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How often should you get screened for cancer? Why does everyone have cancer? How do blood tests for cancer work? Can a baby get syphilis? How many people die from overdose?
Discussing the latest cancer statistics, measles outbreaks, deaths from overdose and contaminated ultrasound gel with AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia, JD, MPH. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Andrea Garcia, JD, MPH, vice president, science, medicine & public health, American Medical Association
Transcript
Garcia: In recent years, cases of congenital syphilis have risen significantly. According to the CDC, from 2012 to 2022, there was a tenfold increase in cases, and this is concerning because congenital syphilis can result in a range of issues for a newborn baby.
Unger: Hello, and welcome to the AMA Update video and podcast. Today is our weekly look at the public health issues facing physicians and patients across the country with the AMA's Vice President of Science, Medicine and Public Health, Andrea Garcia. I'm Todd Unger, AMA's chief experience officer. Welcome back, Andrea.
Garcia: Thanks, Todd. I appreciate the opportunity to be here today.
Unger: Well, let's start with some urgent news from the CDC. Earlier this week, the agency put out a national alert about contaminated ultrasound gel. Andrea, what do we need to know about that?
Garcia: Well, Todd, the CDC is currently assisting with a multistate investigation into contaminated non-sterile ultrasound gel that's used for ultrasound guided percutaneous procedures. That investigation was prompted by reports of Paraburkholderia fungorum detected in blood cultures from patients across multiple health care facilities.
As of May 8, the CDC said they're aware of 40 such cases. Tests have identified at least two ultrasound gel products contaminated with P. fungorum. Those are MediChoice and Clear Image, both of which are manufactured by NEXT Medical Products. In the alert, the CDC provided the specific lot numbers for the contaminated products and steps that health facilities should take to prevent future outbreaks. For more information, check out the episode description for a link to that full alert.
Unger: Well, thank you for that background. Andrea, there was another big update from the CDC recently as well, and this one concerned drug overdose deaths. What can you tell us about that?
Garcia: Well, this was really welcome news to see. According to provisional data from CDC's National Vital Statistics system, drug overdose deaths fell by nearly 27% last year, which is a significant change from the trends we've seen in recent years. In 2024, there were around 80,000 drug overdose deaths. That's down from a little over 110,000 in 2023.
At the start of the pandemic, we started to see noticeable increases in overdose deaths, and for the next few years, they really remained at a very high level. This significant decline in 2024 largely erases those increases and brings us closer to those levels we saw in 2019, when there were around 73,000 overdose deaths.
Unger: Andrea, obviously, that's a really encouraging development when we think about it in this post-pandemic era. What does it mean for our work ahead?
Garcia: I think one important takeaway is that while this decrease is a welcome change, the remaining level of overt overdose deaths is still far too high. Along with this data, the CDC released a statement, and in it, the agency noted that overdose remains the leading cause of death for Americans aged 18 to 44. This is a sobering reminder of the crisis that we are still very much in, and we need to continue our efforts to prevent and treat substance use disorders.
Unger: That is a very high level, and that remains and clearly still a challenge. Andrea, thanks so much for walking us through that. Now let's turn our attention to the measles outbreak in the Southwest. Anything changed since we talked last Wednesday?
Garcia: Well, Todd, we've been closely following this outbreak for months now. And last Friday, there was an interesting update in the data that was released. The Texas Department of Health reported only one new case of measles since its previous update on Tuesday. It's a notable shift, and it might signal that the outbreak is finally beginning to slow down. Obviously, we'll need to see if this trend continues over the coming weeks, but for now, it's a welcome change from the number of new cases that we had been seeing.
Unger: Absolutely. That is really good news and good for Texas. What about the other states that we've been following?
Garcia: Well, as of last Friday, the total number of cases in New Mexico was 74, which is up 3 since we last talked. In Oklahoma, there have been no new cases. The total number there still stands at 17. And then, as of last Wednesday, there were a total of 56 cases in Kansas, which is up from 48 the week before.
I'd also just like to take the opportunity to share that, last week, the AMA did host a webinar with CDC experts on the issue of measles. That webinar touched on a range of topics, including how physicians can prevent and respond to outbreaks in their community. You'll find a link to that webinar in the episode description as well.
Unger: Andrea, thank you so much. Fingers crossed that we don't see those numbers creep up again. Let's turn our attention to a different issue that we've been following over the past few weeks, and that's rising rates of cancer in younger people. And a new study shed more light on this concerning trends. Andrea, what were some of its findings?
Garcia: Well, Todd, this study appeared in the journal “Cancer Discovery,” and it does indeed give us a clearer picture of what cancers are on the rise in people under age 50. Scientists from the National Cancer Institute looked at cancer statistics for different age groups in the U.S., including more than 2 million cancers diagnosed between 2010 and 2019 in people aged 15 to 49.
They found that out of 33 types of cancer, 14 of them had increasing rates in at least one younger age group. The largest increases were in female breast cancer, colorectal, kidney, uterine and pancreatic cancers. But we also saw increases in other types too, including stomach cancer and melanoma.
Unger: Well, clearly this is a big issue. What needs to happen next so we can start to address it?
Garcia: So we know what types of cancers are on the rise in younger people. And now we need to understand why. More research is needed to better understand the risk factors that are relevant to younger people. For example, the authors note that the increase could be due to risk factors such as obesity, but changes in cancer screening guidelines or advances in technology that have improved early detection could also be at play here.
Todd, there were also some encouraging findings in this study that I think are worth mentioning. For more than a dozen types of cancer, the rates in people under 50 were actually going down, and the largest declines were in lung and prostate cancers. Additionally, for most cancers in younger age groups, we are not seeing the rate of death increase, which is reassuring.
Unger: Well, it's nice to hear that there are some positive trends among the bad news. This wasn't the only notable cancer study, though, this month. Another one looked at the role that blood tests might play in detecting cancer in the future. Andrea, what did it find out?
Garcia: Well, this study was in BMJ Open, and it found that multicancer early detection blood tests could catch as many as half of cancers at an earlier stage. Currently, there are only a few screenings that can reliably detect cancer. This includes tests for breast, colon, cervical and lung cancers. Blood testing, however, has the possibility of detecting dozens of different types of cancer by looking for cancer markers in a person's bloodstream.
Now these novel technologies have not yet been FDA cleared or approved. What the study looked at is the effect of screening with these multicancer early detection tests at different intervals, and they found that adding the blood test at usual care intervals could improve patient outcomes.
Unger: It all feels very futuristic between this kind of blood test advances and some of the advances in AI. For instance, I spoke with a physician yesterday about AI and colon cancer testing. That really is promising. Tell us a little bit more about how this study was actually conducted.
Garcia: Well, this was a modeling study that looked at the difference between testing every year or testing every other year. And through that analysis, they found that annual blood testing was associated with 49% fewer late-stage cancer diagnoses and 21% fewer deaths within five years. Blood testing every other year resulted in 39% fewer late stage diagnoses and 17% fewer deaths within five years. These are promising results, and I think we'll have to consider how these tests can complement the current approach to screening for cancer.
Unger: Those indeed are really, really promising. And on the topic of screenings, the U.S. Preventive Services Task force released a final recommendation last week on screening for syphilis during pregnancy. Andrea, what do physicians need to know about that?
Garcia: Well, this is an important recommendation, so let's walk through the details of it. The task force stated that all pregnant women should be tested for syphilis when they first present to care, and screening for syphilis should occur as early in pregnancy as possible. It went on to say that if early testing is not done, then testing should occur at the first opportunity, which really could be as late as admission for delivery.
The task force gave this recommendation an A grade. That means it recommends this service and there's a high certainty that the net benefit is substantial. It also means that physicians should offer or provide this service. This is an especially timely recommendation, since the U.S. has been facing a significant resurgence of congenital syphilis.
Unger: That might be surprising to people. Can you tell us a little bit more about that resurgence?
Garcia: So just as a reminder, congenital syphilis is when syphilis is passed from a pregnant patient to their baby during pregnancy or childbirth. In recent years, cases of congenital syphilis have risen significantly. According to the CDC, from 2012 to 2022, there was a 10-fold increase in cases. And this is concerning because congenital syphilis can result in a range of issues for a newborn baby. These include hearing or vision loss, damage to optic nerves, developmental delays, skeletal deformities and an enlarged liver.
By testing all pregnant patients for syphilis, physicians are able to detect infections as soon as possible and begin treatment. Physicians should refer to the CDC's Sexually Transmitted Infection Treatment Guidelines for the most up to date guidance on treatment.
Unger: All right, Andrea, that's where we will end for today. Thank you so much for joining us and keeping us up to date. If you found this discussion valuable, you can support more programming like it. Physicians can join the AMA at ama-assn.org/joinnow. Patients, you can get involved too by joining the AMA's Patients Action Network at patientsactionnetwork.com. As always, you can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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