Katie Jones's Blog

Katie is from Cedar Rapids, Iowa. She graduated from Grinnell College with a BA in History. She is a second year Master of Public Health student in the Community and Behavioral Health department at the University of Iowa. She works for the MPH Department and for the Iowa Cancer Consortium. She is interested in many public health topics, including health disparities, chronic disease prevention, sexual assault and domestic violence prevention, and health communication. In her spare time, she enjoys cycling and playing board games with friends.

This student blog is unedited and does not necessarily reflect the views of the College of Public Health or the University of Iowa.

Showing posts with label screening. Show all posts
Showing posts with label screening. Show all posts

Wednesday, April 4, 2012

Cancer Complexity

Lately I've been reading a lot of articles complicating the idea that finding cancer early is always a good thing. For example, I just read this NPR article about a Norwegian study that found that mammography can lead to the "over-diagnosis" of breast cancer by finding a tumor "that would never have gone on to cause symptoms or death." This is somewhat similar to some of the criticisms of the P.S.A. test for prostate cancer, which caused a lot of men to get treated for prostate cancer when they likely would have died of something else before the prostate cancer caused any problems.

It seems like the critiques of these screening tests go beyond whether or not the screening tests have high enough specificity and sensitivity (both concepts I first learned about in an epidemiology class here!), and have more to do with the nature of the cancers themselves. It's an interesting idea to me that may be some types of cancers aren't as well-suited for a screening test, since finding them early doesn't lower mortality. Apparently that's the cause with testicular cancer, which, according to the Mayo Clinic, is "highly treatable at all stages, so finding testicular cancer early doesn't make a cure more likely." Judging from this new Norwegian study and from other recent studies, it sounds like with breast cancer, there may some types of breast cancer that are good to find early while there are a few types of breast cancer that might not have the same benefits to being found early.

All of this adds a lot of complexity to an already complicated health problem. The fact that even within a kind of cancer there may be some types that benefit to screening while other types don't is really complicated to communicate to patients. I think generally speaking it's still very much agreed that the mammography, the Pap test, and the various kinds of colorectal cancer screening tests are still good and important to do. One harm of these findings is that it may lead people to not get screening tests done, since they figure "What's the point?", when in reality these screening tests still save lives.

Anyway, that's just been on my brain lately!

I should also note that April is Sexual Assault Awareness Month and there are a lot of great events coming up if you're in the Iowa City area. I know I'll definitely be going to the Take Back the Night rally and the Clothesline Project.

And this is an article my friend showed me that I read recently that was interesting: White Until Proven Black: Imagining Race in the Hunger Games - Anna Holmes, The New Yorker
This doesn't have to do with health; it's about race in books (specifically the Hunger Games but it branches out from there). I'm a fan of the Hunger Games and was really disturbed by some of the racist responses to the casting in the movie and I thought this article explored what those responses mean.

Thursday, November 3, 2011

Back from DC!

I got back from the American Public Health Association conference yesterday, which was held in DC this year. The trip was really fun! I still can't get over how great it is that the MPH program and CBH department basically paid for the whole trip (airfare/travel, registration, and hotel); it's definitely pretty wonderful to get the opportunity to DC for free and be around public health leaders.

Like last year's conference (and most conferences in general, I think), some of the sessions were excellent while others were more so-so. I've found that it seems like most of the sessions are very focused on researching health problems, which, while obviously very important, can be a little frustrating if you're working in an implementation/practitioner capacity. It's always great to learn new things though, and it was fun hanging out with other MPH students and one of my coworkers. It was also nice to see DC again (I hadn't been there since I was in elementary school). One of the highlights of the trip was going to Sprinkles, a cupcake shop that has ridiculously good cupcakes! It was also kind of cool to see Occupy DC (which was set up very close to my hotel).




















One of the most amusing things at the conference - an exhibit had ties for sale with disease patterns.

Here are some articles I've read recently that I've thought were interesting:

Native Foster Care: Lost Children, Shatter Families - Laura Sullivan and Amy Walters (NPR)
Absolutely heartbreaking story about how Native American children are disproportionately taken from their homes and put into foster care.

Her Name is Jahessye Shockley. - Francie Latour (The Hyphenated Life) 
A sad and well-written article about how missing white children get way more media attention (and donations) than missing children of color.

The Birth Control Solution - Nicholas D. Kristof (NYT Op-ed)
A simple case for increased birth control. It's hard to argue with this logic, even if you are pro-life.

What's Luck Got To Do With It? - Jim Collins and Morten T. Hansen (NYT essay)
An interesting article on luck and "return on luck."

Informed Patient: A New Push to Prevent Infections in Cancer Patients - WSJ Health Blog 
About the CDC's new campaign and website.

Mammogram's Role of Savior is Tested - Tara Parker-Pope (NYT Well)
Interesting article about mammograms. It seems that recently there's been more discussion on the potential downsides of various cancer screening tests. Even though this article was interesting, I have to say I'm still a big supporter of mammography - it still has been proven to save lives.

Wednesday, October 12, 2011

Early Detection

My friends joke that all I do is talk about cancer, and here I am - talking about cancer again. But big things have just happened in the cancer world! The United States Preventive Services Task Force (USPSTF) recently decided to not recommend using the P.S.A. test on healthy men to screen for prostate cancer. This decision came after the USPSTF reviewed five clinical trials that showed that the P.S.A. test often results in tests that cause needless complications and that it does not lower mortality. This is a controversial decision for some, especially since there are many men who believe the P.S.A. test saved their life and there are a number of groups who advocate for increased use of the P.S.A. test.

I think this article, the Shortfalls of Early Cancer Detection, brings up some very interesting points, in light of this new decision. Harris states that "scientists had found cancer cells in the blood of patients with seemingly tiny, localized cancers, suggesting that cancer cells could spread silently early in the course of disease. In that case, so-called early detection might not really be early, or of much value. Researchers coined the term 'biological predeterminism' to underscore how the cellular makeup of a given cancer — rather than when it was found — was most important in determining survival." (emphasis mine).

Early detection is a central part of cancer control, and I think it should continue be, especially for the cancers we have effective and proven-beneficial screening tests for (breast, cervical, and colorectal). With these three caners, early detection does make an impact on mortality, and increasing the use of the evidence-based screening tests is an important way to control cancer. But I think Harris makes a good point that maybe for some cancers, finding it early doesn't lead to decreased mortality, and that needs to be taken into account when considering which best course of action to take in terms of research. Although I think for some cancers, like lung especially, the development of an effective screening test would be very beneficial and could lower mortality, maybe there are other cancers where finding it early wouldn't necessarily lower mortality. Maybe for those cancers, a different route needs to be taken, like developing alternative treatments that are more effective.

Anyway, enough about cancer. I'm looking forward to this weekend. I'll be going to see the Old Capitol City Roller Girls play their last bout of the season, the Monster's Brawl. The Roller Girls and some people attending will be wearing costumes, so that should be fun!

Here are some other articles I've read recently that you might be interested in:

Domestic Violence Law Repealed by Lawmakers in Topeka, Kansas - John Hanna, Huffington Post
Pretty upsetting.

Sexy Breast Cancer Ads: Provocative or Patronizing? - Kate Dailey, Daily Beast
I am not a big fan of sexy breast cancer ads and I think Dailey does a nice job of summing up some reasons why - the main one being that it can detract people from the fact that breast cancer affects real people, and the reason we should care isn't to "save second base," but rather to save people.

First Lady Targets World Record for Jumping Jacks - AP
Gotta love Michelle Obama. I think this is pretty fun.

Friday, October 7, 2011

The Mammotives Project Begins!



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The Iowa Cancer Summit just launched their social media campaign project, which is funded by the American Cancer Society, to help understand why women decide to get - or not get - screened for breast cancer. The project is call Mammotives. In addition to Mammotives.org, Mammotives is on Facebook and Twitter. All Iowa women, ages 40+, are welcome to join the conversation. Please spread the word too! We want to reach as many Iowa women age 40 and older as possible. For more information about the project in general, click here.   


I'm really excited for this project, which has been planned by my coworker Kelly Sittig, fellow MPH student Megan Lessard, and people at the American Cancer Society, along with other partners at the Iowa Department of Public Health and the Care For Yourself Program. Although I haven't been very involved in this project, my one claim to fame is that I helped come up with the name! Full disclosure: this awesome website, Wordriod, helped. Wordriod creates a bunch of natural-sounding new words based on what you type in and checks to see if they already exist on the internet. It's really fun!

Monday, September 19, 2011

Iowa's Colorectal Cancer Dialogue

Last Friday, I went to Iowa's first Colorectal Cancer Dialogue, which was organized by the Iowa Cancer Consortium, the American Cancer Society, and the Iowa Get Screened Program. The day-long conference was all about colorectal cancer (CRC) - a type of cancer I didn't realize was as common as it is until I started working for the ICC. This may sound ridiculous, but I didn't even know until recently that one of my grandparents was a CRC survivor. (I found out when I was asking one of my parents about our family medical history; my grandparent had been diagnosed and treated for CRC long before I was born and died when I was in elementary school.)

Colorectal cancer is the second leading cause of cancer-related mortality (lung cancer is the leading cause). The fact that it causes so much mortality is especially upsetting considering that its one of the few cancers for which there are screening tests available and if its found early, the chance of 5-year survival after diagnosis is 90%.

Much of the discussions at the Dialogue focused on how to increase CRC screening rates, either by targeting physicians and other health care providers to recommend screening or by educating adults about the various screening options/providing the tests themselves. When people think of CRC screening, they usually only think of colonoscopy, but there are actually three different kinds of screening tests that have been shown to be effective for average-risk adults aged 50 to 75, including getting an annual fecal immunochemical test (FIT). The speakers included Dr. Durado Brooks (national director of the CRC and prostate cancer division of the American Cancer Society), the University's own Dr. Charles Lynch and Dr. Barcey Levy, and ACS's Lorrie Graaf. Many materials from the Dialogue, including presentations, are available to everyone on the ICC website.

Here are some random public health articles you might be interested in:

Conservatives Step Up Attacks On Public Funding For Birth Control - Julie Rovner
Rep. Steve King from Iowa apparently doesn't realize that women can be on birth control and still have children some other time in their lives.

Time to Revive Home Ec -Helen Zoe Viet
"Too many Americans simply don’t know how to cook. Our diets, consisting of highly processed foods made cheaply outside the home thanks to subsidized corn and soy, have contributed to an enormous health crisis."

Med Schools Fall Short on LGBT Education - Eliza Barclay

And here's a picture of my cat, Alley, sitting on my lap while I tried to work on a literature review paper yesterday: