Disease Management Update
Volume IV, No. 25
October 11, 2007

Dear Healthcare Intelligence Network Client,

As Breast Cancer Awareness Month continues, this week's DM Update focuses on a newly discovered link to early onset of the disease, and how treatment of the disease can vary by race. Stop by the HIN blog to read our daily posts on breast cancer throughout the month of October.

Your colleague in the business of healthcare,
Laura M. Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at: http://www.hin.com/dmdesktop/diseasemanagement.html

Table of Contents

  1. New Gene Linked to Early-Onset Breast Cancer
  2. Disease Management Q&A: Educating Vendors and Providers about Cultural Differences
  3. HealthSounds Podcast: Primary Care Physicians & DM
  4. Breast Cancer Therapy Can Depend on Race
  5. Survey of the Month: Healthcare Trends in 2008
  6. Cultural Competency in Healthcare: Health Plans and Providers Strive to Speak the Same Language

1. New Gene Linked to Early-Onset Breast Cancer

Researchers identified a new gene that, if mutated, may increase a woman’s risk of breast cancer by more than a third, according to a study by the University of Michigan (U-M) School of Public Health. The study was an international collaboration with researchers from Spain, Israel and several centers in the United States, including the U-M Comprehensive Cancer Center.

Researchers found that the gene, HMMR, interacts with the well-known breast cancer gene BRCA1. Alternations in either gene cause genetic instability and interfere with cell division, which could be a path not only to the development of breast cancer but also to new options for treating and diagnosing the disease. Researchers looked at the genes of 923 Jewish Israeli women with breast cancer and similar women without breast cancer.

Overall, the risk of breast cancer was 23 percent higher in women who had one copy of genetic variant, and 46 percent higher in women who had inherited two copies. In addition, those women were diagnosed an average of 12 months younger than women from the control group, suggesting that HMMR is linked to early-onset breast cancer.

To learn more about the findings of this study, please visit:

2. Disease Management Q&A: Educating Vendors and Providers about Cultural Differences

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Loretta Estes, coordinator of cultural and linguistic services and a community affairs coordinator for Passport Health Plan.

Question: My organization interacts daily with hospital staff. We have a vested interest in overcoming cultural barriers in healthcare and want to understand our customers' needs. How can organizations such as mine achieve similar goals?

Response: My main focus has been educating our providers, but working with customers would be a great next step. One of our goals is partnering with vendors so that we're all on the same page. My focus is working with our providers, staff and the community.

For more details on addressing cultural differences in healthcare, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Primary Care Physicians & DM

In this week's disease management podcast, Peter Simpson, president of Segmedica Inc, defines the three types of physicians his organization has identified after years of psychological research. Dr. Maureen Mangotich, medical director of provider and community outreach with McKesson Health Solutions, reviews some feedback McKesson has received after offering new disease management programs to primary care physicians.

To listen to this complimentary HIN podcast, please visit:

4. Breast Cancer Therapy Can Depend on Race

A new study finds treatment for breast cancer differs between African-American women and white women, though the differences are partly dependent on insurance type. Researchers reviewed and analyzed demographic, socioeconomic and medical data from 651 women diagnosed with breast cancer in the early- to mid-1990s to evaluate the role of race in breast cancer treatment.

Among patients with breast cancer that had spread to the lymph nodes, African-Americans were less likely to have adjuvant cancer therapy than white women. White women were almost five times more likely to take Tamoxifen, a Widely used cancer therapy medication, and more than three times more likely to have chemotherapy. Women with early stage breast cancer who had government health insurance were less likely to have combination breast-conserving cancer surgery and radiation, and more likely to have a mastectomy without radiation than patients enrolled in non-governmental plans.

Breast cancer is diagnosed at a more advanced, poor prognostic stage among African-American women than white American women. Studies also suggest that, stage for stage, African-American women have higher cancer mortality rates.

Differences in access to screening and treatment infrastructure, rather than tumor biology, may account for differences in clinical course.

To see more of this survey's results, please visit:

5. Survey of the Month: Healthcare Trends in 2008

Complete our survey on healthcare trends in 2008 and you'll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Cultural Competency in Healthcare: Health Plans and Providers Strive to Speak the Same Language

According to the 2000 U.S. Census, almost 15 percent of U.S. residents speak a language other than English at home or have a limited English proficiency. When members of this population fall ill, cultural differences can cause conflicts and misunderstandings between healthcare providers and patients. A cultural divide can also render communications between a health plan and a member lost in translation. Increasingly sensitive to the needs of diverse populations, many healthcare organizations are making cultural competency training a mandatory component of staff meetings, new employee orientation and the lunch hour.

To download this complimentary white paper, please visit:
Please forward this news announcement to your colleagues who might find it useful.
Contact HIN: For more information on the products and services available through the Healthcare Intelligence Network, contact us at (888) 446-3530 / (732) 528-4468, fax (732) 292-3073 or email us at info@hin.com.
All contents of this message Copyright 2007