HEALTH NEWS
Arthritis Symptoms Worse in African Americans
By Marie Love Darbouze (Allabh Staff Writer)
A study published in the Journal of Rheumatology, April 2005, reveals that African Americans suffering of rheumatoid arthritis report more severe disease and more disability than whites.
African-Americans and Caucasians did not differ however with respect to age, sex, disease duration, rheumatoid factor positivity, and medication compliance.
The pilot study shows that African-Americans had higher scores than Caucasians for HAQ (Health Assessment Questionnaire) and DAS (Disease Activity Score) in this sample of patients analyzed from an academic medical center practice (Washington University School of Medicine in St. Louis, MO).
The average Health Assessment Questionnaire score for the African Americans was 1.5, compared to 0.9 for the Caucasians. Mean Disease Activity Scores were 5.5 for blacks and 4.3 for whites. And pain perception scores and number of tender joints were nearly double for blacks compared with whites.
"Clinicians have to recognize that the severity of disease with rheumatoid arthritis in our culture in 2005 tends to be worse in African Americans. First of all we need to recognize that, and second we need to think about what we can do to improve that," Dr. Richard Brasington of the Washington University School of Medicine in St. Louis, the study's lead author, told Reuters Health.
Source: Journal of Rheumatology, April 2005
Reviewed By Carl Gilbert, M.D.
Earlier Cancer Tests Urged for Blacks
By Carl Gilbert, MD (Allabh Staff Writer)
March 29, 2005 -African Americans should be screened for colorectal cancer beginning at age 45 — five years earlier than other people, according to new guidelines issued by the American College of Gastroenterology.
The recommendation stems from earlier findings that African Americans are more prone to have earlier onset of the disease and higher incidence and mortality rates of colon cancer as compared to whites.
The new guidelines are published in the March edition of the American Journal of Gastroenterology. They state that most African Americans should undergo a colonoscopy every 10 years beginning at age 45. A colonoscopy allows physicians to visually examine the entire colon and remove polyps that might turn cancerous. African Americans tend to be diagnosed with colorectal cancer at a younger age than whites. A 2001 study found that 10.6 percent of African Americans with colorectal cancer were diagnosed before age 50, compared with 5.5 percent of whites.
Cancer of the colon or rectum is the third most common type of cancer in African American men and the second most common type in African American women. African American men were 10 percent more likely to have been diagnosed with colorectal cancer than white men from 1997 to 2001, according to the American Cancer Society (ACS). African American women were 20 percent more likely than white women to have been diagnosed with the disease.
According to the ACS, about 16,090 new cases of colorectal cancer will be diagnosed among African Americans this year.
Obesity and cigarette smoking increase the risk for the disease. Exercise, a healthy diet, hormone replacement therapy, anti-inflammatory drugs and screening with removal of polyps are believed to provide protection from colorectal cancer, the ACS says. Lack of access to healthcare is one of the reasons believed to cause delay in early cancer detection and removal of colonic polyps which are potential sources of colon cancer.
The average cost of a colonoscopy is about $650, and it may sometimes be twice as high, ancillary costs not being included.
Despite the new recommendations, experts say it is unlikely that insurers will soon pay for widespread earlier testing. It took many years and pressure from several cancer groups before insurance companies and Medicare began paying for colonoscopies.
Sources: American journal of Gastroenterology, March 2005 Issue; American Cancer Society
Related Topic: Colon Cancer Screening Low in African Americans
HIV Infection Rate Among Blacks Doubles
By JEFF DONN, Associated Press Writer Health - AP
Fri Feb 25, 2005 ; 4:39 PM ET
BOSTON - The HIV infection rate has doubled among blacks in the United States over a decade while holding steady among whites — stark evidence of a widening racial gap in the epidemic, government scientists said Friday.
Other troubling statistics indicate that almost half of all infected people in the United States who should be receiving HIV drugs are not getting them.
The findings were released in Boston at the 12th Annual Retrovirus Conference, the world's chief scientific gathering on the disease.
"It's incredibly disappointing," said Terje Anderson, director of the National Association of People With AIDS . "We just have a burgeoning epidemic in the African American community that is not being dealt with effectively."
Researchers and AIDS prevention advocates attributed the high rate among blacks to such factors as drug addiction, poverty and poor access to health care.
The HIV rates were derived from the widely used National Health and Nutrition Examinations Surveys, which analyze a representative sample of U.S. households and contain the most complete HIV data in the country. Researchers at the Centers for Disease Control and Prevention compared 1988-1994 data with figures from 1999-2002.
The surveys look only at young and middle-aged adults who live in households, excluding such groups as soldiers, prisoners and homeless. Thus, health officials believe the numbers probably underestimate true HIV rates in this country.
Still, they show a striking rise in the prevalence of the AIDS virus from 1 percent to 2 percent of blacks. White rates held steady at 0.2 percent. Largely because of the increase among blacks, the overall U.S. rate rose slightly from 0.3 percent to 0.4 percent.
Smaller studies had shown rising infection rates among blacks in recent years, but this study takes a longer and more complete look at changes in the general population.
"I think it's very concerning," said Dr. Susan Buchbinder, who leads HIV research for the city of San Francisco. "I think what we need to look at is how we can reduce those rates and get more people into treatment."
She recommended a stronger focus on treating drug addiction.
The lead CDC researcher, Geraldine McQuillan, said she was encouraged to see the HIV rate among younger blacks holding steady at just under 1.5 percent.
"It tells me we're making some headway," she said.
Other national data and published reports studied by the CDC showed that 480,000 HIV-infected people ages 15 to 49 should have been getting antiviral drugs in 2003, yet only 268,000, or 56 percent, were given such medication.
Researcher Eyasu Teshale of the CDC said the gap represents "a substantial unmet health care need."
Treatment is widely viewed as a central component in prevention. Powerful AIDS drugs that came into wide use in the mid-1990s can knock down levels of the virus in the body, reducing the chances that the patient will infect others.
Nearly 1 million people in the United States have contracted the AIDS virus since the outbreak began in the early 1980s. About 40,000 people test positive each year, and more than 18,000 die. However, U.S. infections have remained fairly level in recent years with the use of powerful HIV drugs.
Related Topic: U.S.: HIV Cases Soaring Among African-American Women