Mortality and Medicine: 6 New Findings

Skin Cancer Screening Recommendation Updated.

There is not enough current evidence to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults, the US Preventive Services Task Force determined. However, there is clear potential for harm, including a high rate of unnecessary biopsies and adverse effects and the risk of overdiagnosis and overtreatment. The USPSTF estimated that in 2016, melanoma will develop in 76,400 US men and women and 10,100 will die from it.

JAMA, July 26, 2016

Melanoma Screening Matchup: Primary Care vs Dermatology.

The USPSTF review showed limited evidence on the link between skin cancer screening and mortality, although there was a statistically significant relationship between the degree of disease involvement at diagnosis and melanoma mortality in 8 cohort studies. In 2 studies of visual skin examination, sensitivity to detect melanoma and specificity were 40.2% and 86.1%, respectively, when conducted by primary care physicians and 49.0% and 97.6%, respectively, when performed by dermatologists.

JAMA, July 26, 2016

Physical Inactivity Risks Mortality in Long Follow-up Study.

Low aerobic capacity expressed as predicted Formula was associated with higher all-cause mortality in middle-aged men, independent of established cardiovascular risk factors (smoking, high blood pressure, high serum cholesterol), during 45 years of follow-up. The population-based prospective cohort study shows that physical inactivity is the second leading risk factor for mortality. Smoking is the first.

European Journal of Preventive Cardiology, July 26, 2016

High BMI Does Not Elevate Cardiovascular and Death Risks.

Higher BMI is associated with the onset of diabetes but not with an increased risk of myocardial infarction or death, according to a study of genetic confounding in these associations that involved monozygotic twin pairs. Lower percentages of MIs and deaths occurred in heavier twins than in leaner twins. The authors suggested that lifestyle interventions to reduce obesity may be more effective in decreasing diabetes risk than cardiovascular disease or death risk.

JAMA Internal Medicine, August 1, 2016

Meat and Mortality: Protein Source Makes the Difference.

High animal protein intake was positively associated with mortality and high plant protein intake was inversely associated, especially among persons who had at least 1 lifestyle risk factor. In a prospective cohort study of US health care professionals, substitution of plant protein for animal protein, especially from processed red meat, was linked with lower mortality, suggesting the importance of the source of protein.

JAMA Internal Medicine, August 1, 2016

Improved Survival in Patients Hospitalized with Heart Failure.

Hospitalizations for heart failure with preserved ejection fraction (HFpEF) are up, but the in-hospital mortality rate is down. Study patients hospitalized with HFpEF were older and more often female than those with reduced ejection fraction and had a high burden of comorbidities. Pulmonary circulation disorders, liver disease, and chronic renal failure were independent predictors of in-hospital mortality. Treatable diseases-hypertension, coronary artery disease, and diabetes-were inversely associated.

American Journal of Medicine, June 2016