Palm Beach State College
Lunch and Learn Lecture Series
September 18, 2012
Dudley Brown, Jr., MD, MBA

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BS in Psychology--University of Miami (Coral Gables)
MD--University of Florida College of Medicine
Residency in Obstetrics and Gynecology--Cook County
Hospital, Chicago, IL (Chief Resident)
Private Practice in Woodstock, IL for 8 yrs (Medical
Director)
MBA--Northern Illinois University
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Office locations: Forest Hill & N. Flagler Dr (by Good
Samaritan Hospital) in WPB; University Dr in Jupiter
Surgeries and Deliveries at Good Samaritan and St Mary’s
Medical Centers in WPB
(561)357-6277 www.tenetfloridaphysicianservices.com

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Cervix
Breast
Ovary
Colorectal
Prostate

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2nd most common cancer in women
~500,000 new cases/ year
~275,000 deaths / year

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>70% decline in mortality last 60 years
#13 in cancer deaths for women
In 2010, ~12,200 new cases and ~4,200 deaths

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50% of new cases are in unscreened women
10% had not had a screen in 5 years
30% due to system error (sampling, interpretation)

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Under 21 y/o, do not screen
21-29 y/o, Pap every 2 yrs
30 y/o and older, Pap every 3 yrs if 3 consecutive negative tests
65 y/o and older, stop if 3 consecutive negative tests & no abnormal tests in last 10yrs
Any age after hysterectomy, stop if done for benign condition (e.g. fibroids, abnormal periods) and no h/o
HG CIN

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Most common cancer in women
#2 in cancer deaths in women
37% decline in mortality from 1997 to 2005
2010 estimates; ~207,000 new cases, ~40,000 deaths

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Ages 40-49, every 1-2 yrs (varies by organization)
Ages 50-74, every 1-2 yrs (varies by organization)
Age 75 and older, No recommendation for age to stop
ACOG recommends clinical breast exam annually after
19 y/o
“Self breast awareness” recommended

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2 nd most common Gyn Cancer
#1 in Gyn cancer deaths
2010 estimates; ~21,800 new cases, ~13,800 deaths

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~75% diagnosed at > stage 2
Nonspecific symptoms
No proven screening test
Recommended screening test is an annual pelvic exam
CA 125 is not a recommended screening test

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High false positive rate leading to unnecessary surgery and increased cost
Identifies late stage disease
Research continues for an effective screening test

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#3 in cancer deaths in women & men (#2 for Hispanic men)
50% screening rate in US
Average risk people should begin screening at 50 y/o
Screening tests include; FOBT, Stool DNA test, Flexible
Sigmoidoscopy, Colonoscopy

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Most common cancer in men
Walnut-sized organ just below bladder and in front of rectum
200,000 men diagnosed annually and 25,000 deaths
Risks factors: age > 50, African American, 1st degree relative with disease

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Difficulty in starting urination
Weak or interrupted flow of urine
Frequent urination, especially at night
Difficulty in emptying the bladder completely
Pain or burning during urination
Blood in the urine or semen
Pain in the back, hips, or pelvis that doesn't go away
Painful ejaculation
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Some men do not have any symptoms

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Controversy exits regarding screening recommendations
USPSTF recommends against PSA-based screening in men without symptoms
Usual screening tests: Digital Rectal Exam (DRE) and
Prostate Specific Antigen (PSA)

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Thyroid
Diabetes
Cholesterol
Bone Density

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Recommendations vary per organization
Start at 35 y/o and screen every 5 yrs with TSH blood test (American Thyroid Association)
Screen at 50 y/o (American College of Physicians)
Other organizations say only screen if someone in symptomatic
Bottom line, discuss with your physician, especially if there is a family history of Thyroid disease

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Screen with blood test if BMI >25 and another risk factor present (e.g. Hypertension, age > 45, certain ethnic groups, habitual physical inactivity) American
Diabetes Association
Screen if BP consistently > 153/80 (treated or untreated) USPSTF
Screen in pregnancy
Bottom line, discuss with your physician, especially if there is a family history of Diabetes

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Osteoporosis is characterized by low bone mass
(density) and architectural changes in the bone which increases the susceptibility to fracture

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Postmenopausal women age 65 and older
Postmenopausal women younger than age 65 if risk factors are present (e.g. previous fracture as an adult, parents with h/o hip fracture, steroid therapy, low body weight, smoking)
No screening for premenopausal women

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Start screening with a blood test at age 20 and every 5 yrs after that, NCEP III
Start at age 20 for men or women risk factors for CHD,
USPSTF
Start at age 35 for men and age 45 for women if no risk factors for CHD, USPSTF
Bottom line, speak with your doctor

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Lung (#2)
Colorectal (#3)
Diabetes
Cholesterol
Lifestyle changes (proper diet, regular exercise, no smoking, alcohol in moderation)

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Dr. Dudley Brown, Jr.
Board Certified, Ob/ Gyn
Offices in West Palm Beach and Jupiter
(561)357-6277
Accepting New Patients