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Health Care Reform, Swine Flu Top Health News for 2009

Furor over cancer screening changes and lifting of embryonic stem cell ban also grabbed headlines

WEDNESDAY, Dec. 30 (HealthDay News) -- Potentially historic moves toward health care reform, the emergence of the pandemic H1N1 flu and controversial changes to cancer screening all made 2009 a very busy year for health news.

Here are the top 10 health news stories from this past year, as selected by editors at HealthDay:

1. Major Health Care Reform Draws Near. After a summer punctuated by raucous "town hall meetings" and battling proposals from both sides of the aisle, House and Senate bills on health care reform were each passed in time for Christmas. The Senate version costs $871 billion but would expand coverage to more than 94 percent of Americans under the age of 65, including 31 million who are currently uninsured.

Voting on the bills was split along party lines, however, and more work needs to be done to hammer out differences between the House and Senate versions before President Barack Obama could sign any bill into law. If a final bill does go into effect, experts agree it would mark the most sweeping change to U.S. health care since the introduction of Medicare in the 1960s.

2. Emergence of Pandemic Swine Flu. Cases of a new, sometimes deadly strain of H1N1 influenza that seemed to target children and young adults first emerged in Mexico in March, and quickly spread to the United States and beyond. The World Health Organization's Director-General, Margaret Chan, warned that "all of humanity" was under threat, and the U.S. Centers for Disease Control and Prevention issued nearly daily press advisories as the number of ill mounted. Vaccines were rushed into production, and as infections peaked in October public demand for the shot had outstripped supply.

By November, however, the autumn wave of H1N1 began to subside and vaccine supplies were plentiful. As of Dec. 19, the CDC has confirmed 36,163 hospitalizations and 1,630 deaths linked to influenza since the end of August -- a number that is well within rates for prior flu seasons. Experts now worry that a second, winter wave of H1N1 flu is yet to come, although the virus remains tough to predict.

3. Changes in Cancer Screening Guidelines Spark Controversy. It used to be so simple: at a certain age and risk profile, Americans were advised to get various cancer screens at predictable intervals. That all changed in 2009. Early in the year, a long-simmering debate over the effectiveness of the PSA blood test for prostate cancer boiled over, with two major studies offering up arguments both pro and con for the test.

And in the fall, experts at the American College of Obstetricians and Gynecologists advised women to wait until age 21 to get their first Pap smear, and reduce frequency of testing to once every two years.

But the biggest firestorm centered on the mammogram, after a federal panel of experts in November advised that women in their 40s no longer needed the annual breast cancer screen. Breast cancer survivors, celebrities and groups as prestigious as the American Cancer Society all opposed the new recommendations, urging that decisions on mammography remain between a woman and her physician.

4. Obama Lifts Ban on Stem Cell Research. Early in March, President Obama signed a measure lifting an eight-year ban on federally funded research using embryonic stem cells sourced from all but 21 pre-existing lines. The ban, implemented early in President George W. Bush's first term, drew fierce criticism from scientists who said it stymied potentially lifesaving research, but it was supported by those who believe that tampering with embryos involves the taking of human life. Earlier this month, the U.S. National Institutes of Health announced the release of 13 new embryonic stem cell lines for use in taxpayer-funded research, with more to come.

5. Fears Over Radiation Risk from CT Scans. American medicine's decades-long love affair with the CT scan may be waning, with numerous new studies suggesting that as CT use has exploded, cancer risks linked to radiation from the scans have likewise surged. In fact, one study published in December in the Archives of Internal Medicine estimated that 29,000 future cancer cases could be linked to CT scans performed in 2007 alone.

6. FDA Gains Oversight of Tobacco Products. In a move anti-smoking advocates have been lobbying to see for decades, President Obama in June granted the U.S. Food and Drug Administration oversight over cigarettes and other tobacco products. The agency's clout in helping to curb smoking -- especially among the young -- remains to be seen, but American Heart Association CEO Nancy Brown called the move "a bold and courageous step."

7. Worries Over Two Common Plastics Chemicals. New findings on health effects from bisphenol A (BPA) and phthalates -- ubiquitous chemicals found in items such as baby bottles, children's toys and eating utensils -- sparked public fears this year. Researchers found high levels of BPA tied to impotence in men, aggression in young girls, infertility and arrhythmias; while phthalates were associated with "feminized" play and breast development in boys. Consumer advocates called for bans on both substances, but the chemicals industry defended their use, saying much more study was needed to prove a link.

8. Good News, Bad News in the Fight Against Autism. Parents of children with autism spectrum disorders received a mixed bag of news in 2009. In February, a federal judge ruled out any connection between childhood vaccination and the developmental disorder, a clear setback for families who have long claimed a link. And in December, researchers at the CDC found that the number of 8-year-olds with autism jumped 57 percent between 2002 and 2006, to one in every 110 children. But there was good news, too: A study in this month's issue of Pediatrics found that an intensive intervention program for toddlers can work to curb autism -- if it is begun early enough.

9. Alternative to Warfarin May Be Near. For decades, a tough-to-manage blood thinner called warfarin has been the standard of care for millions of heart patients. The drug offers potent anti-clotting powers but must be constantly monitored to minimize bleeding risks. This fall, however, three promising studies suggested that a new drug, dabigatran -- already approved in Canada and Europe -- works as well as warfarin but is much easier to control.

10. New Promise in the Fight Against AIDS. HIV, the virus that causes AIDS, had a rather bad year in 2009. Results from one of the first completed vaccine trials found the combo shot had only a modest effect in shielding recipients from infection, but it did suggest that more potent immunization could be possible. And on the treatment front, the WHO in October announced that in 2008, 42 percent of people in the developing world who are infected with HIV now had access to life-extending medications -- a tenfold increase in access over the prior five years.

SOURCES: HealthDay News reports, 2009

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