Breast cancer testing may need to be tailored by race: Study

Antonio_Diaz/iStock/Thinkstock(NEW YORK) -- When should women receive their first mammograms? The widely accepted current guideline says age 50. But that might not be early enough for some ethnic groups, according to new research.

A Harvard-based study published Wednesday shows that a higher percentage of Asian, Black and Hispanic women are diagnosed with breast cancer by age 50 than white women.

"The situation with breast cancer is one of the best examples of how science done without regard to racial differences can produce guidelines that would be ultimately harmful to minority patients," lead author Dr. David Chang, an associate professor of Surgery at Harvard Medical School, said in a statement.

Researchers looked at a national database of almost 750,000 patients from 1973 to 2010 and more than 30 percent of breast cancer diagnoses in the study for the Asian, Black and Hispanic women, happened before they were 50 -- 32.8 percent, 31.0 percent and 34.9 percent, respectively. For white women, the rate of breast cancer found before 50 was 23.6 percent.

Breast cancer screening has been the subject of much debate in recent years and the guidelines have changed. A mammogram is the main diagnostic tool, an x-ray that looks for cancerous masses in the breast; it can help find hidden or small cancers too small to feel or normally see. It’s imperfect, but it’s the best safety net yet devised to catch breast cancers early.

A national panel of doctors and public health officials, the U.S. Preventive Services Task Force, usually creates general recommendations. But other groups like the American Cancer Society (ACS) have their own recommendations, too. For example, USPSTF recommends biennial mammograms starting at 50, but ACS recommends annual mammograms starting at 45.

"If the science upon which clinical guidelines are based was not done in a way that respects racial differences, there is little that can be done at the point of delivery to improve patient care," said Chang, who also practices at the Massachussetts General Hospital Department of Surgery.

To create a safety net that provides similar protection for nonwhite patients, this study recommends that Asian and Black women start screening at 47, and that Hispanic women start at 46.

They also found that Black and Hispanic women are often diagnosed at later stages of the cancer.

Some bigger questions weren’t addressed in this study: would earlier mammograms make these women actually live longer? Would the additional tests be worth the cost in terms of lives saved, or would the same risks of over-testing apply?

As medical research adds more data to the discussion -- balancing risks, rewards, costs, and new research -- a "one size fits all" recommendation on breast cancer screening becomes increasingly difficult.

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Walt Disney Co. commits more than $100M to bring comfort to children and their families in hospitals

ABC News(NEW YORK) -- Robert A. Iger, chairman and chief executive officer of the Walt Disney Co., Wendesday announced an innovative plan to dedicate more than $100 million in company resources, including cash, products and services, to reinvent the patient and family experience in children’s hospitals across the globe.

This initiative will roll out over five years, expanding the company’s rich legacy of supporting children’s hospitals, which dates back to Walt Disney.

“Disney’s timeless stories have touched hearts and lifted spirits for generations, and we believe they can bring comfort to children and families going through a very difficult time,” said Mr. Iger. “Using the powerful combination of our beloved characters and legendary creativity, we’re planning to transform the patient experience in children’s hospitals around the world – creating a personalized and engaging atmosphere that will inspire young patients and ease the stress of a hospital stay.”

Leveraging its renowned “Imagineers”—the global experts in theme park and family entertainment design—the company plans to introduce a rich array of distinctly “Disney” elements into children’s hospitals. Drawing on their decades of creativity, and working with patient care experts, Imagineers will use some of the world’s most iconic characters and stories to weave together many different touchpoints and experiences creating a supportive atmosphere that is personal, warm and entertaining for patients and families during their time at the hospital.

Concepts for these elements include:

- A new RFID-based system allowing patients to customize their hospital visit by choosing their favorite Disney stories and characters, which will surround them during their stay. The system will also unlock special elements to further personalize and enhance the experience, such as “enchanted” artwork that comes alive.

- Themed treatment and patient rooms featuring interactive murals of Disney stories, bed linens and gowns featuring each child’s favorite characters, and personalized in-room entertainment. Additionally, well stocked mobile “play carts” will include Disney-themed games and activities to give families something to do together to help alleviate stress and boredom.

- Disney first-run movies and television shows, available both in-room and in themed pop-up movie theaters in the hospital, along with other Disney entertainment options.

- Disney customer-experience training for doctors, nurses and staff. The renowned Disney Institute, a part of the Walt Disney Co. that provides professional development training focused on leadership, employee engagement and high-quality service, will create a customized program for health care professionals designed to foster a less stressful, patient and family-centric hospital experience. The first hospital to work with Disney in this comprehensive new approach is Texas Children’s Hospital in Houston. As the largest children’s hospital in the United States, recognized as a national leader in pediatric health, Texas Children’s will add valuable insight in collaboration with Disney on these and other new experiences.

“We are honored to be the inaugural hospital to collaborate with Disney on this exciting patient-focused initiative,” said Mark A. Wallace, President and CEO of Texas Children’s Hospital. “Patient care is at the center of our mission, and in addition to providing the highest-quality medical care to children, we strive to make the hospital experience as enjoyable and stress-free as possible for every patient and their family. We are looking forward to working with Disney to enhance our efforts in this area.”

Disney is working with a panel of medical experts, including doctors, nurses, hospital administrators, parents and child life professionals from around the world, to advise on the best ways Disney can help hospitals create a more personalized and comforting experience for patients and families.

“Disney stories and characters provide a shared vocabulary between our young patients and their medical team,” said Dr. James B Fahner, M.D., F.A.A.P Division Chief, Pediatric Hematology and Oncology at Helen Devos Children’s Hospital/Spectrum Health in Grand Rapids, Michigan, and a member of the panel working with Disney on this initiative. “The magic of Disney restores some childhood innocence during a very difficult time, and also allows us as caregivers to be at our very best. I can’t think of any company that is better suited to lead this type of work than Disney.”

The company is also expanding its work with children’s wish-granting organizations. In 2017, the Walt Disney Co., through all its affiliated brands, granted more than 10,000 wishes for children facing critical illnesses around the world. Since Disney granted its first wish request in the early 1980s, it has fulfilled more than 120,000 wishes.

This new initiative to reimagine the children’s hospital experience is part of the company’s “Team of Heroes” community outreach and philanthropy efforts. The Walt Disney Co. is dedicated to delivering comfort, happiness and inspiration for families around the world and recognizes it takes a team to make a significant impact.

ABC News is a subsidiary of the Walt Disney Co.

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VA plan would give every service member mental health benefits after leaving military

iStock/Thinkstock(WASHINGTON) -- Secretary of Veterans Affairs David Shulkin announced Tuesday that the VA will send President Donald Trump a plan this week that would give every service member mental health benefits when they leave the military.

The plan follows President Trump’s executive order signed in January aimed at improving mental health resources for veterans.

“Suicide prevention is the top clinical priority,” said Shulkin.

In addition to this new plan, the VA has partnered with AMVETS, a congressionally-chartered veterans service organization, to create a new mental health initiative dubbed HEAL, which stands for health care, evaluation, advocacy, and legislation.

“AMVETS is making this investment to place a team of licensed healthcare experts on the front lines where American veterans have direct access to a clinician that can guide them through the maze of the VA healthcare system,” said AMVETS national executive director Joe Chenally.

One of the first investments for AMVETS was hiring the organization’s first chief medical executive, Lana McKenzie.

McKenzie said the program will extend services to all veterans suffering from traumatic brain injury (TBI) and those who are at a high risk for suicide.

“First, we will facilitate access to appropriate mental health screenings and treatment plans to ensure they include proper follow-up,” said McKenzie. “Second, we will use public forums, roundtables, and town hall meetings to raise awareness in local communities around the country.”

She estimated that about 320,000 veterans incur some degree of TBI during service and that 20 veterans take their lives every day.

The cost for the HEAL program comes from hiring licensed professionals to join the team and is partly paid by corporations invested in AMVETS.

On March 19th, a toll-free number will be available for veterans and their family members to access the HEAL program.  That number is 1-833-VET-HEAL, and the corresponding e-mail address is

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Suspected opioid overdoses increased 30 percent in one year, CDC report says

iStock/Thinkstock(NEW YORK) -- The opioid epidemic shows no signs of leveling off, as the most recent report covering most of the U.S. shows an average 30 percent rise in suspected overdoses, in just one year.

Between July 2016 and September 2017, the suspected opioid overdoses across 45 states increased by an average of 30 percent, according to a new report from the U.S. Centers for Disease Control and Prevention.

One of the surprising statistics in the report: The problem holds true for both men and women, across different age spans, races and regions.

In the time period studied, 15.7 per 10,000 emergency room visits were for opioid overdoses. The largest increases were in the Midwest –- a 70 percent rise -- and the West, with a 40.3 percent hike.

The new figures are based on an updated tracking system the helps hone in on the correct number of opioid-related cases faster, the CDC said. The agency now uses emergency department statistics, in addition to hospital billing data.

"Long before we receive data from death certificates, emergency department data can point to alarming increases in opioid overdoses,” said CDC Acting Director Anne Schuchat, M.D. "This fast-moving epidemic affects both men and women, and people of every age. It does not respect state or county lines and is still increasing in every region in the United States."

More detailed data was collected in 16 states. In large metropolitan areas, the data showed a 54 percent increase in suspected opioid overdoses, although increases were noted in rural centers, as well. Two states showed more than a 100 percent increase in opioid ODs, including Delaware, at 105 percent, and Wisconsin at 108 percent. The next highest levels were in Pennsylvania, at 80 percent higher, and Illinois which rose 65 percent.

There was some good news; some states showed lower rates of opioid overdoses. Two states that have had historically high rates, Kentucky and West Virginia, showed lower numbers of emergency department visits.

"Kentucky saw a decrease of 15 percent ... which may reflect some fluctuations in drug supply," Schuchat said today.

Northeastern states such as Massachusetts, New Hampshire and Rhode Island showed lower emergency room visits, but there is not enough data to know if local interventions were the reason.

In short, the opioid epidemic is not plateauing, and the CDC said these numbers point to a need for enhanced prevention and treatment efforts in emergency departments.

Rapid data that is increasingly available from emergency departments can serve as an efficient way to alert local communities if there is a rise in overdoses.

Because those who have experienced a past overdose are more likely to overdose again, the emergency departments can also use this data to target high-risk patients and connect them to case managers and community resources for substance use disorders.

"To successfully combat this epidemic, everyone must play a role," U.S. Surgeon General Jerome Adams, MD, MPH, said.

The CDC recommends that local health departments should stock enough naloxone for first responders to reverse an overdose and that public safety and law enforcement should coordinate with local public health officials in high drug trafficking areas. The agency also suggests that community partnerships can help provide treatment.

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Reward for missing CDC worker Timothy Cunningham climbs to $15,000, sister says she's adjusting to 'new normal'

CDC(ATLANTA) -- More than three weeks since a Centers for Disease Control and Prevention employee mysteriously vanished, the reward for information in his case has risen to $15,000 and his sister says her family is adjusting to the "new normal."

Timothy Cunningham, 35, a commander in the Public Health Service who responded to public health emergencies including the Ebola virus and the Zika virus, disappeared in Atlanta on Feb. 12. All of his belongings were left at his home, police said.

His sister, Tiara Cunningham, said her parents have "been remaining positive and prayerful."

"I have been trying my best to go through daily activities such as work without getting distracted," she told ABC News via text on Tuesday. "But no one can really prepare you for seeing your face or your brother's face on the news while at work."

"So it's a new normal that isn't normal and many people won't understand," she added.

A reward for information about his disappearance has now climbed to $15,000, Atlanta Police spokeswoman Lisa Bender told ABC News Tuesday. The reward increase was through private donations as well as donations from the family, Bender said.

Cunningham's sister said a GoFundMe page helped raise reward money.

"I was overwhelmed by the support both locally and nationally," Tiara Cunningham said.

"The support of the public is indicative of how impactful Tim's reach is," she added. "He regularly participated in service events around the city. He served citizens in New York City during Hurricane Sandy and was ready to deploy to service in his capacity."

On the last day he was seen -- Monday, Feb. 12 -- Timothy Cunningham called his sister on his way to work, police said.

At work, he met with his supervisor, and during that meeting, he was given an explanation for why he did not receive a promotion, police said. After that meeting, Timothy Cunningham asked to go home sick, police said.

At 9:12 a.m., while driving home, Timothy Cunningham called his mother but she did not pick up and he did not leave a message, police said.

He has not been heard from since.

His concerned relatives drove down from Maryland, finding all of his belongings, including his dog, at his home, according to police and ABC affiliate WSB-TV.

"This is an extremely unusual set of circumstances," Maj. Michael O'Connor of the Atlanta Police told reporters last week.

"The most unusual factor in this case is that every single belonging that we are aware of was located in the residence," O'Connor said. "His keys, his cell phone, credit cards, debit cards, wallet, all his identification, passport -- everything you can think of, we’ve been able to locate. None of those items are missing."

Anyone with information is urged to call 911 or the Atlanta Police Homicide/Adult Missing Persons Unit at 404-546-4235.

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Little boy’s expression at learning new sibling’s gender says it all

ABC News(NEWPORT BEACH, Calif.) -- For an honest reaction, look no further than a kid.

How Jack Casey felt upon learning at the family's gender reveal that his mom would be giving birth to a baby girl was written all over his face.

Jack, 6, already has three sisters.

His mom, Kate Casey, a comedian, author and podcast host from Newport Beach, California, told "Good Morning America" she sensed his feelings right away.

"Once my husband hit the tennis ball, I saw his reaction and began to cry out of concern for his feelings," she said.

The tennis ball exploded in a burst of pink.

"This was the first time we all shared in the surprise of the sex of the baby," Casey said. "I kept the answer in an envelope for weeks. I had some trepidation before the reveal knowing all the kids guessed the baby would be a brother. Jack was really eager to have a little brother since he often complains there are so many girls in our house."

But little Jack has since come around, his mom said. He's looking at the bright side of having another girl in the family.

"We reminded him of all the solo trips he can spend with dad at the batting cage and going to tennis matches," Casey said. "My apologies in advance to his future wife or for any boys who will want to date his sisters."

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Parents encouraging teens to diet can cause higher risk of obesity as adult

iStock/Thinkstock(NEW YORK) -- "Diet," it seems, could be another four-letter-word you shouldn't say to your teen.

Parents who encourage their teens to diet could negatively impact their child's weight-related and emotional health for years to come, according to a study published Tuesday in the journal Pediatrics.

"Experiencing parent encouragement to diet as an adolescent was significantly associated with a higher risk of overweight or obesity, dieting, binge eating, engaging in unhealthy weight control behaviors, and lower body satisfaction 15 years later as a parent," the study, which followed 556 teens whose parents encouraged dieting over a 15-year period, stated.

The researchers even followed the teens -- who came from diverse racial and socio-economic backgrounds -- as they went on to become parents themselves. Their conclusion? The long-term harm that was a result of parental encouragement to diet as a teen "was transmitted to the next generation."

The study encourages that health care providers should work to educate parents about the potential harm associated with encouraging their adolescent child to diet. OF course, the parents may mean to promote health, but seeing that their child has a high chance of passing on negative behaviors when they have their own children, they might want to take a different approach. An emphasis on healthy eating may accomplish the same goals, without the negative effects.

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Teens using e-cigarettes show evidence of same toxic chemicals as smokers: Study 

iStock/Thinkstock(NEW YORK) -- Using e-cigarettes has been promoted as a way to help adult smokers cut back or quit smoking, or at least to minimize the health damage that smoking causes. Teens, even middle schoolers, have taken up e-cigarettes as well. But as researchers continue to study their safety, a new report in Pediatrics shows vaping could lead to the presence of concerning levels of toxic chemicals.

Almost 100 teens from the San Francisco Bay area were examined in the University of California-San Francisco study: 67 teens used e-cigarettes only, 16 used both e-cigarettes and conventional cigarettes and 20 didn't smoke or vape at all.

Urine and salivary gland testing looked for breakdown products of toxic chemicals that have been associated with cancer -- and found them in both smokers and vapers -- but not those who didn’t smoke at all.

Those who smoked cigarettes and used e-cigarettes had urine samples that indicated a higher presence of benzene, ethylene oxide, acrylonitrile, acrolein and acrylamide (all associated with higher risks of cancer). Levels were three times as high as those who used just e-cigarettes.

In turn, the “e-cigarette only” group had three times more evidence of the presence of acrylonitrile, acrolein, propylene oxide, acrylamide, and crotonaldehyde as non-users. Those chemicals, as well, are associated with a higher cancer risk.

The researchers write, "The presence of harmful ingredients in e-cigarette vapor has been established; we can now say that these chemicals are found in the body of human adolescents who use these products."

Apparently, the “flavor” of the e-cigarette cartridge matters. Among e-cigarette-users, the levels of acrylonitrile were higher in those who preferred fruit flavors -- compared to candy, tobacco or menthol flavors.

This is significant because 55 percent of e-cigarette users -- and 67 percent of those who smoked and used e-cigs -- preferred fruit flavors.

The study did not go on to see if any of these teens developed cancer.

This is the first study to assess the chemicals in e-cigarettes among adolescent use, highlighting the need to warn teenagers that there is not much known about the possible negative health risks associated with e-cigarettes.

This article was written by Dr. Najibah Rehman, a third-year resident in preventative medicine at the University of Michigan. Dr. Rehman works in the ABC News Medical Unit.

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Day care workers accused of giving toddlers melatonin gummies

iStock/Thinkstock(DES PLAINES, Ill.) -- Three Illinois day care workers have been charged with endangering children after police say they were discovered to be distributing gummy bears with melatonin to toddlers without parental consent.

Officers were called to Kiddie Junction day care in Des Plaines, Illinois, last Friday after the day care’s management reported three caregivers were suspected of distributing the gummies to a classroom of 12 2- and 3-year-old children. The gummies were given to the children to calm them down prior to nap time, police said.

Police said the three caregivers admitted to passing the gummies out to the children and said they believed they would not be harmful since they were an over-the-counter product. They are cooperating with the investigation, police said.

Despite their belief, Cmdr. Christopher Mierzwa of the Des Plaines police told ABC News the bottle of Walgreens-brand gummies clearly stated they were not to be given to children under the age of 16.

Police said they are investigating more than one incident of these gummies being given to kids in the toddler classroom.

The three caregivers -- 32-year-old Kristen Lauletta, 19-year-old Jessica Heyse and 25-year-old Ashley Helfenbein -- have been charged with two counts of endangering the life or health of a child and two counts of battery and are scheduled to appear in court on April 4, police said. Mierzwa said any attorneys retained by the women would not be known until they appear in court.

When reached by ABC News, Kiddie Junction said they were “not interested” in commenting on the case.

All parents who have children attending Kiddie Junction have been contacted by both the day care and the police department and advised of the investigation, police said.

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Some UK supermarkets to ban selling energy drinks to anyone under 16

iStock/Thinkstock(LONDON) -- Several chain supermarkets in the United Kingdom have begun implementing a voluntary ban on the sale of energy drinks to people under the age of 16.

Waitrose, a chain with more than 350 stores throughout the U.K., today began requiring proof of age for customers buying energy drinks containing more than 150 mg of caffeine per liter.

"As a responsible retailer, we want to sell these products in line with the labelling guidance," Simon Moore, Waitrose’s director of technical and corporate social responsibility, said in a statement on the company’s website. "These drinks carry advice stating that they are not recommended for children, so we’re choosing to proactively act on that guidance, particularly given the widespread concerns which have been raised about these drinks when consumed by under 16s."

Drinks sold in the U.K. that contain more than 150 mg of caffeine per liter must already carry a label alerting customers to high caffeine content, according to guidelines issues by the European Union Food Information Regulation.

The label must include this warning, according to the guidelines, placed near the name of the product: "High caffeine content. Not recommended for children or pregnant or breast-feeding women."

Jamie Oliver, a London-based chef who has taken on the cause of childhood obesity, welcomed the retailers’ actions in a tweet, saying the retailers, "have done the right thing! stopping the sale of energy drinks to children."

The amount of caffeine in one of the energy drinks, 150 mg, is roughly equivalent to two-and-a-half cups of instant coffee, if they are eight ounces each, according to the Mayo Clinic.

It's unclear how much caffeine is safe or unsafe for teens or young children, since studies of its effects are not permitted in children.

For adults, the FDA has cited around 400 milligrams of caffeine a day as an amount not generally associated with dangerous side effects.

The American Academy of Pediatrics (AAP) advised parents in a 2011 report to keep kids and teens away from energy drinks over concerns about the high levels of caffeine.

"Energy drinks contain substances not found in sports drinks that act as stimulants, such as caffeine, guarana and taurine," the AAP said in a statement at the time. "Caffeine –- by far the most popular stimulant –- has been linked to a number of harmful health effects in children, including effects on the developing neurologic and cardiovascular systems."

In addition to those additives, energy drinks can contain kola nut, yerba mate and cocoa, which bring additional caffeine, according to the report published in Pediatrics.

In 2011, there were 1,499 adolescents aged 12 to 17 who went to emergency rooms for an energy drink related emergencies, up from 1,145 adolescents in 2007, according to the Centers for Disease Control and Protection.

Side effects of excess caffeine consumption by children include anxiety, jitteriness, headache, fatigue, irritability, elevated blood pressure and heart palpitations, experts say. The effects can be serious if the child has an underlying heart issue.

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