Add colorectal and breast cancer to the list of malignancies caused by smoking according to new studies.

Two studies strengthen the case for the dangers of secondhand smoke for people exposed to fumes as children and as adults. According to the American Association for Critical Illness Insurance, some 17 cancers are now attributed to smoking. Cancer and heart disease are the major critical illnesses impacting millions of Americans yearly.

Inhaling secondhand fumes may raise a woman’s odds for breast cancer or a child’s lifetime risk for lung malignancies according to the studies. Another study found that long-term smokers have a higher risk of developing colorectal cancer, a finding that factored into the recent decision by the International Agency for Research on Cancer (IARC) to assert that there is “sufficient” evidence to link the two, up from its previous “limited” evidence.

In preparing their reports, the researchers adjusted for other colorectal cancer risk factors, such as not getting screened, obesity, physical activity and eating a lot of red or processed meats. They noted that people who smoke are already more likely to engage in these types of behaviors.

This study followed almost 200,000 people over 13 years. According to the medical researchers, current smokers had a 27 percent increased risk of colorectal cancer and former smokers a 23 percent increased risk compared with people who had never smoked.

People who had smoked for at least half a century had the highest risk — 38 percent higher than never smokers — of developing colorectal cancer. People who ceased smoking before the age of 40 or who had not smoked for 31 or more years had no increased risk.

Other studies focused on the risk of secondhand smoke, or passive smoking. In one, children exposed to secondhand smoke had a higher risk of developing lung cancer as adults, researchers from institutions including the U.S. National Cancer Institute found. In another, California researchers found that adult non-smoking women who had spent long periods of time in smoking environments upped their odds of developing postmenopausal breast cancer.

The breast cancer findings were seen mostly in postmenopausal women, with a 17 percent higher risk for those who had had low exposure, a 19 percent increased risk for those with medium exposure and a 26 percent increased risk for those who had high long-term exposure over their lifetime.

The studies were published in the December issue of Epidemiology, Biomarkers & Prevention,

A lot of smokers wish they could quit smoking, but they dont act on the desire. Afraid it will be too difficult, they shy away from the prospect and keep going with the destructive habit. This is an instance where stop smoking hypnosis can help.

How to quit smoking for good

This prospective study demonstrated that patients that successfully quit smoking before they started treatment had significantly fewer complications.
They demonstrated that of the epithet racial, and socioeconomic status disparity exist in bladder cancer survival.
Data from the Network of Cancer Registries from 205,562 patients aged 75 years that were diagnosed with cancer between 1989 and 1997 indicated that age did not weight the long-term conditional probabilities of death in the same deportment for cancers of the colon or rectum.
Metastatic colorectal cancer patients enrolled into clinical trials differ in characteristics from patients receiving chemotherapy outside a protocol and have better survival, when given the same treatment.
Radiographic evaluations were discussed as well as treatment strategies.
The results indicated that age is an of the epithet variable in the selection of patients for esophageal cancer surgery.

List of References
How to Quit Smoking Without Gaining Weight, Bess Marcus, The American Lung Association, Jeffrey S. Hampl, 2004

Follow these to Quit Smoking Easily is filed under quit smoking.

• Long-term smoking associated with a 30 to 50 percent increased risk.

• Avoiding smoking is one way to reduce colorectal cancer risk.

PHILADELPHIA – New study results strengthen the evidence that people who smoke cigarettes over a long period of time have an increased risk for developing colorectal cancer, even after adjusting for other risk factors.

“This provides one more reason not to smoke, or to quit as soon as possible,” said senior author Michael J. Thun, M.D., M.S., vice president emeritus, epidemiology and surveillance research at the American Cancer Society. “Colorectal cancer should be added to the list of cancers caused by smoking.”

Findings are published in the December issue of Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, as part of a special focus on tobacco.

Thun and colleagues tested the association between long-term cigarette smoking and colorectal cancer after adjusting for multiple other factors that are generally associated with risk, including screening. From 1992 through 2005 the researchers followed almost 185,000 participants aged 50 to 74 years old; participants described their behaviors and medical conditions.

Participants who smoked cigarettes for 40 or more years, or who did not quit before age 40, had a 30 percent to 50 percent increased risk of developing colon or rectal cancer during the follow-up, even in analyses that adjusted for 13 other potential risk factors, according to Thun. After 13 years of follow-up, the researchers identified 1,962 cases of invasive colorectal cancer.

While previous large studies conducted in long-term smokers showed similar results, Thun stated that this study is the first to control for screening and all of the suspected risk factors for colorectal cancer, such as alcohol consumption, physical inactivity and consumption of red or processed meat.

“These findings contributed to the evidence recently reviewed by the International Agency for Research on Cancer (IARC) in October of this year,” Thun said. “IARC upgraded the evidence that smoking causes colorectal cancer from ‘limited’ to ‘sufficient’.”

This IARC reclassification brings the number of cancer organ sites causally related to cigarette use to 17, which includes cancers of the oral cavity, pharynx, nasopharynx, nasal cavity and paranasal sinuses, larynx, lung, esophagus (both squamous cell and adenocarcinoma), stomach, colorectum, liver, pancreas, kidney (both renal cell and transitional cell carcinoma), urinary bladder and lower urinary tract, uterine, cervix, and myeloid leukemia.

Additional resources:

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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, the AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes 30,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and nearly 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants, research fellowship and career development awards. The AACR Annual Meeting attracts more than 16,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes six major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

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Colon cancer affects both men and women of all ages. The spread of this disease is very slow, and so at first there are no symptoms of the disease. The disease is first diagnosed after a routine check up that has been undergone for some other illness or disease. Therefore the best course of action to take sometimes isn’t clear until you’ve listed and considered your alternatives. The following paragraphs should help clue you in to what the experts think is significant is should be known by everybody.

The colon is one of the most important organs in the body. It’s intended purpose is to return water and nutrients into our bodies and help us eliminate waste. American diets are low in fiber and digestive enzymes. This causes the body produce digestive enzymes at the expense of immune system enzymes.

The low level of fiber prevents the colon from cleaning itself and causes a buildup of toxic matter in the colon. The buildup of toxic matter in the colon can lead to many health problems, the most serious of which is colon cancer. The weakened immune system is unable to fight the disease.

Colon cleansing helps the body rid itself of toxic matter. This in turn allows the colon to aid in the digestive process and allows the production of immune system enzymes to return to normal.

There are several ways to cleanse your colon. One is hydrotherapy, where a small disposable plastic hose is used to irrigate the colon. A licensed professional must perform this procedure. Similarly, enemas are often thought to cleanse the colon, but they have been shown to only clean the bottom portion and rectum.

How can you put a limit on learning more? The next section may contain that one little bit of wisdom that changes everything.

Herbal supplements are often used in colon cleansing as well. A plant product called psyllium is most usually the base of these treatments. The psyllium’s fiber expands when it comes in contact with water, and the bulky material causes the bowel to contract and expel waste.

There are also oxygen based cleaners that turn the waste into liquid or gas and help it to be expelled.

Another way is to do juice fasting. Juice fasting gives the entire digestive system a much needed rest and for optimal functioning to take place once again after the break.

In a nutshell, colon cancer can be preventable. If you find yourself having meals that are low in fiber, try doing a colon cleanse. A clean colon will mean a healthy colon and a better immune system for your body.
There’s a lot to understand about prevention of colon cancer. We were able to provide you with some of the facts above, but there is still plenty more to be known and investigated.

Read more

Men who regularly get moderate exercise may have a lower risk of developing prostate cancer. 

Researchers examined men who underwent biopsies for possible prostate cancer.  Those who exercised moderately, the equivalent of three to six hours of walking per week, were less likely to be diagnosed with the disease. 

The study found that compared with their sedentary counterparts, these men were two-thirds less likely to have a biopsy positive for prostate cancer. In addition, men who performed one to three hours of walking each week had an 86 percent lower chance of having an aggressive form of the cancer. 

According to the American Association for Critical Illness Insurance, some 745,000 men are diagnosed with cancer each week.  Prostate cancer is the leading cancer impacting men.  The study findings which appear in the current issue of the Journal of Urology do not prove that exercise helps prevent prostate cancer the researchers point out. But it could offer men another incentive to get active. 

A number of studies have looked at the relationship between exercise and prostate cancer, and while most have pointed to a protective effect, about one-third have found no association.  The medical experts found that among the 111 sedentary men in the study, half were diagnosed with cancer after biopsy. That compared with 27 percent of those men who got the equivalent of three to six hours of walking each week. 

And among men diagnosed with prostate cancer, 51 percent of sedentary patients had more-aggressive cancer, versus 22 percent of those who had been mildly active — getting the equivalent of one to three hours of moderate walking per week.

Exercise itself remained linked to a lower risk of prostate cancer after the researchers accounted for a number of other factors, like age, weight and race.  Exercise has been shown to lower blood levels of testosterone and other hormones that may stimulate prostate tumor growth. Exercise is also believed to stimulate the immune system and the body’s natural antioxidant mechanisms, both of which may help prevent the development of prostate cancer.

 A patient’s income, martial status and race has absolutely no impact on their outcome following curative radiation therapy for the treatment of prostate cancer.

A study conducted at the Henry Ford Hospital in Detroit found that socioeconomic status factors had no impact on predicting the outcome of treatment. All patients did equally well, based on the known prognostic factors.

The study, presented this week at the American Society for Radiation Oncology meeting in Chicago is unique in that nearly 50 percent of patients in the analysis are African American.

Prostate cancer affects one in six men in the United States according to the American Association for Critical Illness Insurance and the majority of all prostate cancer are diagnosed in men older than 65.  Most individuals diagnosed with the illness will survive.  Only one in 35 will die of prostate cancer.   Radiation therapy involves administering high-energy X-rays to kill cancer cells. 

According to the study’s lead researcher, prior studies on socioeconomic status and cancer outcomes done by other groups have had conflicting results.  One study, for example, suggested that African Americans with breast or colon cancer do much worse than white patients because they receive care at hospitals with less expertise. 

Another study the medical experts noted show that men with prostate cancer who are married have better outcomes than those who are unmarried or without a partner. And yet other studies suggested that hospitals with large minority patient populations have higher mortality for cancer.

A shortcoming of many of the studies is the fact that they include a relatively small percentage of African American patients.  By comparison, almost half of the Ford study group was African American, which allowed researchers to undertake a more accurate assessment of how socioeconomic status affects prostate cancer outcomes.

The study included 788 Henry Ford Hospital patients with localized prostate cancer who were treated with external beam radiation therapy. Among those in the study, 48.5 percent were African American with a median household income $36,917, and 46 percent were white with a median household income of $60,190. The patients’ ages ranged from 44 to 90.

While there was a large difference in median household income among African Americans and whites, none of the socioeconomic factors examined predicted for patient outcome. Only known disease risk factors determined overall survival or biochemical (PSA) control rates.

A high-definition (HD) colonoscopy is much more sensitive than standard colonoscopy in finding polyps that could morph into cancer.

According to researchers from the Mayo Clinic it appears that high-definition colonoscopy detects more precancerous polyps. The difference could be as much as 20 percent.

Approximately 14 million colonoscopies are performed each year according to the American Association for Critical Illness Insurance, the industry organization that tracks and reports data related to critical illnesses. Some 745,000 men were diagnosed with cancer each year, roughly 10 percent with colon cancer.

 A study was conducted between September 2006 and December 2007 when the Mayo Clinic in Florida was switching its six colonoscopy procedure rooms from standard colonoscopy endoscopes to high-definition endoscopes.

The findings, presented at the annual meeting of the American College of Gastroenterology in San Diego, Calif., are not only important because a large group (2,430) of patients participated, but they resulted from the only study to date that has compared these two methods in a general clinical practice setting, among all the patients who needed a colonoscopy and with all the physicians who performed it.

An endoscope is the lighted tube inserted into the colon and rectum to look for, and remove, polyps. A high-definition endoscope uses both a high-definition video chip and HD monitors (like HD television) that increase the resolution of the image. Patients were not assigned to one scope or the other. Instead, they were placed in whatever room was available and assigned a gastroenterologist who was on duty at the time.

Researchers found that the rate of detection of adenomas — polyps that are likely to become cancerous — was 29 percent among patients who were scanned with high-definition endoscopes, versus 24 percent for those in which standard endoscopes were used.

The study was funded by Mayo Clinic, and the authors declare no conflict of interest nor do they endorse the products mentioned in the study.

Algunas veces me encuentro con enlaces interesantes que no dan para escribir una entrada larga en el blog, como la publicación de un artículo, o la actualización de una guía de práctica clínica. Muchos de estos enlaces me llegan vía twitter y los retransmito por el mismo medio, pero soy consciente de que mucha gente aún no utiliza esta herramienta por lo que si no están atentos a la barra lateral de este blog es probable que no lo lean. Por esta razón he decidido hacer una recopilación heterogénea de algunos de ellos:

• American Journal of Gastroenterology Guidelines for Colorectal Cancer Screening 2008: This document is the first update of the American College of Gastroenterology (ACG) colorectal cancer (CRC) screening recommendations since 2000. The CRC screening tests are now grouped into cancer prevention tests and cancer detection tests. Colonoscopy every 10 years, beginning at age 50, remains the preferred CRC screening strategy. It is recognized that colonoscopy is not available in every clinical setting because of economic limitations. It is also realized that not all eligible persons are willing to undergo colonoscopy for screening purposes. In these cases, patients should be offered an alternative CRC prevention test (flexible sigmoidoscopy every 5–10 years, or a computed tomography (CT) colonography every 5 years) or a cancer detection test (fecal immunochemical test for blood, FIT).
• Why can’t you tickle yourself? PubMed abstract
• Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities. Thorax 2009;64:863-868
• El abordaje multidisciplinar de la esquizofrenia en Centros de Salud Mental. GuíaSalud id: 443.
• Centro de Recursos del CEADAC: Coincidiendo con el Día Nacional del Daño Cerebral, el Centro de Referencia Estatal de Atención al Daño Cerebral os invita a la presentación del Centro de Recursos del CEADAC el lunes 26 de Octubre a las 12:30 h en el Salón de Actos del centro (Sala Polivalente). Se ruega confirmación de asistencia al evento.
• Primer mapa de la incidencia de la tuberculosis: Martín, R, Monleón-Getino, T. A graphical study of tuberculosis incidence and trends in the WHO’s European region (1980-2006). Eur J Epidemiol. 2009;24(7):381–387.
• Manifiesto del Bibliotecario 2.0 (vía Universo Abierto). Imprescindible su lectura.
• How to add Medline Plus and UpToDate search boxes to your website: Medline - UpToDate Patient Search (vía Clinical Cases and Images – Blog)
• LigerCat: herramienta de búsqueda, muy útil para reforzar nuestras búsquedas en PubMed.
• Visible Human Server: recurso interactivo y gratuito, creado por la Escuela Politécnica Federal de Lausanne, para aprender anatomía humana (vía USALbiomédica)

It’s a detail a baby boomer must not overlook. As you approach middle age, it’s time to have a frank discussion with your primary care physician about colorectal cancer.

It’s a tricky cancer; in the early stages you may be symptom free. You could be feeling as strong as a horse, but inside your large intestine, little growths, called polyps, could be making the dangerous transition from benign to malignant.

To date, the best tool doctors have in diagnosing this disease is the colonoscopy. The very word strikes fear in the toughest men. Men and women will postpone the procedure because they don’t like the idea of a flexible tube running through their lower pipes. But screening is vital. Dr. David Lieberman, chief of the Division of Gastroenterology and Hepatology at Oregon Health and Science University in Portland, Oregon, says the exciting thing about colon cancer screening “is that, unlike other forms of screening where the goal is to detect early forms of cancer, with colon cancer we can actually prevent it because there is this pre-cancer phase of polyps.”

People of average risk should begin screening at age 50. “However, for individuals who have a close relative, a father, mother, sister or brother with colon cancer, they need to talk to their doctors earlier about colon cancer screening. Many of those patients need to begin screening at age 40,” says Lieberman. It’s good to get screened before you have any symptoms because “we know from various studies that if we wait for symptoms, often the cancers are discovered at a later stage and they’re much more difficult to treat.” Symptoms can include rectal bleeding (bleeding in stools), and changes in bowel habits.

While the colonoscopy is considered the “gold standard,” there are a couple of other screening tools. Lieberman says the fecal occult blood test “is a reasonably good test for detecting cancer, but it’s not going to detect pre-cancerous polyps.” The blood test has to be repeated every year. The sigmoidoscopy, like the colonoscopy, can detect polyps and cancers. The sigmoidoscopy can be performed in an office setting without sedation. “The problem with the sigmoidoscopy is that you’re only looking at the lower part of the colon, so if you happen to have growths further up in the colon, they can be missed.” Lieberman says use of the sigmoidoscopy has dropped off in the United States. For those with a family history of colon cancer, the colonoscopy is the recommended test.

During a colonoscopy, Lieberman says “we use a long, flexible tube with a light on the end of it and a little camera in it that we pass through the entire colon.” If you’re worried about pain or discomfort, Lieberman adds, “When we perform these procedures in the United States, everybody receives sedation. Most patients don’t remember the procedure. What they do remember is the day before the procedure…getting ready.”

The day before the colonoscopy is a day you’ll probably remember for years to come. You’ll be limited to a diet of clear liquids. You’ll also be given a solution that will cause you to visit the bathroom MANY times the evening before. The idea is to clean the colon so your doctor can easily spot and remove polyps. The important thing to remember is to follow your doctor’s prep list to the letter.

If you’re polyp-free after a colonoscopy, Lieberman says you won’t need to repeat the procedure for about ten years. If a benign polyp is found, a repeat colonoscopy is needed sooner, depending on the appearance and size of the polyp.

Does lifestyle have anything to do with developing colon cancer? Lieberman says, “There are lots of studies, and I’ve done some of them, which show that there are some risk factors that seem to be associated with a higher risk of developing colon cancer.” These include diets high in animal fat and low in fiber, diets low in calcium, obesity, smoking and low levels of physical activity. Lieberman cautions that if you start eating healthier food, including fruits, vegetables and whole grain bread, you still need to get screened.

Patients should be encouraged to get screened. Lieberman says he gives a lot of lectures to fellow doctors. “One of the things we emphasize is that it’s important to have this discussion with patients because this is one of the most preventable forms of cancer that we know of, because we can detect these polyps and take them out before there is cancer.” That, says Lieberman, is an exciting opportunity.

October 10, 2009.  Human stem cells may provide a means of creating a vaccine against colon cancer and other types of cancers.

Some 1.4 million Americans are diagnosed with cancer annually according to the American Association for Critical Illness Insurance, the national trade orgganization.  “Some 10 percent of cases in both men and women are colon cancer,” notes Jesse Slome, executive director.

American and Chinese scientists reporting noted that cancer and stem cells share many molecular and biological features.   Dr. Zihai Li, of the University of Connecticut Stem Cell Institute, said in a news release that by immunizing the host with stem cells, the researchers were are able to ‘fool’ the immune system to believe that cancer cells are present and thus to initiate a tumor-combating immune program.  The research by Li and colleagues is the first to make the connection between human stem cells and colon cancer vaccination.

The study authors noted that, it has long been believed that immunizing people with embryonic materials may trigger an anti-tumor response by the immune system, but this theory has never advanced beyond animal research. The finding that human stem cells may help immunize against colon cancer is new and unexpected they added.  The study was published online Oct. 7 in the journal Stem Cells.

The researchers vaccinated mice with human embryonic stem cells and found that the mice developed a consistent immune response against colon cancer cells. The vaccinated mice showed a dramatic decline in tumor growth, compared with non-vaccinated mice.

The Province of Québec rolled out a new “biopharmaceutical strategy” Thursday that they say aims to provide “development support for biotech and biopharmaceutical firms.”

The Roll-Out:

The announcement was beautifully coordinated with the relevant constituencies, as illustrated by the near-immediate chorus of support:

• Génome Québec said thank-you for the $30 million, we’ll get right to work.
• Merck Frosst Canada liked pretty much everything, particularly the boost for basic research and the initiatives to improve patient access to medicines.
• Sanofi-aventis also applauds the patient access initiatives, but focuses on the efforts in the new strategy to open lines of communication among government, pharmas, biotechs and academics.
• Rx&D and Pfizer chimed in along similar lines.

The Big News:

BIOQuébec can’t help bragging a little that “the Minister has retained some of the recommendations made by BIOQuébec.” The pride is justified, though.  Biotech advocates have been asking — since before the last federal budget — for a way to monetize the refundable tax credits they’ve been banking.  As part of the new strategy, BIOQuébec says the government will allow

“biotechnology companies within the human health industry [to] benefit from a short term support measure thanks to the quarterly financing of their tax credits.”

Interestingly, BIOQuébec appears to have some information about that initiative that is missing from the government publications (nope, not even in the French version), which only say it aims to “implement new methods of funding R&D tax credits adapted to the specific needs of health-related biotechnology firms.”

Money Talks:

On the financial front, the initiative also highlights a 10-year tax holiday (sparse on details, but expect it to look a lot like the OTEC in Ontario) and Teralys Capital.

Finally, the strategy notes ”three specialized start-up funds aimed at the technology sectors” with $41 million each that will be supported by “private-sector partners.”  Is the Pfizer-FRSQ Innovation Fund one of these?  Wednesday, that fund announced grants totalling $2.3 million for genomics studies of inflammatory bowel disease and metastatic colorectal cancer.

My Bottom Line:

This looks like a broad set of initiatives that aims to improve everything from student recruitment through R&D and commercialization to purchasing and reimbursement decisions.  I particularly can’t wait to see what the SR&ED monetization program looks like.  Hopefully we’ll learn in time to work with other governments *cough*Ontario*cough* as they start 2010 budget processes.

As we know that the cancer is a group of more than 100 types of diseases. It affects the body’s basic unit called cell. Cancer occurs in the body when cells become abnormal along with uncontrolled division of cells. Colon is a part of digestive system where waste materials are stored. And rectum is the end of the colon which is adjacent to anus.

Tumors of colon and rectum are growths which arises from the inner wall of the larger intestine. Benign tumors are termed as polyps of the larger intestine. Malignant tumors are cancerous. Benign polyps do not spread to other parts of the body and can be cured with the help of colonscopy. The risk factors of colorectal cancer includes high fat intake, family histoy , chronic ulcerative colitis etc.

colorectal cancer sympotms are still numerous and non specific. It includes fatigue, weakness, shortness of breath, narrow stools, diarrhea, constipation , red blood in the stool, abdominal pain , weight loss etc. In case of suspicious patient the doctor performs colonscopy to diagnose the tumor. Besides this , x-rays, ultrasonography, and CAT scan of the lungs , liver and abdomen are performed to avoid the metastasis to these parts. To avoid the risk of colorectal cancer, early detection and removal of precancerous colon polyps should be done before making it deadly. Treatments involves surgery, chemotherapy, radiation therapy etc. After the treatment follow-up exams are crucial in case of colon cancer as it has the chances of recurring. Follow -up exams means physical examination, blood tests of the liver enzymes , chest x-rays, CAT scans of the abdomen etc are regualarly done by the doctor .

In western world, its playing crucial role in causing death. For lessening its cases a clear understanding of the causes and course of the disease is needed. It has shown the need of thehour to screen and prevention of this disease.

Collagen tablets

Researchers noted that the inability of the PSA test to distinguish between deadly and harmless prostate cancers makes it unusable as a population-wide screening tool.  PSA is a protein made by the prostate gland. It is found in small amounts in the blood of healthy men, and is often elevated in men with prostate cancer, but also in men with benign prostate enlargement.

 Some 745,000 men in the United States will be diagnosed with cancer this year according to the American Association for Critical Illness Insurance, the industry trade group.  Nearly 300,000 will die and prostate cancer causes about a quarter of all cancer deaths among men.

The lead author of one study, a urologist with Gavle Hospital in Gavle, Sweden, noted that in addition to PSA, further biomarkers are needed before inferring population-based screening for prostate cancer.  The claim was based on a study of PSA tests of over 500 men diagnosed with prostate cancer. Their PSA was measured several years before being diagnosed. Scientists compared those tests with PSA tests from over 1,000 men without prostate cancer.

Reserachers reported that in men with a prediagnostic PSA level below 1 nanogram per milliliter, only six men [1.2 percent] were later diagnosed with a high-risk prostate cancer. Hence, PSA levels below [that] almost ruled out a future high-risk prostate cancer diagnosis.  They noted that the direct implication of their findings in a screening situation was that no matter which PSA cut-off you adopt for selecting men for further diagnostic work-up, you will either have too many false positives or too many false negatives.

Given the current trend in lowering the PSA cut-off to about 3 nanograms per milliliter, the medical reserachers noted that a large number of healthy men will be subject to painful, stressful and costly diagnostic procedures.  Their report worried that the wide overdiagnosis of slow-growing tumors causing unnecessary medical treatment and anxiety.

Although most agencies providing recommendations on prostate cancer screening, especially those outside the United States, do not recommend routine PSA testing for the early detection of prostate cancer, it continues to be performed frequently medical experts noted.

Source: British Medical Journal, 2009, 339:b3934

Follow this link for News Item

Date of publication:September 2009

Publication type:News Item

In a nutshell:Most colorectal cancer screening strategies would save healthcare systems money by picking up cases at an earlier stage and preventing the need for costly chemotherapeutic drugs, which have recently become available, a study has found.

Length of publication: 1 web page

Colostomy (stoma) bags and mounting plate (top right).

I was going through a lot of old photos today, and came across a funny one I’d completely forgotten. About a year ago I was working with a medical writer to document treatment for colorectal cancer. I was going to take several photos to accompany this video and a text about living with a stoma. That’s when I decided to play a little trick on the writer.

I was on my way to photograph different types of ostomy pouching systems, when I spotted a vacuum cleaner bag on a shelf. It struck me how similar it looked to the bags I was carrying to the photo room, so I took it along.

After taking photos of the proper stoma equipment (top photo), I placed the vacuum cleaner bag next to a stoma mounting plate for the last photo (below).

The "seasonal holiday stoma bag" spoof.

I fed all the photos into our publishing system alongside the writer’s text, adding this caption to the fake one:

Stoma bag for use on seasonal holidays and other occasions of excessive food consumption.

Then I waited to see what happened.

Sure enough, a half an hour later the writer came to my office looking serious and said she needed to talk to me about the photos. There was one type of pouching system she hadn’t seen before, and wondered if I knew what it was called? And then she burst out laughing.

We quickly agreed to keep the photo to see how the medical editor for the text (a stoma care specialist nurse) would react. Fortunately she also thought it was funny.

Photos by Øystein Horgmo
Top: © www.oncolex.no
Bottom: Creative Commons

An aspirin a day can prevent colon cancer in people with a genetic disorder that increases their risk of developing the disease.

Colorectal is the second biggest cause of cancer death in the United States and Europe, where a total of 560,000 people develop the disease each year, and 250,000 die from it according to the American Association for Critical Illness insurance, the national trade organization.

Scientists at the Institute of Human Genetics at Newcastle University in Britain said the benefits of aspirin were only seen after several years.  The researchers noted that they uncovered a simple way of controlling stems cells that make tumors grow.

The researchers tested over 1,000 people with Lynch syndrome — an inherited condition that predisposes a person to a range of cancers, particularly of the colon.  Some were given aspirins and some a placebo.

Follow-up tests after 10 years showed that although there was no difference in cancer rates after 29 months, a significant difference was detected after four years.  Fewer people in the aspirin group developing colon cancer, the study’s leader noted.

To date, there have been only six colon cancers in the aspirin group as opposed to 16 who took placebo, the study notes.  There is also a reduction in endometrial cancer.

People with Lynch syndrome have an increased risk of many cancers including stomach, colon, brain, skin, and prostate. Women carriers also have a high risk of developing endometrial and ovarian cancers.

In low daily doses aspirin has been found to stave off the risk of heart attacks and strokes, as well as chase away occasional aches and pains.  Other scientists have previously found it can reduce the risk of developing colon cancer and suggested it does so by blocking the enzyme cyclooxygenase2, or COX-2, which promotes inflammation and cell division and is found in high levels in tumors.

Over 1 million additional men were likely to have been incorrectly diagnosed and treated for prostate cancer.

Researchers indicated that over the past two decades, the introduction of prostate-antigen screening, or PSA, has resulted in the overdiagnosis reported in a new study published online by the Journal of the National Cancer Institute.

The report notes that overdiagnosis has been associated with early diagnosis in prostate cancer, but there have been no previous national estimates of its magnitude.  Nearly 800,000 American men are diagnosed with cancer each year according to the American Association for Critical Illness Insurance, the national trade organization.  Prostate cancer accounts for 10 percent of all cancer-related deaths.

Using data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program, researchers at the Dartmouth Institute for Health Policy & Clinical Practice examined age-specific prostate cancer incidence rates in American men diagnosed and treated in each year after 1986.   The PSA screening was introduced in 1987.

According to the study, an additional 1.3 million men were diagnosed.  These they note would otherwise have never been diagnosed absent screening, and more than 1 million have been treated since 1986. 

The increased diagnosis has been most dramatic among younger men.  The diagnosis for prostate cancer has more than tripled since 1986 in men aged 50-59 (from 58.4 to 212.7 per 100, 000) and more than a sevenfold increase in men under age 50 (from 1.3 to 9.4 per 100,000).

While colorectal cancer kills nearly 50,000 Americans a year only 61 percent of Americans who should be screened do so, new research finds.

Colorectal cancer is the second leading cause of cancer death in the United States after lung cancer.  There are several types of screening tests available according to the American Association for Critical Illness Insurance which advocates the importance of screening as a way for more Americans to survive deadly cancers.

Despite highly publicized education campaigns and widespread agreement about the importance of colorectal cancer screening, screening rates still lag.  Rates for minorities, the uninsured and other vulnerable groups are lower still, with only 22 percent of lower-income people screened.

Using data from a Texas health system researchers identified 20,000 men and women ages 54 to 75 who were eligible for colorectal cancer screening.  About 15 percent of the patients lived below the poverty line.

Patients most likely to get screened included those who saw a doctor regularly or who had health insurance.

Those with insurance were almost three times as likely to be screened, and those who saw the doctor regularly were nearly four times as likely to be screened.

Women were slightly more likely than men to be screened. Hispanics were slightly more likely to be screened than whites.

The study appears in the September issue of Cancer Epidemiology, Biomarkers & Prevention. 

• Only 22 percent of screen-eligible patients are screened
• Insurance, regular visits are the number one predictor of screening
• Higher rates of screening lead to less cancer

PHILADELPHIA, Sept. 8, 2009 – Colorectal cancer screening rates are much lower among those in a safety net health system compared to the national average, and the number one predictor of screening is a combination of regular visits and insurance access.

Colorectal cancer is the second leading cause of cancer death in the United States behind lung cancer. Nearly 50,000 Americans will die from colorectal cancer this year. Although scientists have differing opinions on the best method, the benefits of early screening are beyond debate – cancers caught early are easier to manage and treat.

Still, the nationwide rate of colorectal cancer screening is 61 percent, with much of the lack of screening concentrated among blacks, Hispanics and those without insurance. However, results of a study published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, showed that the screening rate was merely 22 percent among individuals served by a safety net health system in Texas.

“Of our patients who did get screened, they either had insurance or saw their doctor regularly. Once you controlled for those variables, the screening rate was essentially zero,” said Samir Gupta, M.D., assistant professor in the Department of Internal Medicine at the University of Texas Southwestern Medical Center.

Gupta and colleagues conducted their study using data from the Tarrant County Hospital District John Peter Smith Hospital Health Network, a safety net health system. The system serves 155,000 individuals a year in Tarrant County, Texas, a geographic area that includes Fort Worth, and is committed to delivering health care to the uninsured, Medicaid and other vulnerable patients.

Using their electronic administrative records, Gupta and colleagues identified 20,416 patients who were between 54 and 75 years old and were eligible for colorectal cancer screening. The median age of these patients was 60 years, and about 60 percent of them were women. Approximately 15 percent of the population lived below the poverty line and median household income was $35,419. The majority of the patients were either black or Hispanic; nearly 20 percent reported a primary language other than English.

Although 40 percent were classified as having health insurance, including those on Medicare and Medicaid, another 40 percent only had medical coverage through their connection to the safety net system; 20 percent had no insurance at all.

Over the previous five years, 22 percent of these patients were screened for colorectal cancer. Women were slightly more likely than men, and Hispanics were slightly more likely to be screened than whites, but the largest increase came when insurance and regular medical care were considered. Those with insurance were almost three times as likely to be screened, and those who saw the doctor regularly were nearly four times as likely to be screened.

Karen Glanz, Ph.D., M.P.H., professor of medicine and nursing at the University of Pennsylvania and an editorial board member of Cancer Epidemiology, Biomarkers & Prevention, said this study documents an important issue in a specific population.

“The idea that colorectal cancer screening rates are too low is not a new idea, but this is one of the first to document it in a specific population,” said Glanz. “Access to care clearly has consequences, and any talk of health care reform needs to address proven prevention measures like screening.”

Gupta said a national model already exists for successful screening. Low income, uninsured and underserved women can get breast and cervical cancer screening through the Centers for Disease Control’s National Breast and Cervical Cancer Early Detection Program, but Gupta said such an approach is far too disease-specific.

“Theoretically, the same model could be applied to colorectal cancer, but do we want to keep passing legislation for programs that target specific types of cancer, or could we provide more broad access to health care so we can make a serious and coordinated effort at prevention?” said Gupta. “That’s the question that needs answering.”

Additional Resources:

Download research photos through the following links
Samir Gupta, M.D.
Karen Glanz, Ph.D., M.P.H.

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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world’s oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 28,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and nearly 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. The AACR publishes six major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship and advocacy.

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