Starting at 30, women can collect their own vaginal samples for HPV testing at a doctor’s office.Doctors routinely advise that women undergoing screening for cervical cancer receive Pap smears every three years beginning at age 21. Now, beginning at 30, women have a new option.Instead of undergoing a pelvic exam, these patients may go to a doctor’s office and collect their own vaginal sample to be tested for human papillomavirus, the infection that causes most cases of cervical cancer, according to new guidelines issued on Tuesday by a national health services panel.Self-collection of the sample was approved in May by the Food and Drug Administration. The HPV test should be repeated every five years from age 30 until 65, when most women can stop screening, the U.S. Preventive Services Task Force said.Other screening options for those 30 and older include continuing with Pap tests every three years, or a combined Pap smear and HPV test every five years, the task force said. But an HPV test every five years is the ideal screening method, providing the best balance of risks to benefits.The new recommendations apply to women and anyone who was assigned female at birth and still has a cervix, regardless of whether they have been vaccinated against HPV.The advice was issued amid growing concern about a falloff in cancer screenings, and confusion resulting from changes over time in screening regimens and tests used for early detection and prevention of cervical cancer.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Anthem Blue Cross Blue Shield officials had planned to roll out the changes nationwide but said they were misunderstood.Anthem Blue Cross Blue Shield, a major health insurer, on Thursday rolled back a policy change that would have capped payments for anesthesia for patients, and would have denied claims altogether if any given procedure exceeded a time limit.The policy, which was to be tested before a national rollout, prompted controversy — first from anesthesiologists and then, after a flurry of media reports, from legislators in Connecticut and New York, where the policy was to go into effect in February.Anesthesiologists said that the change in reimbursement was unprecedented and would have overturned a formula standard since the 1990s.“No other commercial health insurer, no government payer, Medicare or Medicaid, has ever done anything like this and come up with an arbitrary time limit for anesthesia services,” Dr. Don Arnold, president of the American Society of Anesthesiologists, said.“Surgery and other procedures can take variable lengths of time,” he added. “Certainly procedures and techniques are standardized, but patient needs are unique and they require variable amounts of time, care and attention.”Gov. Kathy Hochul of New York wrote on X, formerly known as Twitter: “Outrageous. I’m going to make sure New Yorkers are protected.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Anthem Blue Cross Blue Shield officials had planned to roll out the changes nationwide but said they were misunderstood.Anthem Blue Cross Blue Shield, a major health insurer, on Thursday rolled back a policy change that would have capped payments for anesthesia for patients, and would have denied claims altogether if any given procedure exceeded a time limit.The policy, which was to be tested before a national rollout, prompted controversy — first from anesthesiologists and then, after a flurry of media reports, from legislators in Connecticut and New York, where the policy was to go into effect in February.Anesthesiologists said that the change in reimbursement was unprecedented and would have overturned a formula standard since the 1990s.“No other commercial health insurer, no government payer, Medicare or Medicaid, has ever done anything like this and come up with an arbitrary time limit for anesthesia services,” Dr. Don Arnold, president of the American Society of Anesthesiologists, said.“Surgery and other procedures can take variable lengths of time,” he added. “Certainly procedures and techniques are standardized, but patient needs are unique and they require variable amounts of time, care and attention.”Gov. Kathy Hochul of New York wrote on X, formerly known as Twitter: “Outrageous. I’m going to make sure New Yorkers are protected.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

After a court overturned a ban, the agency has proposed restricting chlorpyrifos to 11 food crops, illustrating the limits of federal regulation.Almost 25 years after federal regulators curbed household use of a pesticide linked to learning disorders in children, and three years after a total ban on its use on food crops, the chemical is again being applied to everything from bananas to turnips in most states.The saga of this pesticide, which has the unwieldy name chlorpyrifos, is a stark reminder of why so many Americans are alarmed about industrial farming and the food supply. The concern helped propel Robert F. Kennedy Jr.’s presidential candidacy and subsequent selection to head the Department of Health and Human Services.The issue is also a vivid illustration of the obstacles that regulators will face if they try to make good on campaign promises to remove harmful chemicals from the food supply, as Mr. Kennedy often has.The latest twist arrived on Monday, when the Environmental Protection Agency proposed outlawing the use of chlorpyrifos on farmed foods — except on 11 crops, including fruits children tend to eat in large quantities, such as apples, oranges, peaches and cherries.In an interview, Dr. Michal Freedhoff, assistant administrator of the office of chemical safety and pollution prevention at the E.P.A., said the proposed rule would provide the greatest benefit to children’s health while still abiding by a federal-court decision last year that overturned the agency’s original ban.The proposal will lower the amount of the pesticide applied to fields and orchards annually by 3.9 million pounds, from the 5.3 million pounds used each year from 2014 to 2018, according to a preliminary E.P.A. analysis.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Americans are dying of illnesses related to alcohol at roughly twice the rate seen in 1999.The number of deaths caused by alcohol-related diseases more than doubled among Americans between 1999 and 2020, according to new research. Alcohol was involved in nearly 50,000 deaths among adults ages 25 to 85 in 2020, up from just under 20,000 in 1999.The increases were in all age groups. The biggest spike was observed among adults ages 25 to 34, whose fatality rate increased nearly fourfold between 1999 and 2020.Women are still far less likely than men to die of an illness caused by alcohol, but they also experienced a steep surge, with rates rising 2.5-fold over 20 years.The new study, published in The American Journal of Medicine, drew on data from the Centers for Disease Control and Prevention.Deaths related to alcohol included those caused by certain forms of heart disease, liver disease, nerve damage, muscle damage, pancreatitis and alcohol poisoning, as well as related mental and behavioral disorders. The study did not include other deaths influenced by alcohol, such as accidents.“The totality of the evidence indicates that people who consume moderate to large amounts of alcohol have a markedly increased incidence of premature deaths and disability,” said Dr. Charles Hennekens, a professor of medicine at Charles E. Schmidt College of Medicine at Florida Atlantic University and one of the study’s authors.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Trends in child health are in fact worrisome, and scientists welcome a renewed focus on foods and environmental toxins. But vaccines and fluoride are not the cause.Robert F. Kennedy Jr., now President-elect Donald J. Trump’s pick to lead the Department of Health and Human Services, has for years called attention to what he considers an “epidemic” of chronic disease that has left America’s children among the sickest in the developed world.Mr. Kennedy blames environmental toxins and a broken food system. But he also points to some of the most widely acclaimed advances of the last century: fluoridated water and vaccines that have nearly eradicated diseases like polio.Most child health experts are adamantly opposed to scaling back fluoridation or immunizations, saying such changes would harm health and trigger outbreaks of deadly infectious diseases.But many do not reject Mr. Kennedy’s primary diagnosis: There is a child health crisis in America.“On this particular point he’s right,” said Dr. Philip Landrigan, a pediatrician and epidemiologist who directs the Program for Global Public Health and the Common Good at Boston College.Even as infectious diseases and child mortality plummeted in the 20th century, he added: “There is no question noncommunicable diseases in children are up. I disagree with him that vaccines are the cause.”Many scientists like Dr. Landrigan acknowledge that there are disturbing trends in childhood health in the United States, and they welcome Mr. Kennedy’s focus on foods and chemicals in the environment.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Excessive drinking persisted in the years after Covid arrived, according to a new data.Americans started drinking more as the Covid-19 pandemic got underway. They were stressed, isolated, uncertain — the world as they had known it had changed overnight.Two years into the disaster, the trend had not abated, researchers reported on Monday.The percentage of Americans who consumed alcohol, which had already risen from 2018 to 2020, inched up further in 2021 and 2022. And more people reported heavy or binge drinking,“Early on in the pandemic, we were seeing an enormous surge of people coming in to the clinic and the hospital with alcohol-related problems,” said Dr. Brian P. Lee, a hepatologist at the University of Southern California and the principal investigator of the study, published in Annals of Internal Medicine.“People assumed this was caused by acute stress, like what we saw with 9/11 and Katrina, and typically it goes back to normal after these stressful events are over,” he added. “But that’s not what we’re seeing.”Alcohol can be addictive, “and we know that addiction doesn’t go away, even if the initial trigger that started it has gone away,” Dr. Lee said.Rates of heavy drinking and of alcohol-related liver disease had been rising steadily for decades before the pandemic struck. But alcohol-related deaths surged in 2020, with one study reporting a 25 percent increase in a single year, said Christian Hendershot, director of clinical research at U.S.C.’s Institute for Addiction Science.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

In a first, the guidelines link poor pregnancy outcomes to stroke and call on doctors to exercise greater vigilance.New guidelines for preventing strokes spell out for the first time the risks faced by women, noting that pre-term births and conditions like endometriosis and early menopause can raise the risk.“Prior guidelines tended to be sex-agnostic,” said Dr. Brian Snelling, director of the stroke program at Baptist Health South Florida’s Marcus Neuroscience Institute, who was not involved in writing the guidelines.“Now we have more data about sex-specific subgroups, so you’re able to more appropriately screen those patients.”The focus of the recommendations by the American Stroke Association, published on Monday in the journal Stroke, is primary prevention — the effort to prevent strokes in individuals who have never had one. It represents the first such update in a decade, and it’s the playbook by which millions of Americans will be cared for.A stroke is a sudden blockage of blood flow to the brain, or sudden bleeding in the brain. It is a leading cause of the death in the United States, and the incidence has been rising even among adults 49 and younger, stoked by increases in obesity, high cholesterol, diabetes and — perhaps most significantly — high blood pressure.Nearly 800,000 strokes occur each year, leading to severe disability and more than 160,000 deaths. Some 57 percent occur in women. At least 60 percent are preventable.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Rates of breast cancer — the second leading cause of cancer deaths in U.S. women — climbed by 1 percent a year from 2012 to 2021, and even more sharply among women under age 50 and among Asian American/Pacific Islander women of all ages, according to an American Cancer Society report published on Tuesday.The biennial report is among the most comprehensive and detailed studies of breast cancer occurrence over recent years. One in 50 U.S. women will develop invasive breast cancer by the age of 50, the authors said, based on National Cancer Institute calculations.The sharpest increases in young adults by age during the decade were among women in their 20s, whose rate increased by about 2.2 percent a year, though their absolute risk remains very low, at about 6.5 per 100,000 women. Among Asian American/Pacific Islander women, who historically also have had a low prevalence of the disease, rates increased by 2.7 percent a year among those under 50, and by 2.5 percent a year among older women.Cancer is generally considered a disease of aging, and that hasn’t changed: The vast majority of breast cancer cases and deaths still occur among older women. But the new study is one of several documenting a troubling uptick in malignancies among younger Americans.These so-called early-onset cancers pose special challenges. Striking in early adulthood or midlife, they tend to be aggressive yet are often missed because they are not expected, and routine screenings are aimed at older adults.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Scientists continue to rethink the idea that moderate drinking offers health benefits.Adults under age 50 have been developing breast cancer and colorectal cancer at increasingly higher rates over the last six decades, and alcohol use may be one factor driving the trend, according to a scientific report published on Wednesday.The report, by the American Association for Cancer Research, highlights scientific breakthroughs that have led to new anticancer drugs and improved overall survival.But the authors also described a troubling pattern: Even as cancer death rates have declined, the overall incidence of several cancers has been rising inexplicably, with an especially alarming increase among younger adults in cancers of the gastrointestinal system, like colorectal cancer.The report estimates that 40 percent of all cancer cases are associated with modifiable risk factors. It recommends reducing alcohol consumption, along with making lifestyle changes such as avoiding tobacco, maintaining a healthy diet and weight, exercising, avoiding ultraviolet radiation and minimizing exposure to pollutants.The authors called for raising awareness through public messaging campaigns and adding cancer-specific warning labels to alcoholic beverages.The recommendations come amid a radical rethinking of the putative health benefits of moderate alcohol consumption, which for years was considered to be protective against heart disease.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.