The USPSTF recommends against routine screening mammography in women aged 40 to 49 years. The decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient’s values regarding specific benefits and harms.
The USPSTF recommends biennial screening mammography for women between the ages of 50 and 74 years. (Grade B recommendation)
The USPSTF recommends against clinicians teaching women how to perform breast self-examination. (Grade D recommendation)

For women like myself who were brought up to think that early detection saves lives, these guidelines are hard to accept. At first I was comforted by reading that they don’t apply to women in high-risk groups. Then I learned that the high-risk group only included women “at increased risk for breast cancer by virtue of a known underlying genetic mutation or a history of chest radiation.” Again, having been taught early on that a strong family history of breast cancer (even without the known genetic mutation) puts one in a higher-risk category, I was shocked to learn that even these people might be counseled to follow the new recommendations. So then I took a closer look at their reasoning.

Turns out the guidelines are based on the idea that routine mammograms for women in their forties (and yearly versus biennial mammograms for women in their fifties) can actually do more harm than good. In their words, “the USPSTF reasoned that the additional benefit gained by starting screening at age 40 years rather than at age 50 years is small, and that moderate harms from screening remain at any age.” So we’re looking at “small” vs. “moderate” here. These “moderate harms” include “psychological harms, unnecessary imaging tests and biopsies in women without cancer, and inconvenience due to false-positive screening results.” They also determined that the number of lives saved by early screening is not enough to counterbalance these harmful effects. For women in their forties, one life is saved for 1904 women screened; for women in their fifties, one life is saved for 1339 women screened. This boils down to a 15% and 14% risk reduction, respectively.

Ok- I am by no means an expert, but I can tell you that I would much rather undergo the “inconvenience of a false-positive,” or what turns out to be an unnecessary biopsy, rather than die of a tumor that could have been detected, had I only found the lump via a self exam or went in for a mammogram at age 48.  I realize that the financial costs (in addition to the psychological costs) of unnecessary imaging tests and biopsies are high, and that one life saved for every 1904 women screened is a very small number.  But, when that one life saved turns to be your mother, or your wife, or your best friend- or YOU- it seems a lot bigger, doesn’t it?

The reason this ad bothered me so much is because the answer was not written upside down on the bottom of the poster, as one might hope. Instead, you have to go to Marbles the Brain Store and ask an associate (which makes sense, from a marketing perspective). So, this past Friday night, I was very excited to happen upon a Marbles in the new wing of Old Orchard Mall in Skokie.

The bad news: I was not at all correct. The good news? The store was packed! On a Friday night! The genius of Marbles is that many of their games and hands-on puzzles are open and available for use on tables throughout the store. It was full of families, teens and couples, learning while playing. Even I was able to redeem myself by pulling apart (and putting back together!) one of those puzzles made of two pieces of interlocked metal.

If your mind is in need of sharpening and you happen to be in the area, I highly recommend checking it out. And this isn’t a shameless sales pitch- I’m in no way affiliated with the store. I just like to see people and their brains having fun together.

Oddly, Kellogg’s maintains that, “…science shows that these antioxidants help support the immune system.” I sent them a note last week, requesting literature citations supporting this position. No reponse yet.

Nurition and health expert Marion Nestle has been blogging about the Krispie fiasco, and even has a letter from the San Francisco City Attorney, demanding evidence for the immunity claim.

The trouble is, the claim is not supported by any real scientific evidence.  Yes, vitamins and antioxidants in natural foods like fresh fruits and vegetables are part of a healthy diet. But exactly what role vitamin-fortified foods play in helping your immune cells fight disease is not understood.

Worse yet, three of the first four ingredients in the cereal are not exactly those which we associate with health: rice, sugar, cocoa processed with alkali, and semisweet chocolate. Before you run me out of town for allowing my kids to eat Cocoa Krispies, though, I should add that our kids (usually) supplement their cereal with fresh fruit or yogurt.

The dubious “immunity” claim comes at a vulnerable time for parents. The spread of H1N1 flu has triggered several Chicago-area school closures, including our neighborhood Catholic school. Unfounded fears of viral vaccination have parents looking in other directions. Breakfast cereal, however, should not be one of them.

Interestingly, this is not the first time Kellogg’s has made false claims about the benefits of their cereal. Just this past July, the Federal Trade Commission (FTC) filed a formal complaint against Kellogg’s for their marketing claim that Frosted Mini-Wheats have been “Clinically shown to improve kids’ attentiveness by nearly 20%.” Here’s a link to the full version of the FTC complaint.

Just for kicks, I sent a note to Kellogg’s, asking for references to the scientific study or studies that support their “immunity” claim. I’ll post their response.

So what can you do to keep your body’s immune system healthy? Getting a good night’s sleep, and exercising are both options that have real scientific data behind them.

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Almost every “ride” featured a basic science/health trivia question.  A sampling:

1. In 1953, scientists Watson and rick discovered that DNA takes what unique shape?
2. Atoms are really tiny. What is their even-smaller center called?
3. In what tube does the fertilization of a woman’s egg normally take place?
4. What famed Italian astronomer discovered three of Jupiter’s moons in 1610?
5. Often invoked as a political metaphor, what scientific test determines if a substance is an acid or a base?
6. What fatty acid identified by the FDA is beneficial in fighting heart disease?
7. Co-opted by a 1980’s television show, what occurs when an electron jumps from one energy level to another?

Of note – the contestants answered every single one of these questions correctly.  I was quite impressed. And it wasn’t all New Yorkers, either. There were several groups of tourists as well.

The National Science Foundation conducts a survey of public scientific knowledge every year, asking true/false questions that in many ways are easier than those above. Scores vary by educational background, typically ranging from 40% (< high school) to 75% (graduate study) correct.

So how well can you do?  Post your answers in the comments below and I’ll share the answers in a few days.

Recent studies are turning up mathematical abilities in many different species of animals. Chickens, bees, and of course monkeys have all shown promise in being able to deal with simple mathematical operations, like differentiating between numbers, counting, and summing. The animals are performing math linguistically like we do – they are not physically counting out objects or identifying numbers. Rather, it is some sort of innate ability constituting rough math.

Irene Pepperberg of the Massachusetts Institute of Technology terms this a sort of “number sense,” capable of being learned even in invertebrates. Important to note is that accuracy is not as important for them as it is to us; according to Jessica Cantlon of the University of Rochester, the monkeys don’t mind missing – for them it’s all about the reward. They would rather do the problem quickly and make a mistake and move on than ensure their answer was correct by taking more time. For us, there is a definitive psychological component to our mathematical abilities. We’ve all taken that math test where you think you know how to do the problem but you aren’t quite sure, so you spend too much time on that problem and forget to focus on the rest. We care deeply about the correctness of our math.

The implications of this discovery and research might have profound effects on the education of our children. The suggestion that math ability is built into us biologically suggests that we may be able to introduce math subject matter to children at an earlier age. Since studies have shown that children learn much faster at a young age than when they get older, this has profound importance in an age where math is so important for the future. It also opens up the question to what other skill sets we take for granted as ours alone that may extend to the animal kingdom. What other abilities are built into us as instinct that we have expanded and developed upon? Suddenly, it seems, we aren’t as smart as we thought we were, comparatively speaking, of course. I don’t know about you, but if you can do what this monkey can do, I will be very impressed.

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His study involved attaching radio transmitters to the shells of wood turtles. During his studies, he observed and counted dead wood turtles on a set of railroad tracks. New York’s Metropolitan Transportation Authority has a train rail running right through the area he was studying. What he discovered was that the dead wood turtles were not being killed by passing trains, but were getting stuck between the rails and were dying from the summer heat. On his own, he came up with a solution….turtle bridges. What the heck is that? Click here and take a look at the video.

So, today I learned what a turtle bridge looks like and what purpose it serves. But the thing I find really cool about this story is that a private citizen had an idea to study something in the world around him, discovered something new, and came up with a simple solution to a problem. It makes me want to run out and look more closely at the world around me. Is there something that I’ve seen before but never thought deeply enough about to allow me to see how I can lend a hand? How about you, reader? If you look more closely at the world today, will you spot something new? Let me know!

So how much federal funding was invested in this Nobel Award?  According to the National Institutes of Health, approximately $32 million between the three researchers. To the average reader, this sure sounds like a lot. But when you consider that an average 4-year research grant to support a small lab can easily total $1.5 million, and many labs have two or more, it’s actually a bargain.

It’s also worth pointing out that the economic burden of cancer illness and deaths in 2004 alone was nearly $200 billion.

The recognition that telomeres play an important role in aging and cancer – which was not foreseen – serves as yet another reminder why research dollars invested in “basic research” are dollars invested wisely.

As an aside, every time I think of telomeres I recall one of my favorite Saturday Night Live skits, “Stand Up and Win.” It’s the one featuring Jerry Seinfeld as M.C. of a game show. The winner receives a year’s supply of the plastic thingies that protect the ends of shoelaces. Seinfeld exclaims, “They don’t have a name!”

This fall I am teaching a seminar at Northwestern called, “Who Discovered HIV?”  It is a historical retrospective of the first 10-15 years of the AIDS epidemic.  Last year, the Nobel Prize in Physiology or Medicine was shared between three scientists.  Two of them, Francoise Barre-Sinoussi and Luc Montagnier, won for discovering HIV.  The award in Physiology or Medicine was controversial last year because many people felt that the Nobel Committee should have also recognized Robert Gallo, an American biomedical researcher.  Why wasn’t he recognized?  That is one of the questions we will be trying to answer in class this fall.  When I meet with the class next week I plan to share with them the information that Charlie gave me about his clinic in Minneapolis.  But before hanging up on Charlie, I had the chance to share some information with him that I have learned from the students in my class.  I thought I would share it with you as well.

Last week I had the students in my class fill out a questionnaire.  I wanted to gauge their base-line knowledge of HIV & AIDS.   What I found out, and what I shared with Charlie on the phone, was surprising to me.  Some of the answers I found to be the most interesting were:

When asked if they thought condoms offer protection against the spread of HIV, 27% of the class answered that condoms did not offer protection or they did not know whether or not they did.

When asked if they thought HIV could be transmitted by kissing an individual with AIDS, 29% of the class said that they thought it could happen or they did not know if it could happen.

When asked if they thought that HIV could be transmitted by sharing eating utensils with an AIDS patient, 41% of the class said that it could be transmitted or they did not know if it could be transmitted by sharing eating utensils.

After being surprised by some of the questionnaire responses, I asked my seminar class what kind of sex education they had in school before coming to college.  Almost to a person, everyone in the class said that IF they had sex education, they had to bring a signed permission slip from their parents that allowed them to attend the classes.  If the parents did not sign the permission slip or, as was the case with some of the students in my class, the permission slip was lost, the students were sent to the library to study.  If you didn’t have a permission slip for whatever reason, the default was to miss the class.  When I was in school, sex ed. was mandatory and if you missed the class you were marked as absent.  A friend of mine recently told me that nuns taught him sex ed.  In his words, “They were embarrassed and visibly uncomfortable, but they taught it all.”  Not having children of my own, I really had no idea how things have changed.  Is withholding information that could save their child’s life someday something that some parents support these days?  If it is the case that parents want to be able to teach their children the information at home, what happens when the parents aren’t teaching the most up-to-date, scientifically accurate information?

Again, what the heck is happening in Minneapolis?