Top news of the day from across the health care landscape.
New recommendations by the US Preventive Services Task Force advise against screening for thyroid cancer in patients without symptoms because the risks outweigh the benefits. Catching cancer early can be lifesaving, but the task force concludes that screening for thyroid cancer can often backfire, and almost always detects cancers that would never turn into life-threatening tumors, according to NPR. Once tumors are detected, surgeons will typically remove the thyroid gland. However, this surgery can have significant adverse events, including severed nerves that control speech and swallowing, or the removal of the parathyroid gland, which regulates calcium. Furthermore, patients are placed on a thyroid hormone for the rest of their lives. “If you look early, you just find a whole new category of patients that has the disease but is never going to suffer from it at all,” Dr Gilbert Welch, Dartmouth Institute for Health Policy and Clinical Practice, told NPR. “But they will suffer from the treatment.”
Although it is well-known that nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with heart risks, a new study published in BMJ found these risks can occur within just 1 week of starting treatment. The investigators conducted a systematic review of studies that included more than 446,000 patients aged 40 to 79 years, of whom more than 61,000 had heart attacks. Of the patients who used NSAIDs 1 to 7 days, the risk of heart attack increased 24% for celecoxib (Celebrex), 48% for ibuprofen, 50% for diclofenac (Voltaren), and 53% for Aleve, the New York Times reported. Rofecoxib (Vioxx), which was removed from the market in 2004 for cardiovascular risks, increased 58%. The study concluded that the duration of treatment, as well as higher doses increases the risk of heart complications, but there was no significant increase after 1 month of treatment. The authors noted that the absolute increase in risk is small, but that patients should speak with their physicians and be aware of their own baseline cardiovascular risk.
The adverse events (AEs) of statins may be caused by psychological factors rather than the cholesterol-lowering drugs themselves, according to the NY Times. In a study published in The Lancet, investigators examined more than 10,000 patients randomized to receive either atorvastatin (Lipitor) or a placebo. For an average of more than 3 years, the investigators tracked reports of more than 2 dozen different AEs. The results showed that although patients who used statins reported slightly more renal and urinary AEs, there were no real differences in AEs between the 2 groups. Patients were then told whether they were taking a statin or placebo, and over the course of 3 years, the investigators tracked 6409 patients who continued the regimen and 3490 who did not take any statins. Once patients knew whether they were taking statins or the placebo, patients administered statins reported a 41% higher rate of muscle pain or weakness than those on placebo. The authors noted that the reported muscle pain is real, but it may have little to do with the drug itself, the NY Times reported. “It’s a real phenomenon that if you’re aware of a problem with a drug, you’re more likely to complain about it,” senior author Dr Peter Sever said in the report.