Dr Jaganathan Sickan, Associate Medical Director, Abbott Diagnostics, Singapore, talks to ETHealthworld on why women are still being under-diagnosed in India.
How well is India adapting to the idea of preventive diagnostics?
Preventive diagnostics is something that is very new, now preventive medicine has come into play in the field of medicine.
Preventive diagnostics is a method of identifying diseases even before there is a clinical setting in the diseased state. As far as India is concerned this is very new and we would gain more by doing preventive diagnosis for our patients.
Are women being under-diagnosed?
Women are being underdiagnosed in many diseases and this is because most women will bear the pain and only when they cannotbear it any further do they come to the doctor for their check-up.
If women are put through few important tests that will diagnose their disease at an early stage you will find out that yes women today are underdiagnosed.
What are the diseases that are being underdiagnosed in your opinion?
Here I would like to highlight three health diseases which are heart disease, ovarian cancer and thyroid disease in pregnancy.
From a study that we recently did with the University of Edinburgh, we were able to show that women are being underdiagnosed as far as acute myocardial infarction is concerned.
We did a comparison using the older troponin and the newer troponin for patient who came to the emergency department with chest pain. Through the use of older troponin they identified more males with acute myocardial infarction compared to females. But when they used the high sensitive troponin eye on the same subjects the diagnosis of women increased by 23% while only 2% increased in male.
So from this we are clear that if you use an older troponin you are going to miss the diagnosis by 1 in 5 women who come for diagnosis. This is happening because the older troponin only has a single cut-off value whereas the new high sensitive troponin eye has a gender specific cut-off value.
With the new high sensitive troponin eye which has a significant lower cut off value for females, we were able to pick up women who came with chest pain or acute myocardial infarction. So we increased our diagnosis of women by 23%.
What has been the recent development in the field of ovarian cancer?
Most of our physicians or gynecologists are using a single marker known as CA-125 which is excellent in picking up stage 2 and stage 4 ovarian cancers.
Recently a new marker has been launched in India known as HE4. This marker picks up about 80% of stage 1 and stage 2 ovariancancers, so when you form the combination of HE4 and CA-125 together your chances of picking up early ovarian cancers are much better.
How efficient are we in diagnosis of thyroid disease in pregnancy?
Thyroid disease is a very interesting thing especially in India. Doctors have started screening pregnant mothers for Thyroid disease.
If the mother is TPO antibody positive she has a 6.5 times higher risk of having an abortion in this pregnancy. TPO antibodyhelps you to identify subclinical hypothyroidism and also gives you the risk stratification on what the women will have after delivery…
If we were to do TPO antibody in those mother who have diabetes, the risk becomes 150%. So we are able to risk stratify what is going to happen to the patient when she delivers.
Date: 21st July, 2016