History of Prostate Cancer Tied to Higher Odds for Melanoma

Studies followed thousands of white male health professionals

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Women in Appalachia have higher rates of late stage breast cancer

Sep. 26, 2013 — Older women living in the poorest areas of Appalachia in the U.S. fail to get regular breast cancer screening and have a higher incidence of later stage breast cancer, reports a new study in Health Services Research.

About 25 million people live in the 13 states that make up the Appalachian region, a 205,000-square-mile region that follows the spine of the Appalachian Mountains from southern New York to northern Mississippi. The National Cancer Institute has recently publicized Appalachia's higher rates of cancer and poorer outcomes for residents diagnosed with cancer.

To examine regional disparities in breast cancer screening and diagnosis, researchers evaluated Central Cancer Registry and Medicare claims data from three Appalachian states (Kentucky, Ohio, and Pennsylvania) to measure the incidence of later stage breast cancer in the region's poorest counties compared with its more affluent counties. The counties' economic statuses were compared based on factors such as unemployment rates, average home values and average monthly wages.

Women living in the most economically deprived counties -- located in eastern Kentucky and southeastern Ohio -- had 3.31 times as many late-stage tumors compared to those in the least deprived counties. Appalachian women in the study over age 65 had a 17.3 percent incidence of later stage breast cancer compared to a national average of 16 percent for women of the same age.

The degree of disparity between the counties was stronger than the researchers had suspected, said lead author Roger T. Anderson, Ph.D., from the department of public health science at Pennsylvania State University College of Medicine.

"Overall, we found counties that are struggling economically tend to have inadequate health care resources or infrastructure and have the highest rates of later-stage breast cancer," said Anderson.

There were also disparities in how often women received recommended mammography screening. Although area women over the age of 65 had Medicare insurance coverage, only 53 percent had mammography screening within the 2 years before their cancer diagnosis compared with the national average of 67 percent.

Anderson explained that counties that struggle economically may set up a "perpetuating cycle of few services to promote cancer prevention and early detection in communities and less overall use of preventive services."

Clement Gwede, Ph.D., associate director of diversity at the Moffitt Cancer Center in Tampa, agreed, saying that solutions to the disparities in late stage breast cancer in the nation's more distressed communities must include improved access to mammography screening resources, education and awareness, and related resources.

"Without these broad and sustained strategies, the vicious cycle will persist," Gwede added.

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Current pledges to reduce greenhouse gas emissions put over 600 million people at risk of higher water scarcity

Sep. 12, 2013 — Our current pledges to reduce greenhouse gas emissions, which are projected to set the global mean temperature increase at around 3.5°C above pre-industrial levels, will expose 668 million people worldwide to new or aggravated water scarcity.

This is according to a new study published today, 13 September, in IOP Publishing's journal Environmental Research Letters, which has calculated that a further 11 per cent of the world's population, taken from the year 2000, will live in water-scarce river basins or, for those already living in water-scarce regions, find that the effects will be aggravated.

The results show that people in the Middle East, North Africa, Southern Europe and the Southwest of the USA will experience the most significant changes.

The results show that if the global mean temperature increases by 2°C -- the internationally agreed target -- then eight per cent of the world population (486 million people) will be exposed to new or aggravated water scarcity, specifically in the Near and Middle East.

Lead author of the research Dr Dieter Gerten, from the Potsdam Institute for Climate Impact Research, said: "Our global assessments suggest that many regions will have less water available per person.

"Even if the increase is restricted to 2°C above pre-industrial levels, many regions will have to adapt their water management and demand to a lower supply, especially since the population is expected to grow significantly in many of these regions."

"The unequal spatial pattern of exposure to climate change impacts sheds interesting light on the responsibility of high-emission countries and could have a bearing on both mitigation and adaption burden sharing."

According to Dr Gerten, the main driver of new or aggravated water scarcity is declining precipitation; however, increased temperatures will also lead to an increase in evapotranspiration of water and, thus, decrease the resources.

The anticipated increase in population will have even stronger effects on the ratio of water demand and water availability in some regions.

To assess the impacts of different mean global warming levels, the international group of researchers combined existing simulations from 19 climate change models with eight different global warming trajectories. The latter ranged from 1.5°C to 5°C increases above pre-industrial levels, resulting in a total of 152 climate change scenarios that were examined.

In addition to water shortages, the researchers assessed the impact that future climatic changes may have on global terrestrial ecosystems. They sought to discover what areas will be affected by strong ecosystem changes, and whether these areas are rich in biodiversity and/or contain unique species.

"At a global warming of 2°C, notable ecosystem restructuring is likely for regions such as the tundra and some semi-arid regions. At global warming levels beyond 3°C, the area affected by significant ecosystem transformation would significantly increase and encroach into biodiversity-rich regions," continued Dr Gerten.

"Beyond a mean global warming of 4°C, we show with high confidence that biodiversity hotspots such as parts of the Amazon will be affected."

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Pacific humpback whale abundance higher in British Columbia

Sep. 11, 2013 — Humpback whale populations are on the rise in the coastal fjords of British Columbia, doubling in size from 2004 to 2011, according to results published September 18 in the open access journal PLOS ONE by Erin Ashe from the Sea Mammal Research Unit at the University of St. Andrews and colleagues from other institutions.

Researchers estimated abundance of Pacific humpback whales (Megaptera novaeangliae) using photo-identification surveillance of identifiable adults. They found that the number of humpback whales in the region increased each year, and doubled from 2004 to 2011, resulting in a total of 137 whales in 2011. The survey was conducted year-round, but abundance was estimated only during the summer months of July to September, when the migrating whale population is largest.

The survey focused on summer feeding regions in the coastal fjords that serve as a pit stop for whales to refuel between migrations. Migrating whales can travel as far as Hawaii or Japan and go several months without feeding. Whatever the whales are doing seems to be working.

The authors estimated that survivorship, the average probability of an adult whale surviving from one year to the next is among the highest reported anywhere for this species. During this critical refueling stage in these waters, the whales are more vulnerable to environmental stressors, such as those potentially created by increasing tourism and industrial development in the region.

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The above story is based on materials provided by Public Library of Science.

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Journal Reference:

1. Erin Ashe, Janie Wray, Christopher R. Picard, Rob Williams. Abundance and Survival of Pacific Humpback Whales in a Proposed Critical Habitat Area. PLoS ONE, 2013; 8 (9): e75228 DOI: 10.1371/journal.pone.0075228

Note: If no author is given, the source is cited instead.

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Despite higher survival, brachytherapy to treat cervical cancer declines in US

Sep. 11, 2013 — A study by researchers at Brigham and Women's Hospital (BWH) found that brachytherapy treatment was associated with better cause-specific survival and overall survival in women with cervical cancer. The population-based analysis also revealed geographic disparities and decline in brachytherapy treatment in the United States. Brachytherapy is a type of cancer treatment in which radioactive implants are inserted directly into the tissue near the tumor site.

The study is published in the September 2013 issue of The International Journal of Radiation Oncology.

The researchers used the Surveillance, Epidemiology, and End Results (SEER) Database to identify 7,359 patients with advanced stage cervical cancer treated with external beam radiation therapy (EBRT) between 1988 and 2009. (The 18 SEER population-based registries cover approximately 28 percent of the US population and include Connecticut, New Jersey, Metropolitan Detroit, Iowa, New Mexico, Hawaii, Seattle, Utah, Alaska, San Francisco-Oakland, San Jose-Monterey, Los Angeles, Greater California, Kentucky, Louisiana, Metropolitan Atlanta, Rural Georgia, and Greater Georgia. The registries collect information about patient and tumor characteristics and first course of cancer-directed treatment.)

Of the 7,359 patients identified, the researchers found that 63 percent of these women received brachytherapy in combination with EBRT, and 37 percent received EBRT alone. Factors associated with higher odds of brachytherapy use included younger age, being married, earlier years of diagnosis, earlier stage and certain SEER regions.

Moreover, brachytherapy usage rate decreased from 83 percent in 1988 to 58 percent in 2009. There was a sharp decline from 43 percent to 23 percent in 2003. The researchers noted that the decline may be related to the decreasing incidence of cervical cancer and increased adoption of alternative treatment techniques, such as intensity modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT).

In terms of patient survival, brachytherapy was associated with a higher four-year cause-specific survival (64.3 percent vs. 51.5 percent) and overall survival (58.2 percent vs. 46.2 percent) compared to EBRT alone. Brachytherapy treatment was also independently associated with better cause-specific survival and overall survival.

"The shift away from brachytherapy is concerning, and has directly lowered the survival rates of cervical cancer patients," said Akila Viswanathan, MD, MPH, director of BWH Gynecologic Radiation Oncology, senior study author. "High-quality brachytherapy must continue to be used, ideally with image-guidance, to maximize survival and minimize toxicity."

Brachytherapy is an important component of treatment that escalates the dose of radiation to the primary tumor while minimizing the dose to critical organs at risk. The standard treatment of locally advanced cervical cancer is EBRT with concurrent chemotherapy, followed by brachytherapy.

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Smog Tied to Higher Risk of Lung Cancer, Heart Failure

WEDNESDAY, July 10 (HealthDay News) -- There's more evidence that smog boosts a person's risk of both lung cancer and heart failure, with even short exposures to small amounts of pollution harming the body.

A pair of newly published European studies found that regularly breathing in air tainted with even low levels of air pollution raises your long-term risk of lung cancer. That finding came from a review of data from nearly 313,000 people across nine European countries. The study was published online July 10 in The Lancet Oncology.

At the same time, short-term exposure to smog has also been linked to increased risk of hospitalization or death from heart failure, according to a study led by the University of Edinburgh that reviewed data from 12 countries worldwide, published the same day in The Lancet.

The findings of the two studies further corroborate the known health risks of air pollution, said Dr. Albert Rizzo, immediate past chair of the national board of directors of the American Lung Association. He was not involved with the new research.

"On a day-to-day basis, a lot of people who aren't diagnosed with a specific illness may not know the importance of protecting yourself against these pollutants. Insult to your airways on a repeated basis can lead to dire consequences," said Rizzo, section chief of pulmonary/critical care medicine at Christiana Care Health System, in Wilmington, Del.

The lung cancer study assessed the risk of long-term exposure to particulate matter in the air by comparing local air pollution levels to reported cases of cancer, in an effort led by the Danish Cancer Society Research Center.

Researchers found that the risk of lung cancer grew with even tiny increases in the amount of particulate pollution in the air. Particulate pollution is the sort of black sooty smoke produced by diesel trucks and buses and by coal-fired power plants.

For example, consider that a human hair is about 70 micrometers wide. Lung cancer risk rose 18 percent every time the amount of 2.5 micrometer-wide particulates increased by 5 micrograms per cubic meter of air, the study said. Risk rose 22 percent every time the amount of 10 micrometer-wide particulates increased by 10 micrograms per cubic meter of air.

"We found no threshold below which there was no risk; the results showed a picture that 'the more the worse, the less the better," the authors said in a journal news release.

The other study compared air quality conditions in specific areas with reports of heart failure hospitalization or death. Researchers found that smog concentration is closely associated with heart failure hospitalization and death.

More specifically, they calculated that the risk of being hospitalized or dying from heart failure rose by about 3.5 percent with every increase of 1 part per million of carbon monoxide and about 2.4 percent for every increase of 10 parts per billion of sulfur dioxide.

Risk also rose 1.7 percent for every 10 parts per billion increase in levels of nitrogen dioxide, and 2 percent for every increase of 10 micrograms per cubic meter of particulate matter.

The study estimates that a modest reduction in particulate levels in the United States could prevent roughly 8,000 heart failure hospitalizations and save more than $300 million annually.

The researchers speculate that smog causes inflammation of the lungs that spills over and creates stress on the heart.

"Even a healthy young athlete who jogs on a high ozone day is going to feel that exposure," Rizzo said. Less healthy people might end up suffering heart failure from the increased stress.

To protect themselves, people in areas with high levels of air pollution should consider installing HEPA (high-efficiency particulate air) filters in their homes, said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital, in New York City.

"This is something that people can do in the home or office to filter the air and get some of the particular offenders trapped in filters," Horovitz said. "A toxic substance is going right into the lungs, and I don't think it's a leap of scientific understanding to know it's bad for you when you apply a toxic substance directly to tissue."

People also should avoid going outside during times of heavy concentrations of air pollution, particularly if they are performing strenuous tasks like mowing or exercising, Horovitz said.

For his part, Rizzo said people also should lobby the U.S. Environmental Protection Agency to tighten the nation's clean air regulations.

More information

To learn more about particulate pollution, visit the U.S. Environmental Protection Agency.

SOURCES: Albert A. Rizzo, M.D., immediate past chair, national board of directors, American Lung Association, and section chief, pulmonary/critical care medicine, Christiana Care Health System, Wilmington, Del.; Len Horovitz, pulmonary specialist, Lenox Hill Hospital, New York City; July 10, 2013, The Lancet Oncology and The Lancet, online

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Research Gets to Root of Redheads' Higher Melanoma Risk

THURSDAY, Aug. 22 (HealthDay News) -- It's well known that natural redheads are at higher odds for deadly melanoma skin cancer, and new research in mice may help explain why.

Researchers at Harvard Medical School say the genetic mutation responsible for red hair and light skin also appears to promote a well-known cancer-causing pathway.

A person's hair color and skin tone are influenced by a gene receptor called melanocortin-1 (MC1R), and a mutation in MC1R accounts for the 1 percent to 2 percent of people who are born redheads.

In experiments with mice and cell cultures, researchers found that the same MC1R mutation -- called MC1R-RHC -- triggers a specific biochemical signaling pathway when a redhead is exposed to ultraviolet radiation from the sun and other sources.

This pathway, called P13K/Akt, has been tied to breast, ovarian and lung tumors, according to the study, which was published online Aug. 22 in the journal Molecular Cell.

"[The findings] provide a possible molecular mechanism as to why red-haired individuals harboring [these] mutations are much more susceptible to UV-induced skin damage than individuals with darker skin, resulting in a 10- to 100-fold higher frequency of melanoma," study co-senior author Wenyi Wei, an investigator at Beth Israel Deaconess Medical Center and an associate professor of pathology at Harvard, said in a medical center news release.

The researchers also said their findings are a starting point for future studies. For example, people who carry the MC1R mutation might be identified as being at higher skin cancer risk, or drugs that target the P13K/Akt pathway might help treat certain melanomas.

Melanoma is among the rarest of skin cancers, but it also is the most deadly, accounting for 75 percent of skin cancer deaths, the researchers said.

Researchers note that research conducted in animals often does not have the same results in humans.

More information

The U.S. National Cancer Institute has more about melanoma and other skin cancers.

SOURCE: Beth Israel Deaconess Medical Center, news release, Aug. 22, 2013

Copyright c 2013 HealthDay. All rights reserved.

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