Preventive medicine
-
Preventive medicine · Feb 2023
Multicenter Study Observational StudyPerformance of a targeted methylation-based multi-cancer early detection test by race and ethnicity.
Disparities in cancer screening and outcomes based on factors such as sex, socioeconomic status, and race and ethnicity in the United States are well documented. A blood-based multi-cancer early detection (MCED) test that detects a shared cancer signal across multiple cancer types and also predicts the cancer signal origin was developed and validated in the Circulating Cell-free Genome Atlas study (CCGA; NCT02889978). CCGA is a prospective, multicenter, case-control, observational study with longitudinal follow-up (overall N = 15,254). ⋯ The sensitivity for cancer signal detection across groups ranged from 43.9% [n = 57; 95% CI: 31.8-56.7%] to 63.0% [n = 192; 95% CI: 56.0-69.5%] and generally increased with clinical stage. The MCED test had consistently high specificity and similar sensitivity across racial and ethnic groups, though results are limited by sample size for some groups. Results support the broad applicability of this MCED test and clinical implementation on a population scale as a complement to standard screening.
-
Preventive medicine · Feb 2023
Down but not defeated: Clinicians can harness the power of policy for LGBTQ+ rights.
The legal and medical rights of lesbian, gay, bisexual, transgender, queer (LGBTQ+) and other gender and sexual minority (GSM) youth are under attack in the United States. Approximately 160 anti-LGBTQ+ bills were proposed across the United States during the 2021 legislative session, with 70% of states considering at least one anti-LGBTQ+ bill. Over one hundred of the proposed bills specifically target transgender youth and have already resulted in the prohibition of nearly 85,000 13-17-year-old trans youth from participating in sports as their affirmed gender. ⋯ Conversely, the rollback of those liberties may lead to irreparable harm and preventable deaths. The consequences of anti-LGBTQ+ legislation can additionally deleteriously affect local and state economies as companies and organizations move to supportive communities. Clinicians can, and should, play an important role to engage stakeholders and advocate for LGBTQ+ inclusive policies at the institutional, local, state, and national policy level.