Smoking Exposure Now Linked to Colon And Breast Cancers

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,

Walking And Exercise May Lower Prostate Cancer Risk

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.

Race, Income, Marital Status Has No Impact On Prostate Cancer Outcome

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.

High-def Colonoscopy Detects More Polyps

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.

Stem Cell Research Offers Colon Cancer Vaccine Hope

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.

Study: PSA Test Considered Unreliable Prostate Cancer Screening

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.

Aspirin Protects Against Colon Cancer

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.

1 Million Men Overdiagnosed With Prostate Cancer

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).

Colon Cancer Screenings Still Too Low

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. 

Surviving Colorectal Cancer May Depend On Where You Live

Surviving colorectal cancer may depend partially on where you live.

Researchers with the New Jersey Department of Health and Senior Services analyzed survival patterns in different areas of New Jersey among 25,040 men and women diagnosed with colorectal cancer from 1996 through 2003, and monitored through 2006.

They found that the number of people who lived at least 5 years after being diagnosed and treated was about 84 to 88 percent in high-income white neighborhoods, compared with 80 percent statewide.

Survival rates were much lower - just 73 percent - "in low income, racially diverse neighborhoods," they found.  Five-year survival was 83 percent among Caucasians compared with 75, 79, and 80 percent among Blacks, Hispanics, and Asian/Pacific Islanders.   These findings are similar to those from other regions in the U.S. and elsewhere. Taken together, the data provide strong support for the theory that health is affected by many factors, such as biological, behavioral, and environmental traits, the researchers note.

SOURCE: International Journal of Health Geographics, July 23, 2009.

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