammograms starting at age 40. Richard Wender, chief cancer control officer of the ACS, says there's much common ground between the guidelines, however. \"The task force reconfirmed its conclusion that mammography reduced breast cancer deaths for women in their 40s,\" he said. The ACS is reviewing its own breast cancer screening guidelines this year.\u003c/p>\n\u003cp>As for my fear of overdiagnosis? Wender said it's an issue, but the exact extent of the problem is unknown. And, he added, much of overdiagnosis happens in women with \u003ca href=\"http://www.npr.org/blogs/health/2013/08/05/208239545/when-treating-abnormal-breast-cells-sometimes-less-is-more\" target=\"_blank\">ductal carcinoma in situ\u003c/a>, which is Stage 0 cancer that hasn't yet become invasive.\u003c/p>\n\u003cp>In the not-so-far future, molecular tools may help physicians give those women a more accurate prognosis, Wender says, so those at lower risk can opt for less aggressive treatments — or simply watchful waiting. \"The next 10 years are going to be good news for helping women really make decisions about treatment, not just about screening,\" he said.\u003c/p>\n\u003cp>So why am I planning to get a mammogram this year? In part, simply because I'm a few years older. The 50-year cutoff isn't a clear line in the sand, and as Bibbins-Domingo told me, the value of the test increases with age.\u003c/p>\n\u003cp>But to be honest, the main change has little to do with the numbers. I now have a young daughter, and my fear of dying prematurely has become far, far stronger than my fear of getting chemo or even a mastectomy I might not need. I understand the statistics, but I'd feel like a total jerk if I didn't get screened and that unlucky statistic were me.\u003c/p>\n\u003cp>And on the flip side, if my mammogram did show breast cancer and I was treated successfully, I'd probably be grateful I'd been screened, even if there was no way to know whether the treatment was necessary.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>In other words, then and now, I weighed the benefits and the risks and made my own decision, which is exactly what the USPSTF suggests.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Forget Public Health: The Politics of the California Vaccination Debate",
"title": "Forget Public Health: The Politics of the California Vaccination Debate",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_25005\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-e1429575505514.jpg\">\u003cimg class=\"size-large wp-image-25005\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED) \u003ccite>(Craig Miller/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over on the KQED News Politics and Government Desk, John Myers hosts a \u003ca title=\"https://soundcloud.com/politics-california\" href=\"https://soundcloud.com/politics-california\" target=\"_blank\">terrific podcast\u003c/a> on California politics. The most recent edition (published last \u003ca title=\"http://ww2.kqed.org/news/2015/04/17-california-politics-podcast-taxation-vaccination-teacher-tenure/\" href=\"http://ww2.kqed.org/news/2015/04/17-california-politics-podcast-taxation-vaccination-teacher-tenure/\" target=\"_blank\">Friday)\u003c/a> took a hard look at the political debate in California over \u003ca title=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" target=\"_blank\">SB 277\u003c/a>, a bill that would eliminate the state's vaccine personal belief exemption.\u003c/p>\n\u003cp>Myers, KQED News' Marisa Lagos and Anthony York of the Grizzly Bear talk about it starting at 11:20, and their discussion runs about 10 minutes:\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/201184633\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>We've written often (\u003ca title=\"http://ww2.kqed.org/stateofhealth/?s=vaccine&x=-1081&y=-321\" href=\"http://ww2.kqed.org/stateofhealth/?s=vaccine&x=-1081&y=-321\" target=\"_blank\">perhaps exhaustively\u003c/a>) on State of Health about vaccines, but usually it's been from a medical perspective or a public health perspective. But the debate around SB 277 has illuminated the politics around trying to change policy when a very loud, very vocal minority swamps the Capitol.\u003c!--more-->\u003c/p>\n\u003cp>Last week, SB 277 was before the Senate Education Committee. Literally hundreds of people lined up to state their opposition to the bill.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It was one of the longest, largest lines of people, I have seen at the building coming to testify on a bill,\" Myers, who covered the Capitol since 2001, said. He wasn't kidding. For more than 90 minutes, a seemingly-unending stream of people said their name and that they opposed the bill.\u003c/p>\n\u003cp>The measles outbreak that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">originated in Disneyland \u003c/a>put vaccines -- and the people who voluntarily refuse them -- in the spotlight. Over the past months efforts to increase vaccination have been applauded, the \"narrative has felt very pro-vaccination,\" Myers said. \"All of a sudden this week, this showing of people who felt very passionately the other way about it … has temporarily shifted the narrative and maybe did take some people aback about it.\"\u003c/p>\n\u003cp>\"There's a personal freedom issue that I think is resounding,\" said Marisa Lagos. 'You're not really seeing the legislators debating the merits of vaccines. … The debate this week was over whether are you then taking away another kid's rights to a quality education.\"\u003c/p>\n\u003cp>But there's a third group -- the kids (and adults, too) who are immuno-compromised, who can't be vaccinated for medical reasons. They rely on the rest of us for protection. In order to get to \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>, a community needs high vaccination rates. For measles, that's well above 92 percent.\u003c/p>\n\u003cp>SB 277 co-authors Sen. Richard Pan (D-Sacramento) and Sen. Ben Allen (D-Santa Monica) say they wrote this bill to increase vaccination rates in California. But right now, all the introduction of SB 277 seems to have done is give repeated platforms to the tiny minority of people who make use of the personal belief exemption. In the current school year, 2.54 percent of kindergarteners have a personal belief exemption on file.\u003c/p>\n\u003cp>The senators on the education committee had a lot of questions last Wednesday and were left so uncertain about the bill that the committee chair, Sen. Carol Liu (D-Glendale) \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" target=\"_blank\">urged Pan to pull the bill\u003c/a>, get questions answered (and possibly issue amendments) and then bring it back this Wednesday for a vote.\u003c/p>\n\u003cp>\"When you have a very controversial bill, you do legwork ahead of time to try to get committee members on board, to try to build a coalition,\" Lagos said, and added that it looked like Pan and other supporters were \"caught a little flat-footed.\"\u003c/p>\n\u003cp>Myers noted that politics is the about \"the art of compromise… of finding somewhere in the middle. You don't find middle ground in the vaccination debate.\"\u003c/p>\n\u003cp>(This may be true, but there are other options -- such as \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" target=\"_blank\">tightening up the requirements \u003c/a>to obtain a personal belief exemption.)\u003c/p>\n\u003cp>Even some vaccine supporters are highly critical of the approach \"\u003ca title=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" href=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" target=\"_blank\">blundering state legislators\u003c/a>\" have taken.\u003c/p>\n\u003cp>“I’ve heard some people say that they felt like even taking up this issue was a political miscalculation by Sen. Pan,\" said Lagos, \"that you're actually giving a soapbox to people who are against vaccines and maybe it would have been better to leave alone.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate Education Committee will vote on SB 277 Wednesday morning. If the bill passes, it has several more hurdles to go before it might get to the governor's desk.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_25005\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-e1429575505514.jpg\">\u003cimg class=\"size-large wp-image-25005\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS1369_IMG_1902-640x480.jpg\" alt=\"(Craig Miller/KQED)\" width=\"640\" height=\"480\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Craig Miller/KQED) \u003ccite>(Craig Miller/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Over on the KQED News Politics and Government Desk, John Myers hosts a \u003ca title=\"https://soundcloud.com/politics-california\" href=\"https://soundcloud.com/politics-california\" target=\"_blank\">terrific podcast\u003c/a> on California politics. The most recent edition (published last \u003ca title=\"http://ww2.kqed.org/news/2015/04/17-california-politics-podcast-taxation-vaccination-teacher-tenure/\" href=\"http://ww2.kqed.org/news/2015/04/17-california-politics-podcast-taxation-vaccination-teacher-tenure/\" target=\"_blank\">Friday)\u003c/a> took a hard look at the political debate in California over \u003ca title=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" href=\"http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb_277_bill_20150219_introduced.html\" target=\"_blank\">SB 277\u003c/a>, a bill that would eliminate the state's vaccine personal belief exemption.\u003c/p>\n\u003cp>Myers, KQED News' Marisa Lagos and Anthony York of the Grizzly Bear talk about it starting at 11:20, and their discussion runs about 10 minutes:\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/201184633&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/201184633'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>We've written often (\u003ca title=\"http://ww2.kqed.org/stateofhealth/?s=vaccine&x=-1081&y=-321\" href=\"http://ww2.kqed.org/stateofhealth/?s=vaccine&x=-1081&y=-321\" target=\"_blank\">perhaps exhaustively\u003c/a>) on State of Health about vaccines, but usually it's been from a medical perspective or a public health perspective. But the debate around SB 277 has illuminated the politics around trying to change policy when a very loud, very vocal minority swamps the Capitol.\u003c!--more-->\u003c/p>\n\u003cp>Last week, SB 277 was before the Senate Education Committee. Literally hundreds of people lined up to state their opposition to the bill.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It was one of the longest, largest lines of people, I have seen at the building coming to testify on a bill,\" Myers, who covered the Capitol since 2001, said. He wasn't kidding. For more than 90 minutes, a seemingly-unending stream of people said their name and that they opposed the bill.\u003c/p>\n\u003cp>The measles outbreak that \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">originated in Disneyland \u003c/a>put vaccines -- and the people who voluntarily refuse them -- in the spotlight. Over the past months efforts to increase vaccination have been applauded, the \"narrative has felt very pro-vaccination,\" Myers said. \"All of a sudden this week, this showing of people who felt very passionately the other way about it … has temporarily shifted the narrative and maybe did take some people aback about it.\"\u003c/p>\n\u003cp>\"There's a personal freedom issue that I think is resounding,\" said Marisa Lagos. 'You're not really seeing the legislators debating the merits of vaccines. … The debate this week was over whether are you then taking away another kid's rights to a quality education.\"\u003c/p>\n\u003cp>But there's a third group -- the kids (and adults, too) who are immuno-compromised, who can't be vaccinated for medical reasons. They rely on the rest of us for protection. In order to get to \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2013/08/23/5-things-you-should-know-about-vaccines/\" target=\"_blank\">herd immunity\u003c/a>, a community needs high vaccination rates. For measles, that's well above 92 percent.\u003c/p>\n\u003cp>SB 277 co-authors Sen. Richard Pan (D-Sacramento) and Sen. Ben Allen (D-Santa Monica) say they wrote this bill to increase vaccination rates in California. But right now, all the introduction of SB 277 seems to have done is give repeated platforms to the tiny minority of people who make use of the personal belief exemption. In the current school year, 2.54 percent of kindergarteners have a personal belief exemption on file.\u003c/p>\n\u003cp>The senators on the education committee had a lot of questions last Wednesday and were left so uncertain about the bill that the committee chair, Sen. Carol Liu (D-Glendale) \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" href=\"http://ww2.kqed.org/stateofhealth/2015/04/15/vaccine-exemption-bill-stalls-in-sacramento-vote-next-week/\" target=\"_blank\">urged Pan to pull the bill\u003c/a>, get questions answered (and possibly issue amendments) and then bring it back this Wednesday for a vote.\u003c/p>\n\u003cp>\"When you have a very controversial bill, you do legwork ahead of time to try to get committee members on board, to try to build a coalition,\" Lagos said, and added that it looked like Pan and other supporters were \"caught a little flat-footed.\"\u003c/p>\n\u003cp>Myers noted that politics is the about \"the art of compromise… of finding somewhere in the middle. You don't find middle ground in the vaccination debate.\"\u003c/p>\n\u003cp>(This may be true, but there are other options -- such as \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" target=\"_blank\">tightening up the requirements \u003c/a>to obtain a personal belief exemption.)\u003c/p>\n\u003cp>Even some vaccine supporters are highly critical of the approach \"\u003ca title=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" href=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" target=\"_blank\">blundering state legislators\u003c/a>\" have taken.\u003c/p>\n\u003cp>“I’ve heard some people say that they felt like even taking up this issue was a political miscalculation by Sen. Pan,\" said Lagos, \"that you're actually giving a soapbox to people who are against vaccines and maybe it would have been better to leave alone.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate Education Committee will vote on SB 277 Wednesday morning. If the bill passes, it has several more hurdles to go before it might get to the governor's desk.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Disneyland Measles Outbreak to be Declared Over",
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"content": "\u003cfigure id=\"attachment_24968\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939.jpg\">\u003cimg class=\"size-large wp-image-24968\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939-640x427.jpg\" alt=\"The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The outbreak sickened more than 130 Californians. (Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alicia Chang, AP\u003c/strong>\u003c/p>\n\u003cp>The state's measles outbreak that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">began at Disneyland \u003c/a>and reignited debate about vaccinations is nearing an end.\u003c/p>\n\u003cp>The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.\u003c/p>\n\u003cp>Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. More than 130 people in California were infected.\u003c/p>\n\u003cp>The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or had only one of the two recommended doses of the measles-mumps-rubella vaccine.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.\u003c/p>\n\u003cp>The Disneyland outbreak \"reminds us that we are part of a global medical community\" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.\u003c/p>\n\u003cp>The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.\u003c/p>\n\u003cp>Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash. The most recent confirmed measles case in California had \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" target=\"_blank\">rash onset on March 2\u003c/a>, according to state data.\u003c/p>\n\u003cp>As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.\u003c/p>\n\u003cp>Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24968\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939.jpg\">\u003cimg class=\"size-large wp-image-24968\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS13944_53249939-640x427.jpg\" alt=\"The outbreak sickened 134 Californians. (Marsaili McGrath/Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">The outbreak sickened more than 130 Californians. (Marsaili McGrath/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alicia Chang, AP\u003c/strong>\u003c/p>\n\u003cp>The state's measles outbreak that \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/07/nine-measles-cases-tied-to-disneyland-parks/\" target=\"_blank\">began at Disneyland \u003c/a>and reignited debate about vaccinations is nearing an end.\u003c/p>\n\u003cp>The outbreak will be declared over in California on Friday if no new cases pop up, according to the California Department of Public Health.\u003c/p>\n\u003cp>Disease investigators worked for months to contain the highly contagious disease that originated at Disney theme parks in December and spread to several other states and countries. More than 130 people in California were infected.\u003c/p>\n\u003cp>The outbreak cast a spotlight on the small but vocal anti-vaccine movement. Many who fell ill in the Disneyland outbreak were not immunized or had only one of the two recommended doses of the measles-mumps-rubella vaccine.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Public health officials have said vaccinations rates must be high to protect a population from infection. While measles has been declared eliminated from the U.S. for years, outbreaks still occur because the virus can be imported from overseas and spread among people who skip shots for personal reasons or who are too young to be immunized.\u003c/p>\n\u003cp>The Disneyland outbreak \"reminds us that we are part of a global medical community\" and the U.S. should help tame measles raging in many parts of the world, said Dr. Richard Wenzel, an infectious disease expert at Virginia Commonwealth University.\u003c/p>\n\u003cp>The U.S. has experienced measles outbreaks in recent years, including a 2014 episode that sickened 383 people in Ohio's Amish country.\u003c/p>\n\u003cp>Symptoms can appear up to two weeks after exposure and include fever, cough and watery eyes followed by a telltale rash. A measles outbreak is considered over when 42 days — or two incubation periods — have passed since the last onset of the rash. The most recent confirmed measles case in California had \u003ca title=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" href=\"http://www.cdph.ca.gov/programs/immunize/Documents/Measles_Update_4-10-2015_public.pdf\" target=\"_blank\">rash onset on March 2\u003c/a>, according to state data.\u003c/p>\n\u003cp>As one of the world's international destinations, Disneyland was the perfect place to launch a widespread measles outbreak, health experts said. The theme parks attract tens of thousands of visitors from around the globe, who could then return home with the virus.\u003c/p>\n\u003cp>Forty people were exposed to measles while visiting or working at Disney theme parks in December. They then spread the virus to 30 family members. The rest caught measles in the community or from an unknown source, according to state health officials.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Disease detectives have said they likely may never find patient zero — or the person who triggered the outbreak — but believe it's someone who brought measles into the country.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Vaccine Exemption Bill Stalls in Sacramento; Vote Next Week",
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"content": "\u003cfigure id=\"attachment_24949\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS6837_149948672-e1429144072713.jpg\">\u003cimg class=\"size-large wp-image-24949\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS6837_149948672-640x452.jpg\" alt=\"(Kevork Djansezian/Getty Images)\" width=\"640\" height=\"452\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kevork Djansezian/Getty Images) \u003ccite>(Kevork Djansezian/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A bill that would eliminate the vaccine personal belief exemption stalled before the Senate Education Committee Wednesday in Sacramento. Lawmakers were deeply concerned that the bill would bar too many children from school. The bill's co-author, Sen. Richard Pan (D-Sacramento), asked the committee to delay a vote until next Wednesday after the committee chairwoman warned him he did not have enough votes to pass.\u003c/p>\n\u003cp>Pan said he will use the time to address their concerns, possibly adding amendments to the bill.\u003c/p>\n\u003cp>Under the bill, \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a>, California would no longer permit any vaccine exemptions except a medical one, meaning virtually all children would have to be vaccinated in order to attend public or private school. Even home-schoolers who group together would be affected under the current language, one of the committee's complaints.\u003c/p>\n\u003cp>While several committee members expressed their support for vaccines, they were worried that the bill goes too far. \"I'm looking for the compelling state interest in doing something (this) draconian,\" said state Sen. Loni Hancock (D-Berkeley). \"If I'm reading the bill correctly, there's nothing you can do if you choose not to vaccinate your child,\" except home-school and then only with your own children.\u003c!--more-->\u003c/p>\n\u003cp>Hancock said that she wondered if this bill was the \"best way to build community consensus\" around increasing vaccination rates.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Committee chair Carol Liu (D-Glendale) pointedly asked Pan, \"How do you justify the public purpose of public safety and the right for everyone to have access\" to an education.\u003c/p>\n\u003cp>The bill would make California one of only three states -- along with West Virginia and Mississippi -- without a religious or philosophical exemption to vaccination.\u003c/p>\n\u003cp>Only a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/30/vaccine-opt-out-rate-drops-first-time-since-1998-look-up-your-calif-school/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/vaccine-opt-out-rate-drops-first-time-since-1998-look-up-your-calif-school/\" target=\"_blank\">tiny minority of California schoolchildren\u003c/a> -- about 2.5 percent of the state's kindergartners this year -- have a personal belief exemption on file. But parents who support the exemption were out in full force at the hearing, testifying in opposition to the bill, just as they had turned out \u003ca title=\"http://ww2.kqed.org/news/2015/04/07/bill-ending-personal-belief-exemption-for-vaccines-headed-for-key-vote\" href=\"http://ww2.kqed.org/news/2015/04/07/bill-ending-personal-belief-exemption-for-vaccines-headed-for-key-vote\" target=\"_blank\">last week \u003c/a>before the health committee. The health committee had voted 6-2 to advance the bill. Many parents said they would pull their kids out of school rather than meet a vaccine requirement.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/look-up-the-vaccine-opt-out-rate-at-your-childs-school/\">\u003cimg class=\"alignright size-full wp-image-24970\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/lookup.jpg\" alt=\"lookup\" width=\"300\" height=\"151\">\u003c/a>Parents in support of the bill turned out as well, including \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">Marin County father Carl Krawitt\u003c/a>, whose 7-year-old son is in remission from leukemia. The chemotherapy the boy received as treatment wiped out previous vaccine protection. He could not \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">commence revaccination\u003c/a> until February, when his immune system had recovered sufficiently.\u003c/p>\n\u003cp>\"We believe that this is sound public health policy because it keeps our kids safe,\" Krawitt testified. \"You have a duty to legislate from solid evidence, not from fear, and keep our schools safe.\"\u003c/p>\n\u003cp>\u003cstrong>Risk of Backfire?\u003c/strong>\u003c/p>\n\u003cp>But some supporters of vaccinations wonder if the move will backfire. Writing \u003ca title=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" href=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" target=\"_blank\">in the New York Times\u003c/a> about the California bill, Dartmouth government professor Brendan Nyhan referred to the \"blundering approach state legislators there have taken\" and asserted that this \"direct attack on exemptions can rally the anti-vaccine cause.\"\u003c/p>\n\u003cp>Nyhan argued instead in favor of tightening exemption rules, as\u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" target=\"_blank\"> State of Health has previously described\u003c/a>:\u003c/p>\n\u003cul>\n\u003cli>Requiring annual renewal of the personal belief exemption. Right now, parents need only file at kindergarten and seventh grade\u003c/li>\n\u003cli>Require notarization to file the personal belief exemption form\u003c/li>\n\u003cli>For religious exemptions, require a religious leader within the organization to submit a letter on your behalf\u003c/li>\n\u003c/ul>\n\u003cp>But in a phone call late Wednesday afternoon, Pan, the bill's co-author, stood his ground. \"We can't bury our heads and say that nothing is happening in our communities,\" he said. \"We need to have a public debate about what it means to be safe from these deadly diseases.\"\u003c/p>\n\u003cp>He cited the 2010 whooping cough epidemic in California with more than 9,000 cases. Ten infants died. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">Places with higher rates of personal belief exemption\u003c/a> were associated with more cases of whooping cough.\u003c/p>\n\u003cp>The education committee will vote next Wednesday. If approved, it has another committee stop before it would get to the Senate floor. If it passes both those hurdles, it heads over to the Assembly.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/201013686\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24949\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS6837_149948672-e1429144072713.jpg\">\u003cimg class=\"size-large wp-image-24949\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/RS6837_149948672-640x452.jpg\" alt=\"(Kevork Djansezian/Getty Images)\" width=\"640\" height=\"452\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Kevork Djansezian/Getty Images) \u003ccite>(Kevork Djansezian/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>A bill that would eliminate the vaccine personal belief exemption stalled before the Senate Education Committee Wednesday in Sacramento. Lawmakers were deeply concerned that the bill would bar too many children from school. The bill's co-author, Sen. Richard Pan (D-Sacramento), asked the committee to delay a vote until next Wednesday after the committee chairwoman warned him he did not have enough votes to pass.\u003c/p>\n\u003cp>Pan said he will use the time to address their concerns, possibly adding amendments to the bill.\u003c/p>\n\u003cp>Under the bill, \u003ca title=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" href=\"http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\">SB277\u003c/a>, California would no longer permit any vaccine exemptions except a medical one, meaning virtually all children would have to be vaccinated in order to attend public or private school. Even home-schoolers who group together would be affected under the current language, one of the committee's complaints.\u003c/p>\n\u003cp>While several committee members expressed their support for vaccines, they were worried that the bill goes too far. \"I'm looking for the compelling state interest in doing something (this) draconian,\" said state Sen. Loni Hancock (D-Berkeley). \"If I'm reading the bill correctly, there's nothing you can do if you choose not to vaccinate your child,\" except home-school and then only with your own children.\u003c!--more-->\u003c/p>\n\u003cp>Hancock said that she wondered if this bill was the \"best way to build community consensus\" around increasing vaccination rates.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Committee chair Carol Liu (D-Glendale) pointedly asked Pan, \"How do you justify the public purpose of public safety and the right for everyone to have access\" to an education.\u003c/p>\n\u003cp>The bill would make California one of only three states -- along with West Virginia and Mississippi -- without a religious or philosophical exemption to vaccination.\u003c/p>\n\u003cp>Only a \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/30/vaccine-opt-out-rate-drops-first-time-since-1998-look-up-your-calif-school/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/vaccine-opt-out-rate-drops-first-time-since-1998-look-up-your-calif-school/\" target=\"_blank\">tiny minority of California schoolchildren\u003c/a> -- about 2.5 percent of the state's kindergartners this year -- have a personal belief exemption on file. But parents who support the exemption were out in full force at the hearing, testifying in opposition to the bill, just as they had turned out \u003ca title=\"http://ww2.kqed.org/news/2015/04/07/bill-ending-personal-belief-exemption-for-vaccines-headed-for-key-vote\" href=\"http://ww2.kqed.org/news/2015/04/07/bill-ending-personal-belief-exemption-for-vaccines-headed-for-key-vote\" target=\"_blank\">last week \u003c/a>before the health committee. The health committee had voted 6-2 to advance the bill. Many parents said they would pull their kids out of school rather than meet a vaccine requirement.\u003c/p>\n\u003cp>\u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/01/30/look-up-the-vaccine-opt-out-rate-at-your-childs-school/\">\u003cimg class=\"alignright size-full wp-image-24970\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/lookup.jpg\" alt=\"lookup\" width=\"300\" height=\"151\">\u003c/a>Parents in support of the bill turned out as well, including \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">Marin County father Carl Krawitt\u003c/a>, whose 7-year-old son is in remission from leukemia. The chemotherapy the boy received as treatment wiped out previous vaccine protection. He could not \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">commence revaccination\u003c/a> until February, when his immune system had recovered sufficiently.\u003c/p>\n\u003cp>\"We believe that this is sound public health policy because it keeps our kids safe,\" Krawitt testified. \"You have a duty to legislate from solid evidence, not from fear, and keep our schools safe.\"\u003c/p>\n\u003cp>\u003cstrong>Risk of Backfire?\u003c/strong>\u003c/p>\n\u003cp>But some supporters of vaccinations wonder if the move will backfire. Writing \u003ca title=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" href=\"http://www.nytimes.com/2015/04/15/upshot/why-californias-approach-to-tightening-vaccine-rules-could-backfire.html?referrer=&abt=0002&abg=1\" target=\"_blank\">in the New York Times\u003c/a> about the California bill, Dartmouth government professor Brendan Nyhan referred to the \"blundering approach state legislators there have taken\" and asserted that this \"direct attack on exemptions can rally the anti-vaccine cause.\"\u003c/p>\n\u003cp>Nyhan argued instead in favor of tightening exemption rules, as\u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/24/beyond-abolishing-the-personal-belief-exemption-to-raise-vaccination-rates/\" target=\"_blank\"> State of Health has previously described\u003c/a>:\u003c/p>\n\u003cul>\n\u003cli>Requiring annual renewal of the personal belief exemption. Right now, parents need only file at kindergarten and seventh grade\u003c/li>\n\u003cli>Require notarization to file the personal belief exemption form\u003c/li>\n\u003cli>For religious exemptions, require a religious leader within the organization to submit a letter on your behalf\u003c/li>\n\u003c/ul>\n\u003cp>But in a phone call late Wednesday afternoon, Pan, the bill's co-author, stood his ground. \"We can't bury our heads and say that nothing is happening in our communities,\" he said. \"We need to have a public debate about what it means to be safe from these deadly diseases.\"\u003c/p>\n\u003cp>He cited the 2010 whooping cough epidemic in California with more than 9,000 cases. Ten infants died. \u003ca title=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" href=\"http://ww2.kqed.org/stateofhealth/2013/09/30/vaccine-refusals-fueled-california-whooping-cough-epidemic-personal-belief-exemption/\" target=\"_blank\">Places with higher rates of personal belief exemption\u003c/a> were associated with more cases of whooping cough.\u003c/p>\n\u003cp>The education committee will vote next Wednesday. If approved, it has another committee stop before it would get to the Senate floor. If it passes both those hurdles, it heads over to the Assembly.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/201013686&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/201013686'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The Hidden Cost of Mammograms: More Testing and Overtreatment",
"title": "The Hidden Cost of Mammograms: More Testing and Overtreatment",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_24928\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large.jpg\">\u003cimg class=\"size-large wp-image-24928\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large-640x427.jpg\" alt=\"Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" href=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>There's no question mammograms can save lives by detecting breast cancer early. But they can also result in unnecessary testing and treatment that can be alarming and costly.\u003c/p>\n\u003cp>In fact, each year the U.S. spends $4 billion on follow-up tests and treatments that result from inaccurate mammograms, scientists \u003ca href=\"http://content.healthaffairs.org/content/34/4/576.abstract\" target=\"_blank\">report \u003c/a>in the current issue of \u003cem>Health Affairs\u003c/em>.\u003c/p>\n\u003cp>That's a \"stunning number,\" says the study's lead author, Dr. Kenneth Mandl, at Harvard Medical School's Center for Biomedical Informatics.\u003c/p>\n\u003cp>Mandl and a colleague analyzed the insurance records of more than 700,000 women from 2011 to 2013. The women were between the ages of 40 and 59, and they all had routine mammograms to screen for breast cancer during that time period.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>About 11 percent of the women had \"suspicious\" mammograms and were subjected to further testing, including repeat mammograms, ultrasounds and needle biopsies. For nearly all these women — 98.6 percent — cancer was not confirmed in further testing.\u003c/p>\n\u003cp>When Mandl projects this percentage of false alarms to the entire female population over age 40, he estimates that the U.S. spends $2.8 billion each year on follow-up tests for suspicious results that turn out not to be cancer.\u003c/p>\n\u003cp>And even when cancer is detected, some of those tumors might be of low risk to the patient -- slow-growing and not likely to become invasive or life-threatening. But once suspicions are raised, Mandl says, overtreatment is often the result. \"Overtreatment is bad,\" he says. \"That's mastectomy, chemotherapy, radiation, in women who may not have needed any medical treatment at all.\"\u003c/p>\n\u003cp>For example, patients diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024042/\" target=\"_blank\">ductal carcinoma in situ\u003c/a> can face radiation, chemotherapy and even mastectomy despite the fact that the cancer is noninvasive.\u003c/p>\n\u003cp>Mandl estimates that the cost of overtreatment adds up to $1.2 billion each year, resulting in a grand total of $4 billion in unnecessary spending annually.\u003c/p>\n\u003cp>And it's not just the financial cost that's a problem. When a woman receives a suspicious mammogram result, it often creates psychological stress and anxiety, Mandl says.\u003c/p>\n\u003cp>Still, some researchers have issues with Mandl's findings. Dr. Richard Wender, of the American Cancer Society, says the study overestimates the cost of unnecessary testing and incorrect diagnoses. And he says it fails to consider the proven benefits of annual mammograms.\u003c/p>\n\u003cp>\"Mammograms are the most effective way we have to find breast cancer before anybody can feel it, before you're aware of it,\" Wender says.\u003c/p>\n\u003cp>He points to \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961611-0/abstract\" target=\"_blank\">studies\u003c/a> showing that mammograms reduce the risk of dying from breast cancer by 20 percent. \"So whenever we're doing decision-making, either as policymakers or just between one woman and her doctors, it's critical to look at ... benefits as well as downsides,\" he says.\u003c/p>\n\u003cp>The American Cancer Society\u003ca title=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> recommends yearly mammograms\u003c/a> for women starting at age 40. However, the U.S. Preventive Services Task Force \u003ca title=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" href=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" target=\"_blank\">recommends that screenings start later\u003c/a>, at age 50. That's because younger women, between 40 and 49, are more likely to receive false-positive results.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Harvard's Mandl would like to reduce the number of screening mammograms even further. He suggests that screening be based on a woman's overall risk factors for breast cancer, including family history, obesity and breast density, as well as age.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_24928\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large.jpg\">\u003cimg class=\"size-large wp-image-24928\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/04/iStock_000016019343_Large-640x427.jpg\" alt=\"Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\" width=\"640\" height=\"427\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Instead of having mammograms according to age, some doctors think screening should be based on a woman's overall risk for breast cancer. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Patti Neighmond,\u003c/strong> \u003ca title=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" href=\"http://www.npr.org/blogs/health/2015/04/13/398818949/the-hidden-cost-of-mammograms-more-testing-and-overtreatment\" target=\"_blank\">NPR\u003c/a>\u003c/p>\n\u003cp>There's no question mammograms can save lives by detecting breast cancer early. But they can also result in unnecessary testing and treatment that can be alarming and costly.\u003c/p>\n\u003cp>In fact, each year the U.S. spends $4 billion on follow-up tests and treatments that result from inaccurate mammograms, scientists \u003ca href=\"http://content.healthaffairs.org/content/34/4/576.abstract\" target=\"_blank\">report \u003c/a>in the current issue of \u003cem>Health Affairs\u003c/em>.\u003c/p>\n\u003cp>That's a \"stunning number,\" says the study's lead author, Dr. Kenneth Mandl, at Harvard Medical School's Center for Biomedical Informatics.\u003c/p>\n\u003cp>Mandl and a colleague analyzed the insurance records of more than 700,000 women from 2011 to 2013. The women were between the ages of 40 and 59, and they all had routine mammograms to screen for breast cancer during that time period.\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>About 11 percent of the women had \"suspicious\" mammograms and were subjected to further testing, including repeat mammograms, ultrasounds and needle biopsies. For nearly all these women — 98.6 percent — cancer was not confirmed in further testing.\u003c/p>\n\u003cp>When Mandl projects this percentage of false alarms to the entire female population over age 40, he estimates that the U.S. spends $2.8 billion each year on follow-up tests for suspicious results that turn out not to be cancer.\u003c/p>\n\u003cp>And even when cancer is detected, some of those tumors might be of low risk to the patient -- slow-growing and not likely to become invasive or life-threatening. But once suspicions are raised, Mandl says, overtreatment is often the result. \"Overtreatment is bad,\" he says. \"That's mastectomy, chemotherapy, radiation, in women who may not have needed any medical treatment at all.\"\u003c/p>\n\u003cp>For example, patients diagnosed with \u003ca href=\"http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024042/\" target=\"_blank\">ductal carcinoma in situ\u003c/a> can face radiation, chemotherapy and even mastectomy despite the fact that the cancer is noninvasive.\u003c/p>\n\u003cp>Mandl estimates that the cost of overtreatment adds up to $1.2 billion each year, resulting in a grand total of $4 billion in unnecessary spending annually.\u003c/p>\n\u003cp>And it's not just the financial cost that's a problem. When a woman receives a suspicious mammogram result, it often creates psychological stress and anxiety, Mandl says.\u003c/p>\n\u003cp>Still, some researchers have issues with Mandl's findings. Dr. Richard Wender, of the American Cancer Society, says the study overestimates the cost of unnecessary testing and incorrect diagnoses. And he says it fails to consider the proven benefits of annual mammograms.\u003c/p>\n\u003cp>\"Mammograms are the most effective way we have to find breast cancer before anybody can feel it, before you're aware of it,\" Wender says.\u003c/p>\n\u003cp>He points to \u003ca href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2812%2961611-0/abstract\" target=\"_blank\">studies\u003c/a> showing that mammograms reduce the risk of dying from breast cancer by 20 percent. \"So whenever we're doing decision-making, either as policymakers or just between one woman and her doctors, it's critical to look at ... benefits as well as downsides,\" he says.\u003c/p>\n\u003cp>The American Cancer Society\u003ca title=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" href=\"http://www.cancer.org/healthy/findcancerearly/cancerscreeningguidelines/american-cancer-society-guidelines-for-the-early-detection-of-cancer\" target=\"_blank\"> recommends yearly mammograms\u003c/a> for women starting at age 40. However, the U.S. Preventive Services Task Force \u003ca title=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" href=\"http://www.uspreventiveservicestaskforce.org/Page/Topic/recommendation-summary/breast-cancer-screening\" target=\"_blank\">recommends that screenings start later\u003c/a>, at age 50. That's because younger women, between 40 and 49, are more likely to receive false-positive results.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Harvard's Mandl would like to reduce the number of screening mammograms even further. He suggests that screening be based on a woman's overall risk factors for breast cancer, including family history, obesity and breast density, as well as age.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_24787\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-e1427821121824.jpg\">\u003cimg class=\"size-large wp-image-24787\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/03/RS729_farms0613-21-640x428.jpg\" alt=\"(David McNew/Getty Images)\" width=\"640\" height=\"428\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Advocates say the San Joaquin Valley Air District should focus on sources it can control, like farming machinery. (David McNew/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alice Daniel\u003c/strong>\u003c/p>\n\u003cp>California’s Central Valley grapples with some of the dirtiest air in the nation. The culprits range from its vast agriculture industry to trucks on Highway 99. But one local air district is tagging a source far away: Asia.\u003c/p>\n\u003cp>“The world in so many ways is getting smaller in respect to what we always thought was our own backyard issue: ozone,” says David Lighthall, the health science advisor for the San Joaquin Valley Air Pollution Control District.\u003c/p>\n\u003cp>Lighthall is one of the organizers of an \u003ca title=\"http://www.valleyair.org/topc/\" href=\"http://www.valleyair.org/topc/\" target=\"_blank\">ozone pollution conference\u003c/a> starting Tuesday where scientists from California, China, Colorado and other places will discuss trends in global ozone.\u003c/p>\n\u003cp>Scientists say pollutants from fast-growing Asian countries like China are blowing across the Pacific Ocean and increasing ozone levels in vulnerable areas that include parts of California. But how much of a difference that foreign -- or \"transboundary\" -- ozone makes in the Central Valley is debatable.\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Lighthall says that on some days this additional pollution is enough to prevent the district from meeting federal clean air health standards. The Valley's bowl-shaped geography traps pollutants, sometimes for days at a time -- and that includes pollutants from other places, Lighthall says.\u003c/p>\n\u003cp>He says there's an \"upward trend\" in transboundary ozone and the ozone is now \"mixing down and really making a difference on certain days as to whether we actually meet the standard ... or whether we don’t meet it,” Lighthall says.\u003c/p>\n\u003cp>[soundcloud url=\"https://api.soundcloud.com/tracks/198583646\" params=\"color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false\" width=\"100%\" height=\"166\" iframe=\"true\" /]\u003c/p>\n\u003cp>But the EPA disagrees. It says that on the Valley’s worst air days, most ozone pollution comes from local sources. In fact, last year the air district unsuccessfully petitioned the EPA to exempt it from penalties for violating a health standard blaming it on smog from Asia.\u003c/p>\n\u003cp>Some local health advocates say the air district is straying too far from home.\u003c/p>\n\u003cp>“The air district is famous for looking for loopholes,” says Delores Weller, director of the Central Valley Air Quality Coalition, an advocacy group.\u003c/p>\n\u003cp>She says the district is focusing on sources it can’t control and should do everything it can first to tackle homegrown pollution.\u003c/p>\n\u003cp>“It would be great to see an agriculture, farming operations and air pollution conference based here in the Valley as opposed to a trans-boundary ozone conference,” Weller says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the air district says it must research all sources of air pollution to know exactly what it’s dealing with and how best to mitigate. It’s even \u003ca title=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" href=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" target=\"_blank\">funding research at U.C. Davis \u003c/a>to assess the effects of ozone from Asia.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Lighthall says that on some days this additional pollution is enough to prevent the district from meeting federal clean air health standards. The Valley's bowl-shaped geography traps pollutants, sometimes for days at a time -- and that includes pollutants from other places, Lighthall says.\u003c/p>\n\u003cp>He says there's an \"upward trend\" in transboundary ozone and the ozone is now \"mixing down and really making a difference on certain days as to whether we actually meet the standard ... or whether we don’t meet it,” Lighthall says.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cdiv class='utils-parseShortcode-shortcodes-__shortcodes__shortcodeWrapper'>\n \u003ciframe width='100%' height='166'\n scrolling='no' frameborder='no'\n src='https://w.soundcloud.com/player/?url=https://api.soundcloud.com/tracks/198583646&visual=true&color=ff5500&auto_play=false&hide_related=false&show_comments=true&show_user=true&show_reposts=false'\n title='https://api.soundcloud.com/tracks/198583646'>\n \u003c/iframe>\n \u003c/div>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But the EPA disagrees. It says that on the Valley’s worst air days, most ozone pollution comes from local sources. In fact, last year the air district unsuccessfully petitioned the EPA to exempt it from penalties for violating a health standard blaming it on smog from Asia.\u003c/p>\n\u003cp>Some local health advocates say the air district is straying too far from home.\u003c/p>\n\u003cp>“The air district is famous for looking for loopholes,” says Delores Weller, director of the Central Valley Air Quality Coalition, an advocacy group.\u003c/p>\n\u003cp>She says the district is focusing on sources it can’t control and should do everything it can first to tackle homegrown pollution.\u003c/p>\n\u003cp>“It would be great to see an agriculture, farming operations and air pollution conference based here in the Valley as opposed to a trans-boundary ozone conference,” Weller says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>But the air district says it must research all sources of air pollution to know exactly what it’s dealing with and how best to mitigate. It’s even \u003ca title=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" href=\"http://www.latimes.com/science/la-me-pacific-smog-20150201-story.html#page=1\" target=\"_blank\">funding research at U.C. Davis \u003c/a>to assess the effects of ozone from Asia.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Frontline aired an updated version of its 2008 documentary \u003ca title=\"http://www.pbs.org/wgbh/pages/frontline/\" href=\"http://www.pbs.org/wgbh/pages/frontline/\" target=\"_blank\">The Vaccine War\u003c/a> on Tuesday night. The film dives deep into the debate over vaccines. While the overwhelming majority of parents vaccinate their children, a small but growing minority either under-vaccinate their children or refuse vaccines altogether.\u003c/p>\n\u003cp>The debate has taken a new turn in the wake of the measles outbreak which started in Disneyland in December. Public health officials believe a still-unknown person infected with measles visited the park and spread it to others. As the outbreak took hold, a new front in the debate grew: that of people who are immune-compromised.\u003c/p>\n\u003cp>State of Health \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">first told the story of Carl Krawitt\u003c/a> the father of 7-year-old Rhett who was diagnosed with leukemia when he was two and a half. Because of the treatments Rhett underwent to fight his disease, prior vaccine protection was wiped out, and he had to wait until he had been in remission for a year \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">before his vaccines could begin again\u003c/a>. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.\u003c/p>\n\u003cp>Frontline producers told the story of Rhett's family in The Vaccine War.\u003c/p>\n\u003cp>Now, it's your turn. On Wednesday (March 25) at noon PT, Frontline is hosting a live chat, and I'm honored to be the moderator. 'Vaccine War' producer and director Kate McMahon will take your questions, along with Carl Krawitt, and Dr. Arthur Reingold, Head of Epidemiology at the UC Berkeley School of Public Health.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Feel free to leave a question now and please join us at noon for the chat!\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ciframe src=\"http://wwwssl.coveritlive.com/embed.html?altcastCode=0fc95ef8b6&srcdom=www.coveritlive.com&srcdomsec=wwwssl.coveritlive.com&height=550&entryLoc=top&commentLoc=top&titlePage=off&replayContentOrder=chronological&embedType=stream&titleImage=%2Ftemplates%2Fcoveritlive%2Fimages%2FbuildPage%2FNewsImage.jpg\" style=\"width:100%;height:550px\" height=\"550px\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_23614\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-e1422076915312.jpg\">\u003cimg class=\"size-large wp-image-23614\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2015/01/495311669-640x456.jpg\" alt=\"A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\" width=\"640\" height=\"456\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A dose of measles, mumps, rubella vaccine, known commonly as MMR. (Joe Raedle/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Frontline aired an updated version of its 2008 documentary \u003ca title=\"http://www.pbs.org/wgbh/pages/frontline/\" href=\"http://www.pbs.org/wgbh/pages/frontline/\" target=\"_blank\">The Vaccine War\u003c/a> on Tuesday night. The film dives deep into the debate over vaccines. While the overwhelming majority of parents vaccinate their children, a small but growing minority either under-vaccinate their children or refuse vaccines altogether.\u003c/p>\n\u003cp>The debate has taken a new turn in the wake of the measles outbreak which started in Disneyland in December. Public health officials believe a still-unknown person infected with measles visited the park and spread it to others. As the outbreak took hold, a new front in the debate grew: that of people who are immune-compromised.\u003c/p>\n\u003cp>State of Health \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" href=\"http://ww2.kqed.org/stateofhealth/2015/01/26/not-vaccinated-stay-home-from-school-says-marin-dad-of-leukemia-patient/\" target=\"_blank\">first told the story of Carl Krawitt\u003c/a> the father of 7-year-old Rhett who was diagnosed with leukemia when he was two and a half. Because of the treatments Rhett underwent to fight his disease, prior vaccine protection was wiped out, and he had to wait until he had been in remission for a year \u003ca title=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" href=\"http://ww2.kqed.org/stateofhealth/2015/02/13/parents-relieved-as-son-gets-first-post-leukemia-vaccines/\" target=\"_blank\">before his vaccines could begin again\u003c/a>. The Krawitt family has been arguing that those unvaccinated by choice should not be able to attend public school.\u003c/p>\n\u003cp>Frontline producers told the story of Rhett's family in The Vaccine War.\u003c/p>\n\u003cp>Now, it's your turn. On Wednesday (March 25) at noon PT, Frontline is hosting a live chat, and I'm honored to be the moderator. 'Vaccine War' producer and director Kate McMahon will take your questions, along with Carl Krawitt, and Dr. Arthur Reingold, Head of Epidemiology at the UC Berkeley School of Public Health.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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