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Calvin Cole




Calvin Cole  
 
Head of Underwriting & Claims
RGA UK

Welcome to RGA's 
ReSearch Vitals, a new resource dedicated to providing you a collection of key article abstracts and links covering recent medical advances. 

The pace of medical advances and corresponding literature is exceedingly rapid. Our aim is to keep you up-to-date with the latest medical research, curating articles of interest to underwriters, medical officers and claims assessors.  

Please forward this email to your colleagues. I hope you enjoy and find useful.

As always, your feedback is welcomed; let me know what you think.

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In this edition

Cancer

doctor-1149149_1920Association of survival with adherence to the American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors after colon cancer diagnosis: the CALGB 89803/Alliance Trial. JAMA via PubMed.

12 April 2018

The study found that patients who followed the recommendations of maintaining a healthy weight, engaging in physical activity and consuming a diet containing vegetables, fish, and whole grains, had increased survival compared to controls.

Screening for prostate cancer U.S. Preventive Services Task Force recommendation statement. JAMA via PubMed.

8 May 2018

Men aged 55 to 69 years should discuss the potential harms and benefits of PSA-based screening with their doctor, and the decision whether to undergo such screening should be up to the patient. The task force recommends against PSA-based screening for men 70 years and older.

Predictors of unemployment after breast cancer surgery: a systematic review and meta-analysis of observational studies. JCO via PubMed.

14 May 2018

Out of the many variables studied, having a job with either high physical (Odds ratio=2.11) or psychological demands (Odds ratio= 4.26) was strongly correlated with unemployment after breast cancer surgery.

Precision Health

DNA - Strands (1)Estimation of the percentage of U.S. patients with cancer who benefit from genome-driven oncology.  JAMA Oncology via PubMed.

17 April 2018

Since 2006 the percentage of cancer patients who are eligible for genome targeted therapy has increased (5.09% in 2006 to 8.33% in 2018); however, the percentage of patients who benefit from the therapy remains small (4.9% in 2018).

Association of methylation signals with incident coronary heart disease in an epigenome-wide assessment of circulating tumor necrosis factor α. JAMA Cardiology via PubMed.

4 April 2018

Individuals with methylated TNF-α-linked CpG sites had a 9-19% decreased risk of developing coronary heart disease.

 Dr. Dave Rengachary, Senior Vice President, Chief Medical Director, U.S. Mortality Markets at RGA, answers Five Key Questions about epigenetics in a recent Springboard Short.                

A genetic test could help predict the right antidepressant for you. TIME Health.

7 May 2018

GeneSight analyzes a patient’s DNA to determine how well he or she may metabolize medications, which can affect how the patient will respond to them. Researchers found patients were 30% more likely to the respond to a class of drug the test recommended.

Cardiovascular

Pulse trace (1)

Five-year risk of stroke after TIA or minor ischemic stroke. NEJM via PubMed.

16 May 2018

In the cohort, the rate of stroke (6.4%) remained unchanged during the five years after the initial event. The rate of all-cause death at five years was 10.6%.

 

B-Type natriuretic peptide levels and mortality in patients with and without heart failure. JACC via PubMed.

15 May 2018

In patients both with and without heart failure, levels of BNP are correlated with risk of death. For each level of BNP the risk appears similar in both patient groups.

 Many life insurers are reviewing the use of NTproBNP for underwriting assessment. Dr. Valerie Kaufman, Vice President, Medical Director, and Dr. David Rengachary, Senior Vice President, Chief Medical Director, U.S. Mortality Markets at RGA, recently wrote this RGA Springboard Short  about how best to use NTproBNP testing to optimize cardiovascular risk selection.   

Associations of fitness, physical activity, strength, and genetic risk with cardiovascular disease: longitudinal analyses in the UK Biobank Study. Circulation via PubMed.

9 April 2018

Patients who engaged in fitness and physical activity had a lower risk of cardiovascular disease regardless of their genetic risk. In particular, patients with high genetic risk and high levels of cardiorespiratory fitness had a 49% reduction in risk (Hazard ratio= 0.51) of coronary heart disease.

Lifestyle & Wellness

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Association of disrupted circadian rhythmicity with mood disorders, subjective wellbeing, and cognitive function: a cross-sectional study of 91,105 participants from the UK Biobank. Lancet Psychiatry via PubMed.

15 May 2018

By studying a subset of participants from the UK Biobank, disruption in circadian rhythms was shown to be associated with mood disorders—including major depressive disorder and bipolar disorder—as well as lower reported levels of happiness and greater reported feelings of loneliness.

 

Association of a negative wealth shock with all-cause mortality in middle-aged and older adults in the United States. JAMA via PubMed.

3 April 2018

Older adults who experienced a sudden loss of wealth, defined as losing 75% or more of total assets over two years, had a significantly increased risk of mortality (HR=1.50) during a 20-year follow-up compared with those who experienced continuous positive wealth.

 High net worth individuals are an important target market for many insurers. Hilary Henly, Head of Underwriting (Ireland) and Director of Divisional Underwriting Research, recently reflected on the opportunities and risks associated with high net worth business. Hilary’s article considers the challenge of providing an effortless customer experience while verifying the client’s financial status.   

Neurological

Neurons - Fourth Width

Long-term risk of dementia among people with traumatic brain injury in Denmark: a population-based observational cohort study. Lancet Psychiatry via PubMed.

10 April 2018

Compared to controls, people with traumatic brain injury (TBI) had an increased risk of dementia compared both with people without a history of TBI (HR=1.24) and with people with non-TBI trauma (HR=1.29).

Anticholinergic drugs and risk of dementia: case-control study. BMJ via PubMed.

25 April 2018

Certain classes of anticholinergic drugs have a strong association with future dementia incidence. Patients’ risk of dementia increased with exposure to anticholinergic drugs prescribed to treat depression, urinary incontinence and Parkinson’s disease.