Primary Care Malpractice claims against primary care physicians are more difficult to defend and lead to a higher percentage of paid claims. A recent study in the Journal of the American Medical Association (JAMA) reported a study of 7224 malpractice claims over a 5 year period in Massachusetts, with 551 arising from primary outpatient care. The study found that although primary care claims accounted for only 7.7% of claims, they were significantly more likely to be settled (35% vs. 20%) and/or result in a plaintiff's verdict (1.6% vs. 0.9%).
New guidelines for cervical cancer screening have been released by the American Cancer Society in conjunction with the U.S. Preventive Task Force (USPTF) that are based on new understanding of the role that human papillomavirus (HPV) infection plays in the development of this disease. The guidelines recommend less frequent testing across all age groups and are aimed at detecting early cellular abnormalities while at the same time reducing unnecessary biopsy procedures and the anxiety caused by false positive PAP smears. Vaccination against HPV has reduced the incidence of cervical malignancy but the vaccine only protects against for 70% of cervical malignancies. The decreased recommendations for screening may cause women to reduce the frequency of their gynecologic visits and consequently cause missed opportunities for the detection of other women's health issues that are detected during routine visits.
Cancer screening rates in the United States declined over the last ten years, and the only testing in conformance with Health People 2010 (HP2010) goal of 50% or more was for colorectal . Adherence rates for screenings have generally declined for all other types and are below HP2010's target. On the other hand, survival met goals for all types except cervical cancer. Increased prevention efforts are needed if the United States is going to continue to meet its survival goals into the future. Despite earlier diagnosis and more effective treatments that increase survival, it is still a leading cause of death and chronic illness, with deaths in the United States exceeding 570,000 in 2011.
Prostate cancer survival for men with metastatic disease significantly improved with routine Prostate Specific Antigen (PSA) testing over the last 20 years, despite a current US Preventive Task Force's (USPTA) recommendation against general screening. A study in the Journal of Urology showed a significant reduction in the stage severity of the cancer in men who followed with testing. Overall survivability increased for men with metastatic disease who underwent screening, especially black American men. The study leaves no doubt that PSA testing plays a role in extending lives for such patients. It also supports the use of PSA testing for general screening in asymptomatic patients.
The Journal of the National Cancer Institute reported that the daily use of aspirin helps prevent death from cancers. Dr. Eric Jacobs did the study to further investigate a report of an estimated 37% reduction in deaths among people using aspirin for 5 years of more. Data from 110,139 elderly individuals participated in the study and were followed for 11 years. There was an overall mortality reduction of 16%, with a reduction in mortality of 40% for gastrointestinal malignancies and about a 12% decrease for all others.