Medicaid patients who were mailed FITs more likely to complete them | Fecal occult blood tied to elevated all-cause mortality risk | Tenofovir may reduce hepatocellular carcinoma risk in patients with HBV
July 18, 2018
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A study of Medicaid patients showed that those who received fecal immunochemical tests in the mail were more likely to complete colorectal cancer screening than those who were just reminded. Colorectal cancer is more treatable if caught early, but only about 63% of the population is screened, and the rate drops further among vulnerable and lower-income patients, said Alison Brenner of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill, who led the study.
Patients with detectable fecal hemoglobin or a positive guaiac fecal occult blood test result face a higher risk of dying from colorectal cancer, as well as a 58% greater risk of all-cause mortality, compared with those who had a negative test result, according to a study in Gut. The findings were based on data for 134,192 patients ages 50 to 74 years who had gFOBt from March 29, 2000, to March 29, 2016.
The risk for hepatocellular carcinoma in patients with chronic hepatitis B was greatly reduced by treatment with tenofovir disoproxil, according to a study led by Mindie Nguyen, professor of medicine in the division of gastroenterology and hepatology at Stanford University Medical Center. The eight-year study of hundreds of patients showed the reduction affected cirrhotic and noncirrhotic patients.
The mortality rate in the US linked to liver cancer was 43% higher in 2016 than in 2000, while the overall cancer-related mortality rate declined, according to the CDC. The liver cancer death rate rose across all cohorts except Asians and Pacific Islanders, and the increase is related to rising rates of obesity and hepatitis C infections, said Farhad Islami of the American Cancer Society.
Five Democratic lawmakers sent a letter to HHS Secretary Alex Azar and CMS Administrator Seema Verma urging them to reverse their decision to suspend Affordable Care Act risk adjustment payments to insurers. The suspension will "further destabilize the individual and small group markets that millions of Americans rely on for health insurance" and it could force insurers to leave the individual markets or raise premiums, they wrote.
A bundle of bills aimed at expanding health savings accounts and reducing employer health benefit costs passed out of the House Ways and Means Committee and moved to the full US House for consideration. The package includes bills that add health treatments, services and over-the-counter drugs to allowable HSA expenses, and expand the definition of high-deductible health plans to include Affordable Care Act bronze and catastrophic plans.
Gastroenterologists should look at new innovations such as advanced EHR systems to improve workflow as the industry moves toward value-based care, said Dr. Arnold Levy, an adviser to gMed. Value-based care emphasizes patient outcomes, so more information provided by the physician makes it easier to measure the care against national registries, Levy said.
An NEJM Catalyst survey of health care executives, clinical leaders and clinicians showed 76% consider costs to a practice or system when making clinical decisions, 72% consider patient out-of-pocket costs and 68% consider total cost of care. Sectors with the biggest effect on health costs included pharmaceutical/biotech, listed by 87% of respondents, and hospitals, health systems and physician organizations, listed by 75%.
Gastroenterology procedures are expected to be the fastest-growing segment of the ambulatory surgical center market, according to a Future Market Insights report. The compound annual growth rate for gastroenterology is expected to be 4.7% through 2027, with growth taking place in North America, Latin America, Japan, the Asia-Pacific region and Europe.
GI training programs have areas of need that are covered in a variety of ways, including inviting outside speakers to help fill those gaps. Now you can have the ACG come to you, and have a well-known national expert spend time with your fellows. You choose the speaker, ACG covers honoraria and travel expenses for the visiting professor. Learn more and apply today for the 2019 ACG Edgar Achkar Visiting Professorships. Deadline: Friday, July 20.
The next Special Issue of The American Journal of Gastroenterology will focus on the gut microbiome. AJG requests your high-quality, clinically relevant research about the role of the microbiome in all areas of gastroenterology and hepatology. Submit your manuscripts by Aug. 15, 2018, and be sure to indicate in your cover letter that your manuscript is intended for the Special Issue on the microbiome. Depending upon response, some accepted manuscripts may be published in other issues of AJG. Send questions to Managing Editor Lindsey Topp.