Public health warnings have been effective in getting more Americans to stop smoking cigarettes, but lung cancer still kills more Americans than any other cancer. The percentage of Americans who smoke has decreased by half over about the last 30 years, from 30% in 1980 to 15% in 2012, but there are still over 150,000 deaths a year. Most cancers are still diagnosed at an advanced stage today. In the long run, quitting smoking will reduce lung cancer deaths 20 years from now; however, in the short run, it's not enough because most lung cancer deaths occur in ex-smokers who remain at risk even after they stop. Smokers need screening for lung cancer annually for 15 years after quitting.
Robotic surgery procedures have increased dramatically since they were first approved by the FDA in 2000, and so have the percentage of patients who have been injured by them. There are 2000 da Vinci systems installed in the US medical facilities today and 367,000 robotic procedures were done in 2012, mostly for gynecologic and urologic procedures with hysterectomies and prostatectomies accounting for the vast majority of cases. But while the percentage increase in the number of surgeries between 2011 and 2012 was 26%, the number of adverse events to patients increased by 34%, with a total of 282 robotic surgery injuries last year. Even more troubling is that a study in the Journal for Healthcare Quality reported that the number of reported injuries in 2012 only represent a small fraction of the actually injuries that occurred. The study found that a number of adverse events were not even reported.
The use of robotically assisted hysterectomy has become more frequent since the FDA approved the use of the robotic surgical platform for gynecologic procedures. Although robotic surgery is more costly, a recent study has shown that the outcomes for robotic surgery are not superior to open abdominal, vaginal and laparoscopic surgery for benign disease. The study looked at 275,000 cases at 441 hospitals between 2007 to 2010 and compared the rate of intra-operative complications, surgical site complications, medical complications, transfusion requirements, reoperation rates and mortality. Robotically assisted surgery did not significantly improve outcomes or reduce complications. The frequency of abdominal and vaginal approaches for hysterectomy declined from 54% to 41% of cases and from 22% to 20% respectively. The frequency for laparoscopic hysterectomy rose from 24% to 30%. But the frequency for robotic surgery skyrocketed from 0.5% to 30% of procedures during the study.