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Practice Guideline Briefs

Am Fam Physician. 2007 Dec 15;76(12):1878-1880.

CDC Evaluates the Effect of Revised Guidelines on the Prevention of Group B Streptococci Disease

Source: Centers for Disease Control and Prevention

Published source: Morbidity and Mortality Weekly Report, July 20, 2007

Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5628a1.htm

In 2002, the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics revised guidelines for the prevention of perinatal group B streptococci (GBS) disease, which included recommending that health care professionals screen patients to identify candidates for prophylaxis. The CDC has reviewed surveillance data to compare the rates of neonatal and pregnancy-related GBS disease before and after the new guideline was released. Data were reviewed from the two years before (2000 to 2001) and after (2003 to 2005) the publication of the guideline revisions.

From 2003 to 2005, the average incidence of early-onset neonatal GBS disease was 33 percent less than in the pre–guideline revision period; however, although the incidence decreased steadily among white infants between 2003 and 2005, it increased by 70 percent during the same period in black infants. In the years after the guideline revisions, rates of pregnancy-related and late-onset neonatal GBS disease remained stable compared with baseline rates.

Although further research is needed, the authors conclude that these data highlight the need for strategies to reduce the rate of neonatal GBS disease among black infants, evaluation of missed opportunities for prevention, and continued monitoring of disease trends.

CDC Reports a Decrease in the Incidence of Breast Cancer

Source: Centers for Disease Control and Prevention

Published source: Morbidity and Mortality Weekly Report, June 8, 2007

Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5622a1.htm

Although breast cancer is the most commonly diagnosed cancer in U.S. women, the Centers for Disease Control and Prevention (CDC) reports that the incidence of breast cancer has decreased since 1999. Data from population-based cancer registries show that invasive breast cancer decreased annually between 1999 and 2003; and, after increasing between 1999 and 2002, noninvasive breast cancer decreased between 2002 and 2003.

Data were collected from the CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results program. The largest decline occurred between 2002 and 2003 (6.1 percent for invasive disease and 2.7 percent for non-invasive disease). The decrease in breast cancer occurred across several age, cancer stage, and racial groups, with the most significant decrease occurring in women 50 years and older. Factors that may have contributed to the decrease in breast cancer include mammography screening, a decrease in the use of hormone therapy, and differences in risk-factor prevalence, diet, and lifestyle.

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