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Posts Tagged ‘scan’

For today’s consideration I offer up some statistics and information about two cancers common in both men and women, bladder and colorectal, along with some pointers about risk and detection.

For starters, how about a little definition of what exactly we’re talking about. First, the bladder. If you remember anything of biology or health and fitness classes, you might recall that the bladder stores urine until certain signals tell you it’s “full,” and then it contracts to help push the urine down the urethra and out of the body. Secondly, the colorectal area. Since they are connected physically and work in tandem as part of the digestive system, the colon and rectum are often grouped under the collective “colorectal” description. Essentially, the colon is the large intestine, and the rectum is the last six inches or so before the anus.

Okay, with the anatomy lesson over, lets get to the bits that actually matter. Bladder cancer is one of the more common cancers found in men and women but is rarely publicized. According to the American Cancer Society (ACS), in 2009 some 52,810 new cases of bladder cancer were expected in men. Using Census Bureau population estimates, that means any given man had a 0.00035% chance of being diagnosed with a new bladder cancer. Those are whopping odds, I know; and, ladies, you’re numbers are even lower. For 2009, any given woman had a roughly 0.00012% chance of being diagnosed with a new bladder cancer. The 18,170 estimated new cases of bladder cancer in women in 2009 means that men are several times more likely to develop bladder cancer than women are. In fact, the ACS reports that “bladder cancer incidence is nearly four times higher in men than in women and more than two times higher in white men than in African American men.” Sorry Team Blue.

But don’t let the numbers get you down. For men, the cumulative chances of developing bladder cancer remain less than 1% until age 70 and beyond. Lifetime odds are less than 4%. And the odds of dying from it? One-fifth the chance of developing it. Women, as the earlier numbers indicated, have even less to worry about: bladder cancer odds never breach 1% by age group and is only 1.2% over the course of a lifetime. So not exactly a raging pandemic by any means. Which is especially good because bladder cancer has no good method of early detection. The most effective assessment of bladder cancer involves running an endoscope up the urethra and taking a look around. For obvious reasons, this is a procedure to be avoided unless you happen to fall among a high-risk group and or show troubling signs (especially painful urination or bloody urine). For the vast majority of us, this will never be a problem, so don’t concern yourself over it too much.

Colorectal numbers are higher. The ACS expected 75,590 new cases in men and 71,380 new cases in women in 2009, making it “the third most common cancer in both men and women.” Those numbers are also fairly even between the sexes, unlike bladder cancer. However, like bladder cancer and prostate cancer and breast cancer and most other cancers as well, the highest odds come later in life. “91% of [colorectal cancer] cases are diagnosed in individuals aged 50 and older,” reads the ACS statistics release. But it also related that in both men and women, the odds of developing colorectal cancer are less than 1% until age 60. Again, little reason to worry.

But if the 5 – 5.5% chance of developing colorectal cancer over your lifetime have you on edge, there are several methods of early detection. Most of us are familiar with the colonoscopy procedures as described (and sometimes filmed) on TV, where an endoscope is run through the large intestine in search of suspicious lesions or polyps. But if that’s too invasive for your tastes, you might consider a sigmoidoscopy, where physicians examine the rectum and lower third of the colon for abnormalities through a thin device called a flexible sigmoidoscope. It takes about 15 minutes, is less invasive, and can still take biopsies of anything suspicious. It’s recommended every five years and, like conventional colonoscopy, can occasionally (but not commonly) cause bleeding or tears in the intestinal walls, both requiring surgery to repair.

If those don’t fit your fancy, perhaps a double-contrast barium enema (DCBE) would do the trick. Recommended every five to 10 years, it involves a very thorough barium sulfate enema that physicians use to examine the lower digestive tract via x-ray. It exposes the patient to less radiation than a typical CT scan (also called CAT scan) and is somewhat less invasive than colonoscopies or sigmoidoscopies. However, if you don’t mind an enema or the slightly higher radiation of CT or MRI scans, you might opt for the virtual colonoscopy. After an enema, a small tube pumps air into colon (for better differentiation) while CT or MRI scans provide images of the intestinal tract. It’s still less invasive than traditional colonoscopies but does not allow for biopsies or as thorough an internal view. However, it does allow for imaging of surrounding tissues and produces more accurate images than DCBEs.

But if you’re not fond of any foreign materials up the backside, you might just opt for the simplicity and complete non-invasiveness of fecal blood tests. There are two types but both are quite accurate and inexpensive. One type, called FOBT (fecal occult blood test), tests feces for the heme blood component (“heme” as in hemoglobin, part of our red blood cells). The other, called FIT (fecal immunochemical test), is more sensitive and tests for the globin blood component. Pre-cancerous polyps in the colon or rectum often bleed into the fecal matter passing through the digestive tract, which can be detected by these tests. They are simple enough to do at home and are sometimes handed out free of charge at proctology centers, clinics, and other medical service providers. Doctors recommend triple-testing to reduce false positives as the body expels small amounts of blood in feces under normal circumstances. But the tests return positive results for bleeding anywhere between the mouth and anus, so don’t automatically assume colorectal cancer even if there is blood. These fecal blood tests are considered a line of primary identification, as are the similar fecal DNA tests, but for conclusive diagnoses you’re still expected to see a doctor and perhaps choose a colorectal treatment of a more invasive kind.

I think the most important thing to remember is how unlikely these cancers are. And being diagnosed with cancer is a long way from dying of it. So keep an eye on yourself, and get your regular medical check-ups if you like, but don’t waste time and energy worrying about something so unlikely. No matter what you hear on the news.

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Amber Waves of Gain

Let me preface this statistic-rich post by noting the following: 1) most of these numbers were derived from two online sources, so if they were incorrect then I am also; and 2) if you are caught genuinely breaking a law, you deserve to be fined, ticketed, booted, or otherwise reprimanded as defined by local law (with a few exceptions, which may or may not be discussed below). Now, on to the good stuff (it’s long, but it’s worth it).

If the preface didn’t spill the beans, let me do it here by stating that this is a post about our city governments and parking violations.

For instance, in the 2007-2008 fiscal year, New York City brought in revenues of $624 million from parking infractions alone. Since Mayor Michael Bloomberg took office in 2001, the city has hired nearly 800 new “traffic enforcement agents” to help maximize this revenue opportunity, and 200 of those new agents were hired this year. These agents write, on average, 40 tickets per shift (according to an MSNBC news article), which equates to roughly 40,000 new tickets written every week. If the amount fined averaged $20 per ticket, that’s an additional $800,000 every week, per shift, for the city’s piggy bank. Not bad, eh? And that doesn’t account for extremes, like the super-agent who wrote 227 tickets in a 5-hour period on Black Friday 2007, when 41,000 citations were issued across the city in one day.

Boston visitors and residents face a rise in fines, a 75% increase on parking more than a foot from the curb and an increase of more than 112% for parking on a crosswalk. In similar fashion, Sacremento tacked an $8 surcharge onto its parking fines with the express intention of collecting an extra $1.5 million … or more … to ease a budgetary shortfall. Meanwhile, Seattle implemented a camera ticketing system which issued 58,000 tickets in its first three months, totaling some $5 million in fines to be collected. And last year in Colorado, Denver’s ticket revenues jumped $4 million, to a total $20 million from parking violations. Is it me or does this seem a bit extreme?

In cities like Louisville, Kentucky, a minimum of two outstanding parking violations will get your car booted. Boots are usually removed by police at their discretion … after you pay your fines, of course. But if you’re in a hurry and happen to be in Montgomery County, Maryland (just outside Washington, D.C.) or in Baltimore, you can use your cell phone to unlock the boot … after paying your fines … and a $115 fee, apparently for the convenience of a quick de-booting. (The system isn’t confined to Maryland; it is used in a dozen cities, including New Orleans.)

Some cities have begun using a camera-equipped system that allows meter agents to drive at normal speeds and simultaneously scan license plates for outstanding parking violations. Nifty, huh? Nab two birds with one stone and boot previous violators for extra money even if they are currently legally parked. But that’s just the beginning. Have you heard about the new parking meters in production? They text message local police as soon as your flag goes up. (Better hope there’s not a meter agent in the area.) And several large cities have issued electronic ticketing machines to their agents, allowing them to ticket 30% faster. Oh good, their antiquated tools and multi-million dollar annual revenues had me concerned about reduced productivity. Whew. That’s a real load off my mind.

One New Yorker said he’s seen drivers get ticketed for double-parking while waiting for someone to pull out of a space on the street, an almost universally accepted act especially common in areas of concentrated population and limited parking. In a similar stretch of the law, an attorney was ticketed for parking “somewhere between one second and 59 seconds too soon” in an alternate-side violation. He fought the ticket and won; the citation was dismissed by a judge. Which brings us to a whole new sub-topic: how many of these charges are legitimate?

In the Bronx, a dozen residents accused a traffic agent of falsely citing them for double-parking, some arguing they were not even in the United States when the tickets were issued (at the time of the article, no charges had been filed against the agent, who the city defended and who remained on duty). A retired Navy veteran said he was ticketed while dropping off his wife in a bus zone. One reader commented that he was sent a parking ticket, complete with late penalties, without having been in the city for twenty years. (Despite the two decade absence, ownership of a vehicle that did not remotely resemble the ticketed car, and a letter he sent to authorities with a copy of his registration, the ticket is unresolved.)

Another reader said, “the New York City parking signs have purposely been made so confusing that even police officers cannot tell you if it is okay to park.” He went on to note that many signs were damaged, illegible, or missing altogether but agents still ticketed in the effected areas. In some areas, he also shared, “we have Muni-meters, where you have to park your car then walk to the meter several yards away to buy a receipt…to place in the windshield. Meter people will watch you walk to the meter and give you a ticket before you can get back to the car with the receipt. This is NYC government-sanctioned mugging.” Posters from other cities shared stories of similar abuses and I have no doubt that thousands more could easily be included, everything from unlawful ticketing and conspiracy to purposefully mass-ticket all the way to outright harrassment.

And not just in New York City. People from Columbus, Ohio, and Santa Monica, California, share the same stories, as do citizens from Fort Worth, Texas, and Portland, Oregon. Obviously, these are not isolated incidents but a general trend among cities with the primary goal of raising funds. By any means necessary. Chicago, Atlanta, Denver, it makes no difference, and the more tickets written, bogus or otherwise, the more revenues will increase. (For a disgustingly blatant example, visit my previous post, “Holy Jericho”.)

I will take this opportunity to reiterate that those legitimately breaking the law deserve to be fined … but only those breaking the law, and they should not be fined unreasonable amounts.

I’ve had three parking tickets over the years and I paid every one of them without complaint. Even though the last two were tenuously legal at best, I paid, took my receipt, and walked away without a word. Because it wasn’t worth fighting. For $40 I retained the ability to work a full schedule instead of missing days to fight the tickets in court. I retained anonymity and did not bring down the wrath of meter maids and law enforcement everywhere I went. (If you think that’s not important, you’ve never lived in a smaller town.) I avoided the costly unpleasantness of hiring a lawyer. I learned when and where I could push the law, and when and where I couldn’t. I learned that legality has absolutely nothing to do with decency, common sense, or common courtesy. And all for the low low price of only $40.

I’m not denouncing parking tickets. I am denouncing the growing practice of manufacturing falsities and extorting money out of a populace to fund government greed and idiocy. And so should you. It makes me wonder … what else are they falsely accusing us of? How many innocent people are being ruined by similar practices in other disciplines? Like taxes, for example. If the IRS came calling, could you prove your financial statements to their specifications? There is no statute of limitations; what if they ask for files from a decade ago, or two? Or how about the Department of Homeland Security accusing you of terrorist activity, seizing your property, and denying you trial? It’s perfectly legal and they can sell any seized property for profit without ever formally charging you. Local police have the same authority for drug-related activities and can gleen millions annually from the sales of seized items. Why? The short answer is money. But, really, is that all? Is that why are our freedoms are being pared down to nothing while government payrolls balloon and hoover up any dollar they can find?

These are questions we should be asking.
These are questions we should be asking every day, because this country is feeling less and less like ours.

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