Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Most countries offer the Pill over-the-counter

NEW YORK (Reuters Health) - Unlike women in the U.S., Canada and much of Europe, most women in the world can access the birth control pill without a prescription, according to a new study.
As medical organizations and other groups push to ease the prescription requirements for the Pill in the U.S. and elsewhere, "we can start to use this information to... get a sense of the safety of women having access to this method where no prescription is required," said Kari White, who studies birth control at the University of Alabama in Birmingham.
The Pill is generally considered safe, said White, who was not involved in the new work, and some studies have shown that, without a doctor's input, women can accurately screen themselves for risk factors to steer away from using the Pill if it's not appropriate for them.
Earlier this year, the American College of Obstetricians and Gynecologists, a leading group of women's doctors, endorsed the idea of making the birth control pill available without a prescription (see Reuters Health report of November 20, 2012 here: http://reut.rs/UH0Zz9).
In a survey of government health officials, pharmaceutical companies, family planning groups, medical providers and other experts in 147 countries Dr. Daniel Grossman, of Ibis Reproductive Health in Oakland, California, and his colleagues found that women in the U.S. and 44 other countries need a prescription to get birth control pills.
The group reported in the medical journal Contraception that while another 56 countries had laws requiring prescriptions, in practice women could access the contraception over-the-counter.
Thirty-five countries legally allowed access to oral contraceptives over-the-counter, and 11 countries allowed over-the-counter access as long as the woman is screened to ensure that she is a good candidate.
"The patterns we saw were interesting," said Grossman. "Higher income countries - western Europe, Australia, Japan and North America - generally require a prescription."
Grossman told Reuters Health he couldn't explain why these patterns have emerged.
"Perhaps in places like China and India that have pills available over-the-counter formally without a prescription might be consistent with strong national family planning programs," he speculated.
Dr. Ward Cates, of FHI 360, a research organization in Durham, North Carolina, said the lack of a prescription requirement might also reflect a general approach to making health care more accessible in countries where it is less available.
In some countries, "healthcare tends to be more fragmented and healthcare oversight tends to be more fragmented. Therefore the availability of products tends to percolate to outlets that tend to be more accessible to the public," said Cates, who was not part of the study.
Grossman said it will be useful for countries looking to ease restrictions on birth control access to look to the experiences of these countries.
"Will this information about the availability of pills being over-the-counter in other countries influence policy here? Probably not," Grossman told Reuters Health.
"But I do think it helps to put it in perspective that this is not something revolutionary."
SOURCE: http://bit.ly/S51BnH Contraception, online December 10, 2012.
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Annual Pap tests? For some in U.S., old habits die hard

CHICAGO (Reuters) - An increasing number of younger women in the United States are delaying their first Pap test for cervical cancer until after they reach 21, reflecting new U.S. guidelines, health officials said on Thursday.
But 60 percent of U.S. women who have had a total hysterectomy and no longer have a cervix are still getting the tests, a sign that old habits may die hard, experts said.
Although an annual Pap test was once the standard of care, most professional groups including the American Cancer Society, the American College of Obstetricians and Gynecologists, and the U.S. Preventive Services Task Force, a government-backed panel, now recommend that most women get tested every three to five years, and that younger women delay their first test until 21.
And these same three groups agree that screening is unnecessary for most women who have had a total hysterectomy - the removal of the uterus and cervix - for non-cancerous reasons. Likewise, women over 65 who have had years of negative tests no longer need to be screened.
The guidelines are meant to curb overscreening, which increases the risk of unnecessary surgery and preterm birth in younger women, and adds unnecessary cost to the care of women over 65 who have never had a problem Pap and those who have had their cervix removed.
In light of the changes, two teams at the U.S. Centers for Disease Control and Prevention analyzed Pap test data from 2000 to 2010 to see how well doctors were adjusting to the call for less frequent screening.
They found the number of women aged 18 to 21 who had never been screened doubled, rising to 47.5 percent in 2010. The team also found that in 2010, women age 30 and older were less likely to report having a Pap test in the last three years.
And while Pap testing fell among women who had a hysterectomy, dropping to 60 percent in 2010 from 73 percent in 2000, the number still reflects significant overtreatment.
Meg Watson, an epidemiologist with CDC's Division of Cancer Prevention and Control, said there are some women who need to continue screening after a hysterectomy, including those whose surgery was done to remove cancers. But that number is small.
"We feel that this would still be a minority of women, and it should not be the 60 percent that we're seeing now," she said.
CDC researchers said the guideline changes are recent, but the trends do reflect a shift toward adhering to them.
TEST 'DEEPLY ENTRENCHED'
Dr. David Chelmow, a professor of obstetrics and gynecology at Virginia Commonwealth University Medical Center, who helped write the latest ACOG guidelines, concedes that it makes little sense to continue to give regular Pap smears to so many women who already have had a hysterectomy.
"It's tough to get cervical cancer without a cervix," he said.
Chelmow said widespread cervical cancer screening has significantly reduced cervical cancer rates in the United States, which have fallen by 70 percent in the last four decades.
The practice of annual Pap tests is "deeply, deeply entrenched," he said.
Although overscreening adds to health costs and unneeded worry and procedures for everyone, overscreening young women may carry even greater risks because treatments can weaken the cervix and hamper a young woman's chances of carrying a child full term, said Watson of the CDC.
Cervical cancer is a slow-growing cancer caused by exposure to certain strains of the human papillomavirus (HPV), a common sexually transmitted disease that causes precancerous abnormalities of the cervix.
In women under 21, HPV infection is very common, but cancer itself is "vanishingly rare," occurring at a rate of about one in 1 million, Chelmow said.
Cervical cancer is the second most common cancer in women worldwide, with about 500,000 new cases and 250,000 deaths each year, according to the World Health Organization.
In the United States, about 12,000 women developed new cases of cervical cancer last year, and 4,220 women died from their cancer, according to the American Cancer Society.
Most deaths occur in women who were infrequently screened or were not screened at all.
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Julia Roberts to star in HBO film on early AIDS epidemic

LOS ANGELES (Reuters) - Julia Roberts will star as a paraplegic physician treating patients early in the AIDS epidemic in the stage-to-screen adaptation of the Tony Award-winning drama "The Normal Heart," U.S. cable television network HBO said on Friday.
"The Normal Heart," set to air on HBO in 2014, tells the story of the dawning of the epidemic in 1980s New York.
Oscar-winner Roberts plays Dr. Emma Brookner, who treats several early patients infected with the HIV virus that causes AIDS. Co-star Mark Ruffalo plays Ned Weeks, an eyewitness to how the disease ravaged the city's gay community.
The film will be directed by "Glee" creator Ryan Murphy and was adapted by the play's author, Larry Kramer, an early advocate for AIDS prevention and care.
"Ryan has assembled an extraordinary cast to bring Larry Kramer's landmark theatrical achievement to the screen for the first time, and we couldn't be more thrilled to bring this important film to HBO," Michael Lombardo, HBO's president of programming, said in a statement.
"The Normal Heart" debuted on stage in 1985 in New York and was revived on Broadway in 2011, winning the Tony Award for best revival.
The movie version was originally envisioned as big screen release before HBO took it up as a television film.
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