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Medical literacy may help save lives

AGING
Senior citizens, who make up the fastest growing age group in the country, are also the most reliant on healthcare. Now, researchers at Northwestern University have found that poor health literacy may put seniors at a higher risk of premature death. The researchers collected health information on more than 3,000 seniors, then asked questions designed to test their health literacy, such as their ability to understand Medicaid-like forms or determine what time they should take a medication prescribed for use every six hours. Based on their responses, the seniors were designated as having inadequate, marginal, or adequate health literacy. Six years later, the researchers found that many more of the patients who had difficulty understanding health information had died than those with adequate health literacy: 39 percent and 29 percent of those whose skills were termed inadequate or marginal, respectively, had died, compared to 19 percent for those with adequate health literacy. Although previous studies have found that an individual's level of education can be a predictor of life expectancy, the researchers say their results point to a potentially different situation for seniors. "We found that education among this core was only minimally associated with mortality, and literacy was really the driving factor," said Michael Wolf, assistant professor of medicine and a co-author of the study.

BOTTOM LINE: Seniors' inability to understand and act on medical information could shorten their lives.

CAUTIONS: The association between life expectancy and health literacy may be partially due to one or more unmeasured factors, such as socioeconomic status or cognitive function.

WHAT'S NEXT: The researchers plan to explore the relationship between medical literacy and premature death in more detail, as well as study potential ways to improve health literacy among seniors.

WHERE TO FIND IT: Archives of Internal Medicine, July 23.

MICHELLE SIPICS

CANCER
Experience counts in prostate surgery
Prostate cancer affects 1 in 6 men, making it the most common non-skin cancer in the United States. For men who have cancer solely confined to the prostate, surgery is a standard treatment option. Before going to the operating room, however, men opting for surgery might want to scrutinize their surgeon's level of experience. A new study from the National Cancer Institute reveals that surgeons who had performed prostate cancer operations many, many times are more likely to prevent a prostate cancer recurrence than less experienced doctors. To measure the relationship between surgical experience and prostate cancer recurrence, Vickers and colleagues examined nearly 8,000 prostate cancer patients who had undergone surgery at the hands of one of 72 different surgeons. After controlling for factors such as severity of the cancer, the study showed that patients whose surgeons had performed at least 250 operations had only an 11 percent risk of recurrence over a five-year period, while patients whose surgeons had done prostatectomies fewer than 10 times had an 18 percent risk of recurrence.

BOTTOM LINE: Prostate cancer patients treated by experienced surgeons are more likely to remain cancer free over 5 years than patients treated by less experienced surgeons.

CAUTIONS: Variation in the age of the patients and the type of tumor may have affected the results. As older patients and those with more aggressive tumors have worse results.

WHAT'S NEXT: The authors plan to identify exactly which aspects of the surgical procedure are optimized with practice and which factors might affect the speed at which surgeons learn -- hoping to figure out how to truncate the education process.

WHERE TO FIND IT: Journal of the National Cancer Institute, July.

SUSHRUT JANGI

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