In The News This Week … August 24–30, 2008: Cancer, Infections, the Uninsured, & Tobacco Control Success

Nonmelanoma Skin Cancer & Cancer Risk

Research published online on August 26 in the Journal of the National Cancer Institute has found that people who have had nonmelanoma skin cancer, which is a normally nonfatal form of skin cancer, have double the risk of developing other types of cancers. Researchers found that the risk was especially notable in younger people in the 25 to 44 age group.

The Gene for Neuroblastoma

An article published online on August 24 in Nature reports that mutations in the anaplastic lymphoma kinase (ALK) gene explain most hereditary forms of neuroblastoma and the same mutations play a significant role in high-risk forms of non-inherited neuroblastoma. Also as reported in a news release from the Children's Hospital of Pennsylvania, the study's first author, Dr. Yael P. Mossé said, "This finding means that it is possible to offer simple, non-invasive screening for patients with a family history of neuroblastoma," and, "Furthermore, because there already are drugs in development that target the same gene in adult cancers, we can soon begin testing those drugs in children with neuroblastoma."

Infections & Preterm Labor

A study published on August 26 in PLoS ONE suggests that undiagnosed infections may be responsible for some premature births, after finding bacteria or fungi in 15% of the amniotic fluid samples taken from women experiencing preterm labor. One of the microorganisms was described as an "unassigned, uncultivated, and previously-uncharacterized bacterium." Of the 166 women tested, all 25 who had infected amniotic fluid went on to deliver their babies preterm, while 53 of the women with no infections were able to stop their labor. The heavier the infection in the amniotic fluid, the more likely the women were to deliver younger, sicker infants.

Healthcare & the Uninsured

A paper published online on August 25 in Health Affairs states: "People uninsured for any part of 2008 spend about $30 billion out of pocket and receive approximately $56 billion in uncompensated care while uninsured. Government programs finance about 75 percent of uncompensated care. If all uninsured people were fully covered, their medical spending would increase by $122.6 billion." Additionally, they calculated: "Physicians' donated time and forgone profits amount to $7.8 billion. After government payments to hospitals are subtracted, private philanthropy and profit margins are responsible for at least an additional $6.3 billion." As for how much covering the uninsured would cost, they wrote, "Adding the cost of the additional care to current spending by or for the uninsured, total medical care costs for newly insured people will be about $208.6 billion (roughly $3,800 per full-year-equivalent newly insured person), consisting of $122.6 billion in new spending on top of the $86 billion already in the system. Although this is substantial, not all of this money necessarily represents new government spending."

Uninsured Numbers Down

Meanwhile, on August 25 the Census Bureau reported that the number of people without health insurance coverage declined from 47 million (15.8%) in 2006 to 45.7 million (15.3%) in 2007. (The full report, Income, Poverty, and Health Insurance Coverage in the United States: 2007, is available on their site.) Unfortunately, as explained by Dr. Don McCanne in an August 26 news release from Physicians for a National Health Program, "While any drop in the number of uninsured is welcome news, a closer look at the Census Bureau data for 2007 provides little cause for celebration," because "The new figure – 45.7 million uninsured – is still unacceptably high. … It's the second-highest figure since the 1960s, when Medicare and Medicaid were enacted into law." Furthermore, he explained, last year's gain in the number of insured people was entirely attributable to an expansion of government programs like Medicare and Medicaid. The number of people covered by government health insurance programs increased by 2.7 million. Were it not for this increase, he said, the uninsured numbers would have surpassed the 2006 figure.

California's Tobacco-Control Cost-Savings

Research published on August 26 in PLoS Medicine calculates that California's ant-tobacco campaign has resulted in an $86 billion reduction in healthcare costs, based on 2004 dollars, represents about a 50-fold return on the $1.8 billion California spent on the program between 1989 when it started, and 2004.

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