US Preventive Services Task Force Recommendation Statement on Screening for Atrial Fibrillation—Reply

Davidson, Karina W.; Mangione, Carol M.; Ogedegbe, Gbenga

doi:10.1001/jama.2022.5207

Cited by 449 publications

(722 citation statements)

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“…Furthermore, the updated US Preventive Services Task Force recommendations for aspirin use to prevent cardiovascular disease discusses the withdrawal of aspirin use for CRC prevention, of which it had previously been given a B rating for individuals aged 50 to 69 years with a 10% or greater risk of cardiovascular disease, citing insufficient or conflicting evidence. [31][32][33] Obesity results from the buildup and storage of white adipose tissue, or fat. Adipose cells can induce the inflammatory response and promote immune cell dysfunction through the secretion of adipokines and proinflammatory cytokines, leading to further downstream mechanistic dyregulation.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Body Mass Index in Early and Middle Adulthood and Estimated Risk of Gastrointestinal Cancer

Loomans-Kropp

Umar

2023

JAMA Netw Open

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ImportanceIn a population with significantly increasing rates of individuals with overweight or obesity, understanding the association of obesity with long-term disease risk, such as cancer, is necessary to improve public health.ObjectiveTo investigate the association between body mass index (BMI) and gastrointestinal (GI) cancer risk (colorectal cancer [CRC] and noncolorectal GI cancer) in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial.Design, Setting, and ParticipantsThis retrospective cohort study was a secondary analysis of data from the PLCO Cancer Screening Trial. Participants aged 55 to 74 years were enrolled and randomized to the intervention (screening group) or control group at 10 screening centers between November 8, 1993, and July 2, 2001. The initial analysis of PLCO Cancer Screening Trial data occurred after 13 years of follow-up or December 31, 2009, whichever came first. Participants were reconsented in 2011 and either continued follow-up or refused additional follow-up. For those who reconsented, follow-up for incident cancers continued until December 31, 2014, or death, whichever occurred first. Data analysis for this secondary analysis was performed from April 2022 through November 2022.ExposuresBody mass index and aspirin use, defined as the frequency of use of aspirin or aspirin-containing substances in the last 12 months.Main Outcomes and MeasuresThe primary outcomes were the diagnoses of CRC and noncolorectal GI cancer. The association between BMI and cancer (CRC and noncolorectal GI cancer) was assessed using Cox proportional hazards regression modeling. The association between cancer risk and change in BMI was further analyzed at different ages, and an exploratory analysis was performed to evaluate GI cancer risk among aspirin users.ResultsThis analysis included 135 161 participants (median [range] age, 62 [55-78] years; 67 643 [50.0%] female). Overweight BMI in early adulthood (hazard ratio [HR], 1.23; 95% CI, 1.10-1.37) and overweight BMI in middle adulthood (HR, 1.23; 95% CI, 1.13-1.34) and later adulthood (HR, 1.21; 95% CI, 1.10-1.32) as well as obese BMI in middle adulthood (HR, 1.55; 95% CI, 1.38-1.75) and later adulthood (HR, 1.39; 95% CI, 1.25-1.54) were associated with increased risk of CRC. Similar results were observed for the association with overall GI and non-CRC GI risk and BMI in middle and later adulthood. Maintaining overweight or obese BMI or increasing BMI to overweight or obese in later adulthood was also associated with increased CRC risk. Aspirin use 3 or more times per week did not significantly modify this association.Conclusions and RelevanceIn this secondary analysis of the PLCO Cancer Screening Trial, overweight and obese BMI in early and middle adulthood was associated with an elevated risk of CRC and noncolorectal GI cancers. The results of the current study prompt further exploration into the mechanistic role of obese BMI in carcinogenesis.

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Section: Discussionmentioning

confidence: 99%

Analysis of Body Mass Index in Early and Middle Adulthood and Estimated Risk of Gastrointestinal Cancer

Loomans-Kropp

Umar

2023

JAMA Netw Open

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“…NSAIDs for primary prevention: NSAIDs are recommended for primary prevention of cardiovascular disease, especially for those aged 50-59 years. However, caution is needed due to the increased risk of gastrointestinal bleeding, and further studies are required to determine the risk and benefit balance in this population [ 46 ].…”

Section: Reviewmentioning

confidence: 99%

Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) and Gastroprotective NSAIDs on the Gastrointestinal Tract: A Narrative Review

Sohail¹,

Mathew²,

Patel³

et al. 2023

Cureus

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Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for their anti-inflammatory, antipyretic, and analgesic properties. However, their use is often associated with gastrointestinal tract (GIT) side effects due to the inhibition of both cyclooxygenase (COX)-1 and COX-2 enzymes, leading to a decrease in gastroprotective prostaglandins (PG). To minimize these adverse effects, various approaches have been explored, including selective COX-2 inhibitors, NO-NSAIDs (nitric oxide-releasing NSAIDs), and dual COX/LOX (lipoxygenase) NSAIDs. However, the effects of these gastroprotective NSAIDs on the GIT and their efficacy remains uncertain. This review aims to provide an overview of the current understanding of the effects of traditional NSAIDs and gastroprotective NSAIDs on GIT. We discuss the underlying mechanisms of GIT damage caused by NSAIDs, including mucosal injury, ulceration, and bleeding, and the potential of gastroprotective NSAIDs to mitigate these effects. We also summarize recent studies on the efficacy and safety of various gastroprotective NSAIDs and highlight the limitations and challenges of these approaches. The review concludes with recommendations for future research in this field.

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confidence: 99%

“…The US Preventive Services Task Force (USPSTF) has recommended screening of adults at increased risk for latent tuberculosis (TB) infection (LTBI) . This recommendation (B statement) is based on an evidence review that found that available tests—in particular, the tuberculin skin test and interferon-γ release assays—were sufficiently accurate to identify persons with LTBI and that TB preventive treatment (TPT) regimens now recommended in the US should provide moderate net benefit to persons identified from screening. The USPSTF advised following the recommendations for testing in persons who have immunosuppression made by the American Thoracic Society and Centers for Disease Control and Prevention 2017 and recommendations for TPT made by the Centers for Disease Control and Prevention in 2020 .…”

mentioning

confidence: 99%

“…Before starting screening, a reminder is needed. The USPSTF also recommends that to achieve the benefit of screening, it is important that persons who screen positive for LTBI receive follow-up and treatment; if TPT is not completed, then there will be no benefit of screening. Hence, a decision to implement screening for LTBI in any setting or for any population must include a commitment to ensure adequate follow-up of those with positive test results .…”

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confidence: 99%

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Screening for Latent Tuberculosis Infection

Menzies

2023

JAMA Netw Open

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The US Preventive Services Task Force (USPSTF) has recommended screening of adults at increased risk for latent tuberculosis (TB) infection (LTBI). 1 This recommendation (B statement) is based on an evidence review 2 that found that available tests-in particular, the tuberculin skin test and interferon-γ release assays-were sufficiently accurate to identify persons with LTBI and that TB preventive treatment (TPT) regimens now recommended in the US 3 should provide moderate net benefit 1 to persons identified from screening. The USPSTF advised following the recommendations for testing in persons who have immunosuppression made by the American Thoracic Society and Centers for Disease Control and Prevention 2017 4 and recommendations for TPT made by the Centers for Disease Control and Prevention in 2020. 3 The USPSTF noted that this recommendation is for adults not included in other recommendations 3,4 for LTBI testing and treatment, such as persons living with HIV, persons about to receive a solid-organ transplantation or tumor necrosis factor-α inhibitors, or other groups at increased risk because of immune suppression. The task force also noted that this recommendation is not for contacts of persons with a recent diagnosis of active TB disease, who are generally investigated by public health services. Hence, these recommendations are focused on persons who are otherwise healthy but have increased likelihood (risk) of having TB infection. Although this includes some US-born persons, the vast majority of persons who will be affected by this recommendation are individuals who immigrated to the US from countries where TB incidence is much higher. On the basis of estimates of the prevalence of LTBI among persons in the US who were born outside the US, 5 this represents a very substantial increase from the number of persons now screened.Before starting screening, a reminder is needed. The USPSTF also recommends that to achieve the benefit of screening, it is important that persons who screen positive for LTBI receive follow-up and treatment 1 ; if TPT is not completed, then there will be no benefit of screening. Hence, a decision to implement screening for LTBI in any setting or for any population must include a commitment to ensure adequate follow-up of those with positive test results. 6 This includes medical and radiographic evaluation to exclude TB disease, offering TPT to all those who are eligible, and then education and counseling plus subsequent close follow-up of those who accept TPT, to ensure adherence as well as to detect and manage any adverse effects. Substantial time and resources are needed to ensure that care is well organized for all steps in the cascade to minimize losses, or a screening program will have far less benefit than expected. 6 Numerous studies have shown that there are substantial losses in the cascade of LTBI care, at the steps of initial identification of candidates for screening (testing), medical evaluation, and offering TPT, as well as acceptance and completion of TPT by individuals,...

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US Preventive Services Task Force Recommendation Statement on Screening for Atrial Fibrillation—Reply

Cited by 449 publications

References 5 publications

Analysis of Body Mass Index in Early and Middle Adulthood and Estimated Risk of Gastrointestinal Cancer

Analysis of Body Mass Index in Early and Middle Adulthood and Estimated Risk of Gastrointestinal Cancer

Effects of Non-steroidal Anti-inflammatory Drugs (NSAIDs) and Gastroprotective NSAIDs on the Gastrointestinal Tract: A Narrative Review

Screening for Latent Tuberculosis Infection

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