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The findings are published in the July 21 online edition of BMJ. Health officials in the United States have been urging vaccination of young women and girls.
The researchers estimate that the virus causes an estimated 500,000 cases of cervical cancer in women each year around the world. The virus can also cause warts in the genital area and low-grade cervical growths. Those two conditions are thought to strike 30 million people annually.
In the just-released randomized control trial, researchers studied 17,622 women in 24 countries and territories who had been assigned to take the vaccine or a placebo over a six-month period. The women were aged 16 to 26.
In the big picture, the study authors wrote, the vaccine "provided strong and sustained protection" for four years against various types of warts and low-grade female genital growths.
Article: July 21, 2010
Source: HealthDay News
"We've known for some time that obesity affects hot flashes, but we didn't know if losing weight would have any effect," said Dr. Alison Huang, the study's author. "Now there is good evidence losing weight can reduce hot flashes."
Study participants were part of an intensive lifestyle-intervention program designed to help them lose between 7% and 9% of their weight.
Huang, assistant professor of obstetrics and gynecology at the University of California, San Francisco, said the findings could provide women with another reason to take control of their weight. "The message here is that there is something you can do about it (hot flashes)", said Huang.
Article: July 12, 2010
Source: HealthDay News
A drug used in Europe as emergency contraception may also treat painful uterine fibroids, researchers say.
Their study was presented at the 26th annual meeting of the European Society of Human Reproduction and Embryology in Rome, Italy.
As many as 80% of all women have uterine fibroids (noncancerous growths in the uterus), according to the nonprofit National Uterine Fibroids Foundation. Fibroids may cause severe abdominal pain, heavy bleeding, and interfere with fertility in some women. Surgery is often the only way to treat painful, bleeding fibroids, but surgery too can sometimes compromise fertility.
Enter EllaOne, a member of a new class of drugs called selective progesterone receptor modulators. As of now, EllaOne is used in Europe as a morning-after pill because it blocks the effects of key hormones -- namely progesterone -- involved in ovulation. It is effective for up to five days after unprotected sex. Although EllaOne is not available in the U.S., an FDA advisory panel recently voted that it should be. The new drug is manufactured by HRA Pharma, a European pharmaceutical company, which provided funding for the new study. The hormone progesterone also feeds uterine fibroids, so blocking its effects may help treat painful fibroids.
Article: June 30, 2010
Source: Denise Mann, WebMD Health News
Overweight women undergoing fertility treatment have double the risk of miscarriage of normal weight women, a UK study says.
More than a third of overweight and obese women had a miscarriage compared with one in five of normal weight women, a fertility conference heard.
Previous research has shown that women who conceive naturally are also at a higher risk if they are overweight.
Experts warned that obesity is putting women's fertility at risk.
Article: June 28, 2010
Source: Emma Wilkinson, Health reporter, BBC News
The blood test measures levels of a hormone called anti-Mullerian Hormone (AMH), which is produced by the cells in women's ovaries and is a marker for ovarian function. The test could tell women as young as 20 when they would enter menopause. Sixty-three women reached menopause during the course of the study, and the test was able in most cases to predict the age within about four months of the woman's actual age; the maximum margin of error was between three and four years.
Study author Fahimeh Ramezani Tehrani, president of the Reproductive Endocrinology Department of the Endocrine Research Centre and a faculty member and associate professor of Shahid Beheshti University of Medical Sciences in Tehran, Iran, reported her findings at the European Society of Human Reproduction and Embryology in Rome.
The findings could have implications on how women approach family planning. Researchers said it is one of the first population-based studies to provide a statistical model for predicting age at menopause.
"We developed a statistical model for estimating the age at menopause from a single measurement of AMH concentration in serum from blood samples," Ramezani Tehrani says. "Using this model, we estimated mean average ages at menopause for women at different time points in their reproductive life span from varying levels of serum AMH concentration. We were able to show that there was a good level of agreement between ages at menopause estimated by our model and the actual age at menopause for a subgroup of 63 women who reached menopause during the study."
Ramezani Tehrani says more studies are needed to validate these findings, but the blood test could be an important diagnostic tool to evaluate one's reproductive life and could provide a more accurate response than chronological age.
Article: June 28, 2010
Sources: News release, European Society of Human Reproduction and Embryology. European Society of Human Reproduction and Embryology 26th Annual Meeting, Rome, June 27-30, 2010.
Compared to people whose weight remained stable after age 50, people who gained the most weight after 50 (more than 20 pounds) nearly tripled their risk of developing type 2 diabetes, according to the study in the June 23/30 issue of the Journal of the American Medical Association.
"People over the age of 65 are at the highest risk of developing type 2 diabetes, and they have the highest rates of morbidity and mortality from heart disease, which can be related to diabetes. This is really a key clinic and public health issue," said study author Mary Biggs, a research scientist at the University of Washington in Seattle.
"We showed a strong relationship between increasing weight and waist circumference with the risk of type 2 diabetes," she said. "It's important as we get older to try to maintain an optimal weight."
Article: June 22, 2010
Source: Serena Gordon, HealthDay News
This has been coupled with enhanced understanding of molecular effects of metformin and its potential role in malignancy. It has been revealed that metformin may influence cancer cells through indirect (insulin-mediated) effects, or it may directly affect cell proliferation and apoptosis of cancer cells. Preclinical work has demonstrated a beneficial effect of metformin in breast cancer. The first evidence of a potential effect of metformin in human breast cancer is reported by Jiralerspong et al in this issue of Journal of Clinical Oncology.
In their article, Jiralerspong et al4 observe that diabetic patients with breast cancer treated with metformin experienced higher pathologic complete response (pCR) rates with neoadjuvant chemotherapy than did those treated with other diabetes medications. The authors looked retrospectively at chemotherapy response rates in a group of 2,592 patients, including 157 women with diabetes, treated with neoadjuvant chemotherapy for early stage or locally advanced breast cancer between 1990 and 2007. Diabetic patients treated with metformin experienced a pCR rate of 24%, which was significantly greater than the pCR rate in diabetic women not treated with metformin (8%; P < .001) and numerically (but not statistically) greater than the pCR rate in women without diabetes (16%; P = .10). In multivariate models adjusting for body mass index, stage, tumor grade, hormone receptor and human epidermal growth factor receptor 2 status, age, presence of diabetes, and use of neoadjuvant taxanes, metformin use remained an independent predictor of pCR with an odds ratio of 2.95 (95% CI, 1.07 to 8.07; P = .04). In this model, metformin use was a better predictor of pCR than were established features such as tumor grade, hormone receptor status, and human epidermal growth factor receptor 2/neu overexpression.
Article: June 1, 2009
Source: Journal or Clinical Oncology
The vaccine, which targets four HPV strains strongly linked to cervical cancer, was approved by the U.S. Food and Drug Administration in 2006. The researchers analyzed HPV vaccination rates among more than 1,700 girls in Delaware, New York, Oklahoma, Pennsylvania, Texas and West Virginia. The data came from a national telephone survey called the Behavioral Risk Factor Surveillance System. "This was the first year the survey asked about HPV vaccination," study first author Sandi L. Pruitt, a postdoctoral research associate in the health behavior research division at Washington University School of Medicine in St. Louis, said in a news release. "That portion of the survey was optional, and only six states opted to use it. Ideally, we'd like to know what's happening in more states, but these six states represent a good cross-section of urban and rural, rich and poor, and they do include girls from racial and ethnic groups that closely mirror the rest of the country," Pruitt said.
There were no racial disparities in terms of vaccination. "That's very important because the highest burden of cervical cancer is among women of color, especially Hispanic women and those who live along the U.S.-Mexico border," Pruitt said. Girls of parents with higher levels of education were more likely to have received the HPV vaccine, known as Gardisil, but rates of vaccination declined as family income levels rose. That may be due to the rising number of wealthier parents who choose not to vaccinate their children for anything, Pruitt said.
The study is published in the May issue of the Journal of Preventive Medicine. Of the estimated 11,000 women in the United States diagnosed with cervical cancer last year, about 4,000 will eventually die from the disease. The American Cancer Society and the Advisory Committee on Immunization Practices recommend that girls and young women get the three-dose vaccine.
Article: June 4, 2009
Source: Medicinenet.com
For example, an increased risk of recurrent breast cancer has, specifically, been linked to obesity and diabetes in women. Among other possible explanations, elevated levels of insulin are thought to act as a stimulus for cancer cells to grow and divide. Other diabetes-associated molecules also appear to cause increased cancer cell proliferation, or growth, including insulin-like growth factor (IGF).
Metformin, also known as Glucophage, has become the most commonly prescribed oral medication for the treatment of diabetes. Previous laboratory and public health studies have suggested that metformin may also be able to suppress cancer cell proliferation, and to reduce the risk of death due to cancer. However, thus far, there has been very little direct clinical research evidence available to support this hypothesis.
A new clinical research study, just published in the Journal of Clinical Oncology, sheds further light on the potential role of metformin as a possible new treatment for breast cancer. In this retrospective clinical study from the M.D. Anderson Cancer Center, the medical records of 2,529 patients who received chemotherapy as initial treatment (neoadjuvant chemotherapy) for their early stage breast cancers, between 1990 and 2007, were reviewed. This group of breast cancer patients included 68 diabetic patients who were taking metformin, 87 diabetic patients who were not taking metformin, and 2,374 nondiabetic patients. All 2,529 patients subsequently went on to have surgery for their breast cancers, and the researchers then assessed the response of each woman's breast cancer to their initial chemotherapy.
Article: December 7, 2009
Source: doctorwascher.com
Women using patches with a low dose of oestrogen do not face any extra risk of stroke, a study found. However, those using tablets have a 28 per cent higher risk of stroke than those not taking HRT medication.
Hormone replacement therapy eases symptoms of the menopause, which affects women around the age of 50 due to falling oestrogen levels. Symptoms can include hot flushes, sweats, depression, irritability and loss of concentration. HRT - which comes in patches, pills, implants and sprays - tops up levels of the female hormone oestrogen.
Article: June 4, 2010
Source: The Daily Mail
The Risk of Ovarian Cancer Algorithm (ROCA), which is based on patient age and trends in CA-125 blood testing, demonstrated very few false positives and had a specificity of 99.9%. Although 2 borderline cases were not detected by the ROCA, no cases of invasive ovarian cancer were missed, explained lead author Karen Lu, MD, professor of gynecologic oncology at the University of Texas M.D. Anderson Cancer Center in Houston.
Dr. Lu reported her findings during a presscast that previewed several presentations from the forthcoming American Society of Clinical Oncology (ASCO) 46th Annual Meeting. These data will be presented on June 6. "The beauty of the algorithm is that each individual woman ultimately established her own baseline, based on her prior CA-125 values," she said. The incidence of ovarian cancer in postmenopausal women is 1 in 2500; it is the most lethal gynecologic cancer. Unfortunately, more than 75% of cases present with advanced-stage disease, when cure rates are less than 30%, explained Dr. Lu. If a diagnosis is made at an early stage, then outcomes are generally much better, with reported cure rates of 60% to 90%. "But currently, there are no effective screening methods," Dr. Lu pointed out during her talk.
The purpose of the study was to assess the specificity and positive predictive value of a 2-step screening strategy for healthy postmenopausal women, which incorporated changes in CA-125 over time and age of the participant, to more accurately estimate risk for ovarian cancer. Part of the strategy included referral ofwoman with high ROCA scores to transvaginal sonography (TVS) and to a clinical evaluation with a gynecologic oncologist. In this prospective single-group study, 3238 postmenopausal women from 50 to 74 years of age were enrolled over the course of 9 years. None of the participants had any significant family history of breast or ovarian cancer.
The ROCA offers 3 possible pathways, Dr. Lu explained. Women at low risk will return for an annual CA-125 blood screening, women at intermediate risk will have their CA-125 test repeated in 3 months, and women at high risk will be referred for TVS and clinical evaluation. The majority of women (n=2666; 86%) continued with annual CA-125 screening. "Over the 9-year period, only 2.6% of women were ever triaged to a transvaginal ultrasound," Dr. Lu said, "and 8 women underwent surgery." The average annual rate of referral to 3 month CA-125 screenings was 6.8%; cumulatively, it was 15.4% (n=501). The average annual rate of TVS and gynecologic oncologist referral was only 0.9%.
Of the 8 women who underwent study-directed surgery, 5 ovarian cancers were detected. All 5 were diagnosed at an early stage, Dr. Lu noted. Of the 5 cancers, 3 were invasive disease and 2 were borderline ovarian tumors. The remaining 3 women who underwent surgery had benign lesions, although 1 was later diagnosed with endometrial cancer. The 3 invasive ovarian cancers that were detected were all high-grade epithelial tumors, but at an early stage; 2 were stage 1C and 1 was stage IIB. The 3 women diagnosed with invasive disease all had low-risk annual CA-125 scores before their values rose. In 2 of the cases of ovarian cancer, the CA-125 levels were normal and then rose abruptly after several years of screening, Dr. Lu explained. "In the third case, levels were low (in the 10 to 12 range), but in the fourth year of screening, they doubled to 22," she said. "The ROCA picked up that her baseline had doubled and that triggered her ultrasound and subsequent surgery."
Overall, the ROCA provided a positive predictive value of 37.5% (95% confidence interval [CI]. 8.5% to 75.5%). The combined specificity of ROCA followed by TVS for referral to surgery was 99.7% (95% CI, 99.5% to 99.9%). Dr. Lu emphasized that "it is important to stress the clinical ramifications of the study; it is not practice changing at this time." "We await the results of the definitive trial that examines mortality as an end point, which is currently ongoing in the United Kingdom," she added. The large-scale study of the ROCA that is currently underway involves more than 200,000 women, and results are expected in 2015.
"The ROCA represents yet another example of personalized medicine," said Douglas W. Blayney, MD, president of ASCO. "Here we have it personalized toward a screening strategy. It also represents a more refined application of known technologies that are widely available." Dr. Blayney reiterated that caution is needed before embracing this approach to screening. The relative rarity of this cancer was seen in this study, so it is very important that this strategy "not be adopted widely until a confirmatory study is done," he said.
Coauthor Herbert Fritsche reports receiving research funding from Roche Diagnostics. Coauthor Robert Bast reports serving in a consulted/advisory role for Fujiresio Diagnostics Inc.
American Society of Clinical Oncology (ASCO) 46th Annual Meeting: Abstract 5003. To be presented June 6, 2010.
Article: May 21, 2010
Source: Medscape.com
HPV, a common sexually transmitted disease, can cause cancers such as cervical cancer. The disease is especially prevalent in young women. In the new study, led by Ahti Anttila of the Finnish Cancer Registry, researchers studied the experiences of 58,282 women aged 30 to 60 who took part in routine cervical screening between 2003 and 2005.
The women were randomly assigned to receive an HPV test or a Pap smear test. The researchers then tracked the women for five years. The HPV screening tests did a better job at detecting serious precancerous lesions on the surface of the cervix, known as cervical intraepithelial neoplasia (CIN III), according to the report published online April 28 in the BMJ.
The researchers cautioned that they didn't detect very many cervical cancer cases. Still, they wrote, "considering the high probability of progression of CIN III lesions in women aged 35 years or more, our results are important for prevention of cervical cancer."
Article: April 28, 2010
Source: MedicineNet.com
Symptoms of irritable bowel syndrome (IBS), fibromyalgia, and a painful bladder condition called interstitial cystitis (IC) seem to get worse in some women right before and during menstruation, researchers report.
All three are disorders of the autonomic nervous system. That's the part of the brain, spinal cord, and nerves that controls functions such as blood pressure and bladder control; these functions are largely involuntary and below our level of consciousness.
"Since other autonomic disorders like migraine and fainting seem to have menstrual variations, we theorized that these conditions would have these variations as well," says Thomas Chelimsky, MD, professor of neurology at Case Western Reserve University in Cleveland.
Article: April 16, 2010
Source: MedicineNet.com
Women who exercise moderately during pregnancy give birth to somewhat smaller babies, which may reduce the infants' obesity risk later, according to a new study.
The average birth weight of babies born to exercising mothers was lower but still very healthy.
The average birth weight of babies born to mothers who exercised was 7.5 pounds, compared to 7.8 pounds for mothers who did not exercise, says a team of researchers from New Zealand and the U.S. Babies born weighing 8.8 pounds or more are defined as high birth weight.
At the two-week checkup, the babies of exercising moms averaged 8.1 pounds; the babies of sedentary moms averaged 8.6 pounds.
We would suggest this study support the recommendations of at least 30 minutes of moderate exercise daily and probably more, says study co-author Paul Hofman, MD, a researcher at the University of Auckland in New Zealand. The study is published in the Journal of Clinical Endocrinology and Metabolism.
The new research follows a recent study finding that three out of four pregnant women in the U.S. do not get enough exercise.
Article: April 5, 2010
Source: MedicineNet.com
Breast cancer screening saves the lives of two women for every one who receives potentially unnecessary treatment, research out today suggests. Some cancers grow so slowly that a woman may die from another disease first while other cancers would cause no harm.
Experts are currently unable to distinguish between these less harmful cancers and some more aggressive types, meaning they are all routinely treated.
New research has found that for every case of overdiagnosis, two lives are saved as a result of the NHS breast cancer screening programme. The issue has been the subject of debate recently after other studies suggested the programme does little to save lives.
Article: March 31, 2010
Source: guardian.co.uk
The growing resistance to antibiotics threatens to make gonorrhoea extremely difficult to treat, a Health Protection Agency official has warned.
Current drugs are still effective but signs of emerging resistance mean treatments may soon need to be revised, Professor Catherine Ison says. It could mean multiple-dose treatments instead of single doses, she says.
Gonorrhoea is the second most common bacterial sexually transmitted infection in the UK. Professor Ison says there is a very real possibility that strains of gonorrhoea-causing bacteria that are resistant to all current treatment options could emerge in the near future. She has raised the issue at the Society for General Microbiology's spring meeting in Edinburgh.
Article: March 30, 2010
Source: BBC News
The contraceptive pill can slash the risk of women dying from serious illnesses including heart disease and cancer, according to new research.
And the Pill is particularly effective at preventing bowel, womb and ovary tumours, which together kill more than 23,000 women each year.
The comprehensive study, carried out over 40 years, also found that any woman who has used the Pill at some stage in her life is 12 per cent less likely to die from illness than those who have never used it.
Article: March 12, 2010
Source: The Daily Express
Three diets - Mediterranean, low-fat and low-carbohydrate - are equally effective in helping reverse blocked arteries, say Israeli researchers.
The study of 140 people, reported in the journal Circulation, found diet could reduce the fatty build up in arteries.
The Ben-Gurion University team found that by the end of the two-year study, the arterial wall had been cut by 5%.
Experts said the study was interesting, but diet was not a "magic bullet".
Atherosclerosis is a progressive condition in which the arteries thicken with fatty deposits, increasing the risk of heart attacks and strokes.
Article: March 2, 2010
Source: BBC News
Testosterone deficiency in young male cancer survivors often causes low energy levels and reduced quality of life, and these patients may benefit from testosterone replacement therapy, a new study suggests.
About 15% of male cancer survivors experience testosterone deficiency, which is a late side effect of chemotherapy or radiation therapy.
In this study of 176 young male cancer survivors and 213 young men without cancer, English researchers looked at the association between testosterone levels, quality of life, self-esteem, fatigue and sexual function.
The young male cancer survivors reported reduced energy levels, impaired sexual function and a markedly reduced quality of life. These problems were most severe in those with testosterone deficiency.
Article: Feb 22, 2010
Source: Cancer, news release
In some states, access to mammograms for women ages 40 to 49 has decreased since new breast cancer screening guidelines were released in November by the U.S. Preventive Services Task Force, according to a new survey.
The task force recommended that women at average risk for breast cancer should start having mammograms every two years at age 50 instead of annual screenings starting at age 40.
The online survey of more than 150 breast cancer health educators and providers in 48 states and the District of Columbia, conducted by the Avon Foundation for Women, found that respondents from a fourth of the areas surveyed reported changes in their states' early detection programs for breast and cervical cancer.
The respondents said that the task force guidelines and other factors, including budget cuts, have resulted in fewer women having mammograms or the elimination of early breast cancer screening programs for women younger than 50 offered through state-administered breast cancer screening programs.
Article: Feb 22, 2010
Source: Avon Foundation for Women
The diabetes drug metformin may help obese teenagers lose weight when combined with healthy lifestyle changes.
A new study shows that non-diabetic obese teenagers treated with metformin XR (extended release formulation) along with healthy lifestyle modifications had a more significant decrease in body mass index (BMI, a ratio of weight in relation to height used to indicate obesity) than those treated with lifestyle changes alone.
Researchers say although metformin is commonly used to treat obesity in teenagers without diabetes, there haven't been any studies to confirm its effectiveness as an obesity treatment.
Childhood obesity rates have more than tripled in the U.S. over the last 50 years, and nearly a third of all children in the U.S. are now considered overweight or obese. Obesity in childhood is associated with significant health risks, including type 2 diabetes, high blood pressure, and risk of heart disease as an adult.
Article: Feb. 1, 2010
Source: WebMD Health News
Two professional organizations have jointly issued new recommendations on the use of imaging modalities for breast cancer screening. The recommendations, compiled by the American College of Radiology (ACR) and the Society of Breast Imaging (SBI), appear in the January issue of the Journal of the American College of Radiology.
The recommendations include the guidance that women with an average risk of developing breast cancer should start annual mammography screening at age 40.
This is in marked contrast with guidelines issued recently by the United States Preventive Services Task Force (USPSTF), which included a recommended start age of 50 years for routine biennial screening. The USPSTF issuance led to a firestorm of criticism, including from a number of coauthors of the new ACR/SBI guidelines.
One of the coauthors of the ACR/SBI recommendations, Phil Evans, MD, explained that they are the result of a 2-year consultation process.
These recommendations were not developed in response to the USPSTF recommendations
The impetus behind the recommendations was "gaps" in existing guidelines, such as those of the American Cancer Society, on how the various imaging technologies for breast cancer screening should be used, added Dr. Evans, who is director of the Center for Breast Care at the University of Texas Southwestern Medical Center in Dallas.
"These recommendations were not developed in response to the USPSTF recommendations," Dr. Evans told Medscape Oncology.
Nevertheless, the authors made late revisions to the paper after it was accepted for publication to comment on the USPSTF's controversial recommendations, Dr. Evans explained.
Much of the commentary about the USPSTF recommendations, including the comments in the newly published ACR/SBI recommendations, amount to a missed opportunity, suggested one radiologist approached for comment by Medscape Oncology.
The authors missed a great opportunity to acknowledge and discuss the harms of screening
"The [ACR/SBI] authors missed a great opportunity to acknowledge and discuss the harms of screening and provide true guidance to women and other physicians considering screening," said John Keen, MD, senior attending radiologist at the John H. Stroger Hospital of Cook County in Chicago, Illinois.
Dr. Keen has argued for a more balanced view of breast cancer screening, which presents the benefits of screening in absolute numbers and enumerates the risks for the potential harms, which include false test results, patient anxiety, unnecessary biopsies, overdiagnosis, and overtreatment.
Recently, a prominent epidemiologist published a "balance sheet" of the harms and benefits of mammography to help patients and physicians with mammography decision-making.
"Most women consider the greatest harm to be breast cancer," said Dr. Evans, who added that this was a "personal belief" based on clinical interaction and not on any research finding.
Mammography remains the most important test a woman can undergo to reduce her chance of dying from breast cancer
"Screening mammography remains the most important test a woman can undergoto reduce her chance of dying from breast cancer," he summarized.
Increasingly Complex
The new joint imaging recommendations are an outgrowth of previous recommendations from the ACR but are a first issuance for the SBI, said Dr. Evans.
The message about breast cancer screening with imaging used to be fairly simple
"The message about breast cancer screening with imaging used to be fairly simple: mammography should begin at age 40," explained Dr. Evans, who is president of the SBI.
However, with the addition of other methods for screening, such as magnetic resonance imaging (MRI) and ultrasound, and related data on their uses, the message has become more complex, added Dr. Evans.
"Most women are not at high risk for breast cancer and therefore should undergo mammography. For the other 15% to 20% of women who are at high risk, there might be additional tests, including MRI and ultrasound, that make it possible to detect breast cancer more effectively," he summarized.
The ACR/SBI's recommended start ages for screening depend on a patient's risks. Those at high risk for breast cancer should start screening from a younger age, they suggest.
Recommendations for High-Risk Patients
No data exist on the optimum age to start screening mammography in women at increased risk for breast cancer
The following are recommendations for high-risk patients. However, the authors acknowledge that these recommendations are based on consensus opinion "no data exist on the optimum age to start screening mammography in women at increased risk for breast cancer," they explain.
For BRCA1 or BRCA2 mutation carriers or untested first-degree relatives of a BRCA mutation carrier, an annual mammogram and annual MRI are recommended starting by age 30, but not before age 25.
The same recommendation is made for women with a lifetime risk for breast cancer of 20% or more on the basis of family history.
Also, for women with a history of chest irradiation between the ages of 10 and 30 years, an annual mammogram and annual MRI are recommended starting 8 years after treatment, with the MRI not starting before age 25.
Finally, among women with a personal history of breast cancer (invasive or ductal carcinoma in=C3=82 situ), annual mammography is recommended after the dateof diagnosis; annual MRI or ultrasound can "also be considered."
However, Dr. Keen told Medscape Oncology that this recommended use of MRI, especially among women in their 30s, is controversial.
MRI and ultrasound have not been shown to save anyone's life
"There are 2 problems with earlier screening of high-risk women. The first is that MRI and ultrasound have not been shown to save anyone's life," said Dr. Keen.
Indeed, the ACR/SBI authors acknowledge that only screening with film mammography has been shown to reduce mortality.
Dr. Keen continues: "The second is that radiation is an increasing problem in younger women. A study published in the British Journal of Cancer in 2005 estimated that there are 1.2 to 1.9 radiation-induced breast cancer deaths per 1000 high-risk women screened in their 30s for a decade."
Medscape Radiology recently reported on a Dutch study that found high-risk women (because of BRCA status or family history) exposed to chest-area radiation before age 20 had an increased risk for breast cancer.
Further Notes About MRI and Ultrasound
The new recommendations note that MRI should routinely be used for the contralateral breast at the time of diagnosis in all women. "This will detect another cancer in at least 3% of women," said Dr. Evans.
MRI has advantages and disadvantages compared with mammography, highlighted Dr. Evans. Some of its limitations include the need for an intravenous infusion/injection, spatial confinement/potential for claustrophobia in patients, and greater cost.
"MRI finds more breast cancer than mammography but has a higher false-positive rate than mammography," he said.
In terms of costs, the ACR/SBI authors say that adding MRI to mammography increases screening costs by more than $50,000 per cancer detected.
Ultrasound can be considered in high-risk women for whom MRI is not suitable. Ultrasound can also be considered in women with dense breast tissue as an adjunct to mammography, note the ACR/SBI authors.
Dr. Evans is an unpaid member of the Scientific Advisory Board of Hologic, Inc, which manufacturers and markets film and digital mammography-screening products. Dr. Keen has disclosed no relevant financial relationships.
J Am Coll Radiol. 2010;7:18-27.
Article: January 6, 2010
Source: Medscape Medical News
Christmas party revelry is only weeks away - and with it the high spirits that contribute every year to a marked increase in sexually transmitted diseases. Even during the Second World War seasonal jollity resulted in a rise in the (already increased) rate of STDs.
One sexually transmitted infection with which about 70 per cent of sexually active people are, often unknowingly, confronted at some time, but usually throw off without lasting complications, is HPV, the human papillomavirus. HPV is popularly known as the genital wart virus, but this term irritates doctors who specialise in cervical cytology. They always refer to it as HPV and emphasise that although there are 80 HPV strains only two of these - HPV 16 and 18 - are responsible for about 75 per cent of cervical cancer cases. Another 11 strains of HPV have been shown to cause such tumours occasionally. Two other strains of HPV - 6 and 11 - result in unsightly genital warts, an affliction that frequently necessitates regular attendance at hospital clinics.
As 99.7 per cent of all cases of cervical cancer can be shown to have resulted from HPV infection, and more than 75 per cent of sexually active women have at some time been infected by HPV, the search for a vaccine that would spare women this hazard was intense.
Two vaccines have been licensed for use in this country. The one selected for the government vaccination campaign - and for the private scheme at Boots - is Cervarix. This protects against HPV strains 16 and 18, the two types usually responsible for cancer. The other vaccine is Gardasil, which not only protects against HPV 16 and 18 but also guards against 6 and 11, the strains that cause genital warts. There has been a suggestion that possibly it won't provide quite such lasting protection as Cervarix against 16 and 18.
Article: November 10, 2008
Source: The Times
More than a million women a year are missing out on the benefits of hormone replacement therapy, a leading doctor warns. The number of prescriptions for HRT has fallen from 6.2million in 2001 to a predicted 2.6million for this year as a result of alarming research findings. In the first five months of this year alone, there were 18 per cent fewer prescriptions compared with the previous year.
But evidence has shown the study that sparked fears over the treatment was flawed. Dr John Stevenson, HRT expert at London's Royal Brompton Hospital, said the health scares had been a "disaster" for women's health. He warned that the NHS faces a long-term rise in female patients with fractures and heart disease, which are conditions that HRT combats. "Women now coming into the menopause are too scared to go on to HRT and I think it is a disgrace," said Dr Stevenson, who is chairman of the charity Women's Health Concern. "It has been a huge catastrophe for women and women's health and there is no doubt that women have suffered unnecessarily because of this." In the UK two million women were taking HRT at its 2001 peak but the number has now plunged to one million. Dr Stevenson added: "For most women suffering from menopausal symptoms I would advise them to have HRT without question. There is nothing else that is nearly as effective as HRT."
Article: September 20, 2008
Source: The Daily Mail
January was National Cervical Cancer Screening Awareness Month. "Cervical cancer is the only gynaecological cancer that can be prevented by regular screening, and Pap smear screening is probably the single most important preventative measure that a woman can take to prevent the development of cervical cancer," said Dinh. Dinh says the HPV vaccine is potentially one of the most exciting developments in the fight against cervical cancer, but points out that annual Pap smear screenings are still the best way to prevent this disease.
Article Date: 09 Dec 2007;
Source: MedicalNewsToday.com
Spinal fractures are the hallmark of osteoporosis, but one of the problems with diagnosing them is that they often have no symptoms," said Jane Cauley, Dr.P.H., professor of epidemiology, University of Pittsburgh Graduate School of Public Health. "Many women may be walking around with multiple fractures and not even know it." "Our study... also provides evidence that a simple and non-invasive bone density test can help identify those at risk." (Bone Density Scan).
If you are concerned about osteoporosis, and/or would like to book an appointment for a bone density scan, please contact us.
Article Date: 18 Dec 2007;
Source: MedicalNewsToday.com
"Ovarian cancer is often difficult to diagnose because symptoms are often recognised in the late stages of the disease when ovarian cancer is fundamentally incurable," said Lead Researcher Dr. Richard Moore, assistant professor in the Program for Women's Oncology at Women and Infants' Hospital / Brown University. "Our research was directed at identifying those unique characteristics or 'biomarkers' of the disease that might one day help us detect this disease earlier." "Our results show testing women suspected of ovarian cancer for both CA-125 and HE4 could possibly lead to a screening and diagnostic tool," adds Moore. "This is exciting news, particularly for women in the earliest stages of the disease when it is most treatable."
Article Date: 30 Dec 2007;
Source: MedicalNewsToday.com
