Safe Handling Tips for Preventing Foodborne Illness From Pet Food and Pet Treats

Consumers can take steps to help prevent foodborne illness, including Salmonella -related illness, when handling pet foods and treats. These products, like many other types of foods, can be susceptible to harmful bacterial contamination.

Salmonella in pet foods and treats can cause serious infections in dogs and cats, and in people too, especially children, older people, and those with compromised immune systems. Salmonella in pet foods and treats potentially can be transferred to people ingesting or handling the contaminated products.

FDA has stepped up its efforts to minimize the incidence of foodborne illness associated with pet foods and treats. Pet owners and consumers can also help reduce the likelihood of infection from contaminated pet foods and treats by following safe handling instructions:
Buying

* Purchase products in good condition, without signs of damage to the packaging such as dents or tears.

Preparation

* Wash your hands for 20 seconds with hot water and soap before and after handling pet foods and treats.
* Wash pet food bowls, dishes, and scooping utensils with soap and hot water after each use.
* Do not use the pet's feeding bowl as a scooping utensil—use a clean, dedicated scoop or spoon.
* Dispose of old or spoiled pet food products in a safe manner, such as in a securely tied plastic bag in a covered trash receptacle.

Storage

* Refrigerate promptly or discard any unused, leftover wet pet food. Refrigerators should be set at 40º F.
* Dry products should be stored in a cool, dry place—under 80º F.
* If possible, store dry pet food in its original bag inside a clean, dedicated plastic container with a lid, keeping the top of the bag folded closed.
* Keep pets away from food storage and preparation areas.
* Keep pets away from garbage and household trash.

Raw Food Diets

FDA does not advocate a raw meat, poultry, or seafood diet for pets, but is stepping up its efforts to minimize the risk such foods pose to animal and human health. The agency understands that some people prefer to feed these types of diets to their pets. For the protection of both you and your pet, the FDA recommends you follow these instructions when handling or using raw meat, poultry or seafood, for use in a pet’s diet:

* Keep raw meat and poultry products frozen until ready to use.
* Thaw in refrigerator or microwave.
* Keep raw food diets separate from other foods. Wash working surfaces, utensils (including cutting boards, preparation and feeding bowls), hands, and any other items that touch or contact raw meat, poultry or seafood with hot soapy water.
* Cover and refrigerate leftovers immediately or discard safely.

In addition:

* For added protection, kitchen sanitizers should be used on cutting boards and counter tops periodically. A sanitizing solution can be made by mixing one teaspoon of chlorine bleach to one quart of water.
* If you use plastic or other non-porous cutting boards, run them through the dishwasher after each use.

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Why You must take the Flu Shot this Flu Season?

Each winter, millions of people suffer from the flu. Flu—the short name for influenza—is caused by viruses. Viruses are very small germs. Some viruses can spread easily from one person to another. They cause illnesses or infections like the flu.

For some people, flu is a mild illness. For older people, especially those who have health problems like diabetes or heart disease, the flu can be very serious.

How Serious Is Flu?

Most people who get the flu feel much better in a week or two. But, some people can get very sick. For example, because your body is busy fighting off the flu, you might pick up a second infection. Older people are at great risk of these secondary infections, such as pneumonia.

How Does Flu Spread?

It was mid-November, and Ellen had not gotten a flu shot. One day she was out having lunch with a friend and noticed people sneezing and coughing at the next table. Two days later, Ellen woke up feeling achy and had a fever. She had the flu. Her husband Jack took care of her and was careful to wash his hands after touching Ellen’s dishes. But, a few days later he too was sick. Maybe he used the phone just after Ellen finished talking with their son. Or, maybe he touched a doorknob Ellen used after sneezing. Flu spreads easily from one person to another.

The flu is contagious—that means it spreads from person to person, often through the air. You can pass on the infection before you feel sick. You are contagious for several days after you get sick. You can catch the flu when someone near you coughs or sneezes. Or, if you touch something the virus is on, like Ellen and Jack’s phone or doorknob, and then touch your nose or mouth, you could catch the flu. The flu virus can live on a surface like a book or doorknob for a number of hours. Remember to wash your hands often when you are around someone who is sick. Make a point of washing them before eating and touching your eyes, nose, or mouth. If you can, stay away from sick people. That will help stop the flu from spreading.

Is It the Flu or a Cold?

It’s easy to confuse a common cold with the flu. A cold is milder than the flu, but since the flu can make older people very sick, you should know the difference. That way you will know when to call the doctor who might want to give you a prescription for medicines that can help you get over the flu.

People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call “stomach flu” is not influenza.

Why Do You Need A Flu Shot Every Year?

Flu viruses change often. Each year’s virus is just a little different than the year before. So every year the vaccine in the flu shot is changed. That’s one reason why you need a flu shot every fall.

Are There Side Effects?

Most people have no problem with a flu shot. In fact, for most people, the flu is more dangerous than the flu shot. When you get the flu shot, your arm might be sore, red, or swell a bit. These side effects may start shortly after getting the shot and can last up to 2 days. They should not get in the way of your daily activities. A few people do have a headache or a low-grade fever for about a day after they get the shot. The flu shot cannot cause you to get the flu. If you are allergic to eggs, you should not get the flu shot. Because eggs are used to make the flu vaccine, people who are allergic to eggs could have a serious reaction to the shot.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

Can Flu Be Prevented?

Getting a flu shot every year can help you stay healthy. A flu shot contains the flu vaccine, which could keep you from getting the flu. Medicare will pay for the shot, and so will many private health insurance plans. You can get a flu shot at your doctor’s office or from your local health department. Sometimes grocery or drug stores offer flu shots.

A flu shot won’t keep everyone healthy. But, getting the flu shot every year can mean that if you do get the flu, you might have only a mild case.

Who Should Get a Flu Shot?

The Centers for Disease Control and Prevention, part of the Federal Government, says that people age 50 and older should get a flu shot every year. Anyone who lives with or takes care of people age 50 or older should also have a flu shot every year.

When Should I Get My Flu Shot?

Most people get the flu between November and April. That’s why that time is called the flu season. It takes at least 2 weeks for your shot to start working, so try to get your flu shot in October or early November. Don’t worry if you can’t get your flu shot before the flu season starts. The shot can help keep you healthy no matter when you get it.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

It is important to check with your doctor when you first get the flu. Also, call your doctor if:

* your fever goes away and then comes back; you may have a more dangerous infection.
* you start having breathing or heart problems or other serious health problems.
* you feel sick and don’t seem to be getting better.
* you have a cough that begins to make thick mucus.

What About the “Bird” Flu?

Sometimes a new, different kind of flu virus appears. You may have heard about the avian or bird flu. This flu is an example of how changes in a flu virus might lead to serious illness. However, there is some good news about bird flu. It is rare in people. In most cases, the bird flu has not passed from one person to another, and so, it might not become widespread in humans. But this could change over time. Scientists are working on new vaccines that can help protect people from bird flu. Right now, the flu does not protect you against bird flu.

Things to Remember About the Flu

* The flu can be dangerous for older people.
* The flu can be prevented.
* Older people need a flu shot every year.
* Medicare pays for the flu shot.
* The flu shot is safe.

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"Sunshine" Vitamin D Reduces Breast Cancer Risk

Nidhi Sharma
Women who get an adequate amount of vitamin D through daily exposure to the Sun are less likely to develop breast cancer as compared to women who do not, new studies suggests.

The "sunshine vitamin," when taken in high doses may cut the risk of breast cancer by 70%. Vitamin D is synthesized naturally in human body after the skin is exposed to the ultraviolet (UV) rays and lack of UV exposure is linked to higher risk of breast cancer.

A new study led by Garland FC and colleagues from the University of California San Diego showed there is an association between low ultraviolet irradiance and higher breast cancer risk. The study, which is published in the March 17, 2008 issue of Breast Journal also found high levels of vitamin D translated to a 50% lower risk of breast cancer.

The researchers concluded that "there was a protective effect of UVB irradiance on risk of breast cancer that was independent of fertility rate, proportion of the population overweight, alcohol intake, animal energy intake, and other covariates."

A second study by Canadian researchers, found that women who spent time outdoors or got a lot of vitamin D from their diets or supplements. This holds true especially for teens who were 25% to 45% less likely to develop breast cancer than women with less vitamin D.

Approximately 1,150,000 cases and 410,000 deaths from breast cancer occur annually worldwide, including 215,000 new cases and 41,000 deaths in the United States.

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The Safety and Risks of Acupuncture Treatment

Most modern acupuncturists use disposable stainless steel needles of fine diameter (0.007" to 0.020", 0.18 mm to 0.51 mm), sterilized with ethylene oxide or by autoclave. These needles are far smaller in diameter (and therefore less painful) than the needles used to give shots, since they do not have to be hollow for purposes of injection. The upper third of these needles is wound with a thicker wire (typically bronze), or covered in plastic, to stiffen the needle and provide a handle for the acupuncturist to grasp while inserting. The size and type of needle used, and the depth of insertion, depend on the acupuncture style being practised.

Warming an acupuncture point, typically by moxibustion (the burning of a combination of herbs, primarily mugwort), is a different treatment than acupuncture itself and is often, but not exclusively, used as a supplemental treatment. The Chinese term zhen jiu (??), commonly used to refer to acupuncture, comes from zhen meaning "needle", and jiu meaning "moxibustion". Moxibustion is still used in the 21st century to varying degrees among the schools of oriental medicine. For example, one well known technique is to insert the needle at the desired acupuncture point, attach dried moxa to the external end of an acupuncture needle, and then ignite it. The moxa will then smolder for several minutes (depending on the amount adhered to the needle) and conduct heat through the needle to the tissue surrounding the needle in the patient's body. Another common technique is to hold a large glowing stick of moxa over the needles. Moxa is also sometimes burned at the skin surface, usually by applying an ointment to the skin to protect from burns, though burning of the skin is general practice in China.

An example of acupuncture treatment

In western medicine, vascular headaches (the kind that are accompanied by throbbing veins in the temples) are typically treated with analgesics such as aspirin and/or by the use of agents such as niacin that dilate the affected blood vessels in the scalp, but in acupuncture a common treatment for such headaches is to stimulate the sensitive points that are located roughly in the center of the webs between the thumbs and the palms of the patient, the hé gu points. These points are described by acupuncture theory as "targeting the face and head" and are considered to be the most important point when treating disorders affecting the face and head. The patient reclines, and the points on each hand are first sterilized with alcohol, and then thin, disposable needles are inserted to a depth of approximately 3-5 mm until a characteristic "twinge" is felt by the patient, often accompanied by a slight twitching of the area between the thumb and hand. Most patients report a pleasurable "tingling" sensation and feeling of relaxation while the needles are in place. The needles are retained for 15-20 minutes while the patient rests, and then are removed.

In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment, sensations that are stronger than those that would be felt by a patient not suffering from a vascular headache:

* Extreme sensitivity to pain at the points in the webs of the thumbs.
* In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
* Simultaneous relief of the headache.

Indications according to acupuncturists in the West

According to the American Academy of Medical Acupuncture (2004), acupuncture may be considered as a complementary therapy for the conditions in the list below. The conditions labeled with are also included in the World Health Organization list of acupuncture indications. These cases, however, are based on clinical experience, and not necessarily on controlled clinical research: furthermore, the inclusion of specific diseases are not meant to indicate the extent of acupuncture's efficacy in treating them.

* Abdominal distention/flatulence
* Acute and chronic pain control
* Allergic sinusitis
* Anesthesia for high-risk patients or patients with previous adverse responses to anesthetics
* Anorexia
* Anxiety, fright, panic
* Arthritis/arthrosis
* Atypical chest pain (negative workup)
* Bursitis, tendinitis, carpal tunnel syndrome
* Certain functional gastrointestinal disorders (nausea and vomiting, esophageal spasm, hyperacidity, irritable bowel)
* Cervical and lumbar spine syndromes
* Constipation, diarrhea
* Cough with contraindications for narcotics
* Drug detoxification
* Dysmenorrhea, pelvic pain
* Frozen shoulder
* Headache (migraine and tension-type), vertigo (Meniere disease), tinnitus
* Idiopathic palpitations, sinus tachycardia
* In fractures, assisting in pain control, edema, and enhancing healing process
* Muscle spasms, tremors, tics, contractures
* Neuralgias (trigeminal, herpes zoster, postherpetic pain, other)
* Paresthesias
* Persistent hiccups
* Phantom pain
* Plantar fasciitis
* Post-traumatic and post-operative ileus
* Premenstrual syndrome
* Selected dermatoses (urticaria, pruritus, eczema, psoriasis)
* Sequelae of stroke syndrome (aphasia, hemiplegia)
* Seventh nerve palsy
* Severe hyperthermia
* Sprains and contusions
* Temporo-mandibular joint derangement, bruxism
* Urinary incontinence, retention (neurogenic, spastic, adverse drug effect)

Safety and risks

Because acupuncture needles penetrate the skin, many forms of acupuncture are invasive procedures, and therefore not without risk. Injuries are rare among patients treated by trained practitioners.

Certain forms of acupuncture such as the Japanese Toyohari and Shonishin often use non-invasive techniques, in which specially-designed needles are rubbed or pressed against the skin. These methods are common in Japanese pediatric use.

Common, minor adverse events

A survey by Ernst et al. of over 400 patients receiving over 3500 acupuncture treatments found that the most common adverse effects from acupuncture were:

* Minor bleeding after removal of the needles, seen in roughly 3% of patients. (Holding a cotton ball for about one minute over the site of puncture is usually sufficient to stop the bleeding.)
* Hematoma, seen in about 2% of patients, which manifests as bruises. These usually go away after a few days.
* Dizziness, seen in about 1% of patients. Some patients have a conscious or unconscious fear of needles which can produce dizziness and other symptoms of anxiety. Patients are usually treated lying down in order to reduce likelihood of fainting.

The survey concluded: "Acupuncture has adverse effects, like any therapeutic approach. If it is used according to established safety rules and carefully at appropriate anatomic regions, it is a safe treatment method."

Other injury

* Other risks of injury from the insertion of acupuncture needles include:
* Nerve injury, resulting from the accidental puncture of any nerve.
* Brain damage or stroke, which is possible with very deep needling at the base of the skull.
* Pneumothorax from deep needling into the lung.
* Kidney damage from deep needling in the low back.
* Haemopericardium, or puncture of the protective membrane surrounding the heart, which may occur with needling over a sternal foramen (an undetectable hole in the breastbone which can occur in up to 10% of people [citation needed]).
* Risk of terminating pregnancy with the use of certain acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin.

These risks are slight and can all be avoided through proper training of acupuncturists. For correct perspective, their risk should be compared to the level of side effects of common drugs and biomedical treatment - see below. Graduates of medical schools and (in the US) accreditated acupuncture schools receive thorough instruction in proper technique so as to avoid these events.

Risks from omitting orthodox medical care

Some doctors believe that receiving any form of alternative medical care without also receiving orthodox western medical care is inherently risky, since undiagnosed disease may go untreated and could worsen. For this reason many acupuncturists and doctors prefer to consider acupuncture a complementary therapy rather than an alternative therapy.

Critics also express concern that unethical or naive practitioners may induce patients to exhaust financial resources by pursuing ineffective treatment. However, many recent public health departments in modern countries have acknowledged the benefits of acupuncture by instituting regulations, ultimately raising the level of medicine practiced in these jurisdictions.

Safety compared to other treatments

Commenting on the relative safety of acupuncture compared to other treatments, the NIH consensus panel stated that "(a)dverse side effects of acupuncture are extremely low and often lower than conventional treatments." They also stated:

"the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. For example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow... are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments."

In a Japanese survey of 55,291 acupuncture treatments given over five years by 73 acupuncturists, 99.8% of them were performed with no significant minor adverse effects and zero major adverse incidents (Hitoshi Yamashita, Bac, Hiroshi Tsukayama, BA, Yasuo Tanno, MD, PhD. Kazushi Nishijo, PhD, JAMA). Two combined studies in the UK of 66,229 acupuncture treatments yielded only 134 minor adverse events. (British Medical Journal 2001 Sep 1). The total of 121,520 treatments with acupuncture therapy were given with no major adverse incidents (for comparison, a single such event would have indicated a 0.0008% incidence).

This is in comparison to 2,216,000 serious adverse drug reactions that occurred in hospitals 1994. (Lazarou J, Pomeranz BH, Corey PN., JAMA. 1998 Apr 15;279(15):1200-5.) So to compare indirectly, Acupuncture has a 0.2% chance of causing a minor adverse effect compared to prescription medications having a 6.7% chance of causing a serious adverse event in a hospital setting.

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Gastroenteritis outbreak claims 120 lives in Northern Nigeria

The Nigerian Ministry of Health is trying to determine what caused a gastroenteritis outbreak that has claimed 120 lives in northern Nigeria’s Sokoto state and dozens more in the northwest, according to national health statistics.

“Unfortunately, it is the environment,” said the Ministry of Health’s deputy director, Abdul Nasidi. “The environment is so dirty. We are trying to work with the Ministry of Environment to inculcate in Nigerians how to live in a better environment. We want to get to the bottom of these outbreaks.”

Not cholera

“It is a serious outbreak,” Sokoto state health commissioner, Jabbi Kilgori, said at the height of the outbreak on 10 October. “We have 23 local government areas and at least 10 are affected. We have between 2,000 and 3,000 people affected and 120 deaths.”

He said authorities had initially thought the illness was cholera.

“We have received reports from four, five states in the northwest in particular,” said the Ministry of Health’s Nasidi on 11 October. “From some of the samples taken, we tested for cholera and they were all negative.”

Similar to cholera, gastroenteritis causes diarrhoea, but beyond that, stomach and intestinal inflammation can also cause pain, nausea and vomiting. Parasite-laden faecal-contaminated drinking or cooking water cause both illnesses. If left untreated, both can quickly kill.

Response

Kilgori told IRIN officials are acting as quickly as possible, contrary to what some locals said was a sluggish start to control the spread: “We [local health officials] are taking measures, including the use of oral dehydration [and] antibiotics, disinfecting the affected areas and ensuring that sanitation is improved – especially where people defecate,” he said, adding that the source of drinking water must be protected.

Kilgori said Sokoto state is distributing gastroenteritis treatments worth US$200,000 in the north.

Rivers, ponds and open wells in northern Nigeria, which serve as the main sources of drinking water in the typically arid communities, have been contaminated by unusually heavy rains in recent months, the doctor told IRIN.

“We have to provide proper latrines to these communities,” said Kilgori. “We are also working to protect the source of drinking water and encourage people to avoid drinking water from open water sources.”

Underreporting

Northern residents said the death toll may be higher as most of the deaths were never reported and the victims were buried the same day, in line with Islamic custom.

“I can confirm 90 deaths in Dange Shunni [in the northern region] alone,” declared Sokoto-based primary health worker, Aminu Abdullahi, who visited the area in early October. “Most of [the people] died at home and were buried without the health authorities being informed.”

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Irish Law Reform Commisssion To Consider Advance Medical Directive

There is a need for legislation to cater for people who want to make advance care directives – in other words, who want to make their wishes known about what should happen to them in the event of an incapacitating accident or illness, the Law Reform Commission (LRC) has said.

An advance care directive sets out a person’s wishes about what should happen to them in the event of an incapacitating accident, such as a serious car crash, or illness, such as a stroke or Alzheimer’s disease, that makes it impossible for them to communicate their wishes directly.

Such a directive can be written or verbal and quite often, the person will also nominate another person to carry out their wishes. This other person is sometimes called a health care proxy.

At its annual conference today, the LRC is launching its Consultation Paper on Bioethics: Advance Care Directives, which forms part of its Third Programme of Law Reform 2008-2014.

The paper provisionally recommends that there is a need for legislation in this area and it makes 25 specific recommendations on the topic. Some of the main recommendations it makes are:

-The proposed legislation would not involve euthanasia or assisted suicide and it would not allow a person to refuse basic care.
-It would only deal with advance care directives involving refusal of treatment, e.g. ‘I do not wish to be resuscitated’. It would not deal with requests for treatment, e.g. ‘I want a liver transplant’.
-An advance care directive could be written or verbal, however one that refuses life sustaining treatment would have to be in writing.
-The proposed legislation could, in general, allow a person to refuse treatment on religious grounds.
-A person should be encouraged to seek medical advice when making an advance care directive, but this should only be mandatory in the case of directives involving the refusal of life sustaining treatment.
-A healthcare professional would not have any legal liability where they follow an advance care directive that they believe to be valid and applicable to the condition being treated.

The Law Reform Commission is an independent statutory body whose main role is to keep the law under review and to make proposals for reform. Today’s conference is taking place at Dublin Castle.

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the effectiveness of computer-aided detection (CAD) for screening mammography

When it comes to reading mammogram results, two heads aren’t always better than one.

A new study found that so-called computer-aided detection (CAD) for screening mammography has rates of cancer detection similar to mammograms read by two different radiologists.

“Reading mammograms by a single reader (radiologist) using CAD has been shown to be as clinically effective as having films read by two expert readers,” said the study’s lead author, Dr. Fiona Gilbert, a professor of radiology at the University of Aberdeen in the United Kingdom.

“Women should be reassured that the final decision on recall is made by the human reader using their knowledge and experience to decide if any areas of the mammogram marked by CAD merit further investigations,” she said.

In the United Kingdom and many European countries, the recommendation is that every mammogram be read by two independent radiologists. This practice isn’t common in the United States, according to Dr. Thomas Hall, director of breast imaging for Providence Hospital in Southfield, Mich. “Most mammograms are single-read in America, though most places now, when they get digital mammography, also get CAD,” he said.

Gilbert said, “We know that two readers will detect approximately 10 percent more cancers than a single reader.” But two readers aren’t always available. Sometimes, there might be seasonal shortages, as might occur during the holidays. Or, it may be that there aren’t enough resources to have multiple radiologists available to read mammography results, she said.

So, Gilbert and her colleagues wanted to know if the computer plus one reader would be similarly effective to two readers.

To assess this question, the researchers randomly assigned more than 31,000 women undergoing routine screening mammography to have their films read by two radiologists, by CAD and one radiologist, or using both measures.

Double reading found 87.7 percent of the cancers, while CAD plus a single reading was able to detect 87.2 percent. Recall rates, that is the number of women called back for further testing due to suspicious findings, were 3.4 percent for double reading and 3.9 percent for single reading with CAD.

The study findings were expected to be published in the Oct. 16 issue of the New England Journal of Medicine, but were posted online Oct. 1.

“CAD could increase the cancer detection rate of a single reader in breast screening centers currently using single reading alone,” said Gilbert, who added that, “in countries where double reading is standard practice, CAD could be used if there is a shortage of readers without compromising cancer detection rates.”

Hall said it’s likely that, if this study had been done with a digital mammography system, the results would have been even better. He said for this study, the researchers took mammography films and scanned them into the computer before the computer reading. That means the computer was essentially checking a copy, and when you copy something, information may be lost, he said.

“There are definite advantages to digital mammography with CAD. Digital helps you visualize the anatomy better, and the CAD helps keep you on your toes,” Hall said.

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