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Calcium Associated With Lower Risk of Cancer in Women
Women with higher intake of calcium appear to have a lower risk of cancer overall, and both men and women with high calcium intakes have lower risks of colorectal cancer and other cancers of the digestive system, according to a report in the February 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Calcium is known to benefit bone health, according to background information in the article. Because of this, the Institute of Medicine recommends 1,200 milligrams of calcium for adults age 50 and older, and the 2005 dietary guidelines for Americans recommend 3 cups per day of low-fat or fat-free dairy products. Studies of dairy products, calcium intake and cancer have revealed different results for different cancer sites.
Yikyung Park, Sc.D., of the National Cancer Institute, Bethesda, Md., and colleagues analyzed data from 293,907 men and 198,903 women who participated in the National Institutes of Health-AARP Diet and Health Study. Participants took a food frequency questionnaire when they enrolled in the study between 1995 and 1996, reporting how much and how often they consumed dairy and a wide variety of other foods and whether they took supplements. Their records were then linked with state cancer registries to identify new cases of cancer through 2003.
Over an average of 7 years of follow-up, 36,965 cancer cases were identified in men and 16,605 in women. Calcium intake was not associated with total cancer in men but was in women—the risk decreased in women with intake of up to 1,300 milligrams per day, after which no further risk reduction was observed.
“In both men and women, dairy food and calcium intakes were inversely associated with cancers of the digestive system,” the authors write. The one-fifth of men who consumed the most calcium through food and supplements (about 1,530 milligrams per day) had a 16 percent lower risk of these types of cancer than the one-fifth who consumed the least (526 milligrams per day). For women, those in the top one-fifth of calcium consumption (1,881 milligrams per day) had a 23 percent lower risk than those in the bottom one-fifth (494 milligrams per day). The decreased risk was particularly pronounced for colorectal cancer. Calcium and dairy food intake was not associated with prostate cancer, breast cancer or cancer in any other anatomical system besides the digestive system.
“Dairy food, which is relatively high in potentially anticarcinogenic nutrients such as calcium, vitamin D and conjugated linoleic acid, has been postulated to protect against the development of colorectal and breast cancer,” the authors write. Calcium has been shown to reduce abnormal growth and induce normal turnover among cells in the gastrointestinal tract and breast. In addition, it binds to bile and fatty acids, potentially reducing damage to the mucous membrane in the large intestine.
Source: American Medical Association
Time Stamp: 2/24/2009 at 4:30:01 PM UTC
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Hormone Therapy Associated with Reduced Colorectal Cancer Risk
The combination of estrogen plus progestin, which women stopped taking in droves following the news that it may increase their risk of breast cancer, may decrease their risk of colorectal cancer, according to a report published in the January issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.
“Compared to women who had never taken these hormones, the use of estrogen plus progestin was associated with a reduced risk of colorectal cancer,” said Jill R. Johnson, M.P.H., a doctoral student at the University of Minnesota School of Public Health.
The largest risk reduction, approximately 45 percent, was seen among women who had completed use of estrogen plus progestin five or more years previously.
Johnson and her colleagues extracted data from 56,733 postmenopausal women who participated in the Breast Cancer Detection Demonstration Project follow-up study. Hormone therapy use and other risk factors were ascertained through telephone interviews and mailed questionnaires between 1979 and 1998. During an average 15 years of follow-up, Johnson and colleagues identified 960 new cases of colorectal cancer in this population.
Any use of estrogen therapy was associated with a 17 percent reduced risk in colorectal cancer. Among those who used estrogen, the largest reductions were seen among those who were current users (25 percent reduced risk) and users of ten or more years duration (26 percent reduced risk).
Researchers also found a 22 percent reduced risk among those who had ever used estrogen plus progestin in combination. They further found a 36 percent reduction in risk among those who had used progestin sequentially or less than 15 days per month. Past users of estrogen plus progestin, who had stopped at least five years ago, had a 45 percent risk reduction.
Although Johnson’s study was not designed to look at biological mechanisms for the protective effect of estrogen therapy, she did say that previous research has suggested that hormones may play a role in decreasing levels of insulin-like growth factors, thereby reducing risk. “The biological mechanism will need to be explored in further studies,” said Johnson.
Source: American Association for Cancer Research
Time Stamp: 1/8/2009 at 6:17:39 PM UTC
Deprivation doubles cervical cancer risk
Women living in the most deprived areas of England are nearly twice as likely to be diagnosed with cervical cancer than their affluent counterparts – according to a report presented by national cancer director Professor Mike Richards at the Britain Against Cancer conference today (Tuesday).
The report, published by the National Cancer Intelligence Network (NCIN), reveals a ‘deprivation gap’ that researchers believe is mainly fueled by a lower uptake of cervical screening in deprived areas.
All cases of cancer diagnosed between 1995 and 2004 were included in this nation-wide analysis of the effect of deprivation on cancer incidence, including more than 25,000 cases of cervical cancer.
In the most deprived areas of England, there were 12 women per 100,000 diagnosed with cervical cancer between 2000 and 2004. In the most affluent areas, only 6 per 100,000 women were diagnosed with the disease during the same time period.
Professor David Forman, NCIN information lead who is based at the University of Leeds, said: “These striking figures show there is still much more that needs to be done to tackle cancer in low-income communities.
“Cervical cancer is a largely preventable disease – the national screening program will pick up most cases before they even develop into cancer. Our figures suggest that women living in poorer areas are less likely to attend cervical screening than women who are better-off, so they are more likely to develop the disease.
“Higher rates of smoking in most deprived areas and the earlier onset of sexual activity also contribute to the higher rates of cervical cancer.”
Currently, women in England aged 25 to 64 are invited for cervical screening every three to five years. In 2006, around 20 per cent of women in England invited for cervical screening did not attend, and previous research** has shown that women in deprived areas are around 40 per cent less likely to attend. Screening can pick up on important changes to cells before cervical cancer develops.
Sara Hiom, director of health information at Cancer Research UK, said: “It’s extremely worrying that your income and where you live can have such a significant effect on your risk of cancer. It’s clear that much more needs to be done to encourage women from low-income communities to attend cervical screening.”
Women living in deprived areas were 129 per cent more likely to be diagnosed with cervical cancer between 1995 and 1999. This figure was 106 per cent between 2000 and 2004. Although this drop is not statistically significant, doctors hope this downwards turn will continue.
Professor Mike Richards, who will present the report on behalf of the NCIN, said: “Reducing inequalities in cancer incidence and uptake of cancer services is a key aim set out in the Cancer Reform Strategy. Collecting and understanding data like this is a crucial first step in achieving this goal. The NHS Cancer Screening Program is working with the Improvement Foundation, to improve the uptake of cervical screening in poor areas through targeted pilot programs. The lessons learned from this work due in 2009, will be shared with Strategic Health Authorities and local screening programs to develop best practice.”
Professor Julietta Patnick CBE, Director, NHS Cancer Screening Programs, said: "This is a helpful report shedding light on the relationship between cancer and deprivation. Over recent years we have seen a downward trend in women taking up their screening invitation, especially younger women and those in deprived inner city areas, and the reasons for this are difficult to determine. Cervical screening saves around 4,500 lives a year, and it is important for women to consider this when deciding whether or not to accept their invitation."
Sara Hiom added: “Most cases of cervical cancer are caused by HPV – a sexually transmitted virus – and smoking increases the chances of the virus causing cancer. Greater awareness of the link with smoking and, most importantly, of cervical screening are all key to reducing the risk of cervical cancer in deprived areas. Cancer Research UK is investing in research to understand how to improve public health and cervical screening coverage in low-income groups.”
Source: National Cancer Intelligence Network / University of Leeds
Time Stamp: 12/2/2008 at 2:42:50 PM UTC
Smoking increases depression in women, study reveals
A new study reveals that women who smoke are at greater risk of developing major depressive disorder. The study has been published today the British Journal of Psychiatry.
Researchers from the University
of Melbourne and Barwon Health assessed a group of 1043
Australian women, whose health had been monitored for a decade as
part of the Geelong Osteoporosis Study.
Source: University of Melbourne
Time Stamp: 10/1/2008 at 4:38:12 PM UTC
Roughly One Quarter of U.S. Women Affected by Pelvic Floor Disorders
Weakened Pelvic Muscles May Result In Incontinence, Discomfort, Activity Limitation
Nearly 24 percent of U.S. women are affected with one or more pelvic floor disorders, report researchers funded by the National Institutes of Health. Their analysis is the first to document in a nationally representative sample the extent of pelvic floor disorders, a cluster of health problems that causes physical discomfort and limits activity.
The study also revealed that the frequency of pelvic floor disorders increases with age, affecting more than 40 percent of women from 60 to 79 years of age, and about 50 percent of women 80 and older.
Pelvic floor disorders result when the muscles and connective tissue within the pelvic cavity weaken or are injured. These muscles and ligaments form a sling across the opening of a woman’s pelvis, holding the bladder, uterus, bowel, and rectum in place. The three main pelvic floor disorders are urinary incontinence, fecal incontinence, and pelvic organ prolapse. Pelvic organ prolapse results when pelvic organs such as the uterus, bladder and bowel, collapse onto the vagina. The resulting pressure may cause a bulge or protrusion through the vaginal canal. This protrusion may be uncomfortable, may make physical activity difficult, and may interfere with sexual functioning.
The study results appear in the September 17, 2008 Journal of the American Medical Association.
"The study results underscore the need to identify the causes of pelvic floor disorders and the means to prevent and treat them." said Duane Alexander, M.D., director of the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "The NIH Pelvic Floor Disorders Network is conducting studies to provide much needed answers."
Funding was provided by the NICHD, the National Institute of Diabetes and Digestive and Kidney Diseases and the Office of Research on Women’s Health (ORWH), all at the NIH, and by the National Center for Health Statistics (NCHS) of the Centers for Disease Control and Prevention.
The study’s first author was Ingrid Nygaard, M.D., M.S., of the University of Utah School of Medicine, Salt Lake City. The study was conducted by researchers in NIH’s Pelvic Floor Disorders Network, which seeks to improve diagnosis, treatment, and prevention of pelvic floor disorders in women.
To conduct the study, the researchers submitted questions on pelvic floor disorders for inclusion in the 2005-2006 National Health and Nutrition Examination Survey (NHANES), a periodic survey of the U.S. population conducted by the NCHS.
"Before our study, there were no comprehensive national prevalence estimates for pelvic floor disorders," said Susan Meikle, M.D., M.S.P.H, Project Scientist for the NIH Pelvic Floor Disorders Network.
The 1961 women who participated in the survey answered questions about symptoms of pelvic floor disorders. The women were age 20 and older and were not pregnant. Overall, 23.7 percent of the women had symptoms of at least one pelvic floor disorder: 15.7 percent had urinary incontinence, 9.0 percent had fecal incontinence, and 2.9 had symptoms of pelvic organ prolapse.
The proportion of women who reported at least one pelvic floor disorder increased with age: 9.7 percent of women aged 20 to 39 years, 26.5 percent of women aged 40 to 59 years, 36.8 percent of women aged 60 to 79 years, and 49.7 percent of women 80 or older.
Underweight and normal weight women were less likely to have a pelvic floor disorder (15.1 percent) than were overweight women (26.3 percent) and obese women (30.4 percent).
The prevalence of pelvic floor disorders also varied with the number of times a woman had given birth: 12.8 percent for women who had never given birth, 18.4 percent of women who had one child, 24.6 percent of women who had two children, and 32.4 percent for women who had three or more children.
The researchers did not find any differences in pelvic floor disorders based on race, ethnicity, or level of education achieved.
The researchers noted that their study focused on moderate to severe forms of pelvic floor disorders, and so did not include women with mild symptoms.
Treatment for pelvic floor disorders varies with the severity of symptoms. Treatment may involve behavioral therapies, exercises to strengthen muscles, vaginal devices to hold up the bladder or other pelvic organs, medications, or surgery.
In 2006, researchers in the Pelvic Floor Disorders Network published study results describing a successful surgery to reduce the urinary incontinence caused by pelvic organ prolapse: http://www.nichd.nih.gov/news/releases/surgery_reduces_incontinence.cfm.
Additional information on pelvic floor disorders is available at http://www.nichd.nih.gov/health/topics/Pelvic_Floor_Disorders.cfm.
Time Stamp: 9/18/2008 at 12:40:14 AM UTC
New NIH Research Initiative to Test Treatments for Menopausal Symptoms
Clinical Trials to Target Hot Flashes, Night Sweats
Women troubled by hot flashes and night sweats during the years around menopause want safe, effective treatment options. A new research initiative from the National Institutes of Health (NIH) will establish a multisite research network to conduct clinical trials of promising treatments for the most common symptoms of the menopausal transition.
The initiative — Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) — is led by the National Institute on Aging (NIA) in collaboration with the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the National Center for Complementary and Alternative Medicine (NCCAM) and the Office of Research on Women’s Health (ORWH), all parts of the NIH. The MsFLASH network will be coordinated by principal investigators Andrea Z. LaCroix, Ph.D., and Garnet Anderson, Ph.D., both of the Fred Hutchinson Cancer Research Center in Seattle. The network centers will collectively receive approximately $4.4 million each year of the initiative, which is projected to run for five years.
"Studies such as the Women’s Health Initiative, which raised concerns about the safety of using menopausal hormone therapy, underscore the urgent need for treatments that have been proven safe and effective for alleviating menopausal symptoms," said NIA Director Richard J. Hodes, M.D. "MsFLASH will speed the evaluation of treatments deemed promising by an independent panel at the recent NIH State-of-the-Science Conference on the Management of Menopause-Related Symptoms."
In addition to the Data Coordinating Center, five clinical research centers make up the MsFLASH network, which will conduct randomized clinical trials to test a variety of approaches for treating menopausal symptoms. "Different approaches will be studied for efficacy against hot flashes and night sweats in diverse groups of women in trials with either placebo or usual-care control groups. Investigators will also look at possible effects on other symptoms at middle age, including sleep disturbance, mood disorder, vaginal dryness and sexual function," said Judy Hannah, MsFLASH program official from the NIA’s Division of Geriatrics and Clinical Gerontology.
The MsFLASH centers and principal investigators are:
A number of different treatment strategies are under consideration. Possible treatments to be studied during the five-year project period include:
"For decades, estrogen with or without progesterone has been the treatment of choice for relieving menopause-related symptoms because of the lack of alternative therapies of comparable proven efficacy," noted Sherry Sherman, Ph.D., NIA project scientist for the Menopause Strategies Network. "The collaborative, multidisciplinary, multicenter approach of MsFLASH will enable researchers to test other options—including behavioral and complementary and alternative medicine approaches—to determine whether they are also effective against hot flashes."
Currently, menopausal hormone therapy is still considered the most effective way to control moderate to severe menopausal symptoms such as hot flashes and night sweats. Experts recommend that when it is used, physicians prescribe the lowest effective dose for the shortest period necessary, but some women are reluctant to use menopausal hormone therapy because of possible side effects. Women can experience menopausal symptoms for several years before menopause — the date of their last menstrual period — and sometimes for many years after. For some women with severe menopausal symptoms, the resulting discomfort can greatly diminish their quality of life.
The 2005 NIH State-of-the-Science meeting featured presentations from experts on the biology and symptoms of the menopause transition and on established and potential new treatments for symptomatic relief. An independent panel evaluated the data from the presentations and from an evidence-based search of the literature and published its recommendations on the NIH Web site and in the Annals of Internal Medicine.
Time Stamp: 9/17/2008 at 3:44:03 PM UTC
New Treatments, Continued Research Offer Hope to Fibromyalgia Sufferers
Fibromyalgia is a painful and often debilitating condition that can have a substantial negative impact on quality of life.
Often misdiagnosed or mistaken for lupus, multiple sclerosis or rheumatoid arthritis, fibromyalgia—a chronic, widespread pain condition—affects more women than men and can lead to stiffness, sleep disruption, fatigue, memory or concentration problems, mood disturbances and even irritable bowel symptoms.
For years, physicians and researchers have worked to better understand fibromyalgia and provide treatments to patients with this condition.
Lesley Arnold, MD, director of the University of Cincinnati (UC) Women’s Health Research Program, says that fibromyalgia sufferers now have more treatment options than ever before.
Arnold has led numerous studies on fibromyalgia and was the principal investigator for Cincinnati-based studies of the two medications now approved by the Food and Drug Administration (FDA) for the treatment of fibromyalgia—Cymbalta, manufactured by Eli Lilly and approved in June 2008, and Lyrica, manufactured by Pfizer and approved in 2007.
She says that these new treatment options are a step in the right direction, but that more research is needed to find additional approaches for managing the condition.
“No two patients are exactly the same,” says Arnold, “which means that not everyone will respond the same way to currently available treatments."
“While it is very gratifying to see that the clinical trials in fibromyalgia have led to the availability of two new treatment options, we need to continue to find alternative approaches to the management of this often disabling disorder,” she adds.
The Women’s Health Research Program develops personalized treatment plans for fibromyalgia patients and offers access to cutting-edge research studies testing a variety of medications for the condition. They also collaborate with rheumatologists, sleep specialists, neurologists, psychiatrists and physical therapists to determine the best ways for treating patients.
Fibromyalgia studies are being conducted on an ongoing basis. If you are over 18, have been diagnosed with fibromyalgia or suspect you may have the condition and wish to participate in a clinical study, call the Women’s Health Research Program at (513) 475-8114.
Arnold is a paid consultant for both Pfizer and Eli Lilly and has received funding from both in support of research studies.
Source: University of Cincinnati
Time Stamp: 7/10/2008 at 3:56:09 PM UTC
Mothers' High Normal Blood Sugar Levels Place Infants at Risk for Birth Problems
Pregnant women with blood sugar levels in the higher range of normal — but not high enough to be considered diabetes — are more likely than women with lower blood sugar levels to give birth to babies at risk for many of the same problems seen in babies born to women with diabetes during pregnancy, according to a study funded in large part by the National Institutes of Health.
These problems included a greater likelihood for Caesarean delivery and an abnormally large body size at birth. Infants born to women with higher blood sugar levels were also at risk for shoulder dystocia, a condition occurring during birth, in which an infant’s shoulder becomes lodged inside the mother's body, effectively halting the birth process.
The study authors declined to make recommendations for acceptable blood sugar levels for pregnant women. The researchers were unable to identify a precise level where an elevation in blood sugar increased the risk for any of the outcomes observed in the study. Rather, the chances for the outcomes were observed to increase gradually, corresponding with increases in the women’s blood sugar levels.
It is well known that high blood sugar levels characteristic of the diabetes that occurs during pregnancy present risks for expectant mothers and the infants born to them. The current study is the first to document that higher blood sugar levels, not high enough to be considered diabetes, also convey these increased risks. Furthermore, when the researchers mathematically adjusted for other potential causes of these risks — such as older maternal age, obesity, and high blood pressure — the increased risks due to higher blood sugar levels were still present.
"These important new findings highlight the risks of elevated blood sugar levels during pregnancy," said Duane Alexander, M.D., director of the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development, which provided much of the funding for the study. "NIH-supported studies now in progress will provide guidance on how to manage them. Until the results of those studies are available, all pregnant women should consult a health care professional about being screened for diabetes during pregnancy."
Additional NIH funding was provided by the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Center for Research Resources.
Diabetes results from difficulty transferring sugar (glucose) from the blood to the body’s tissues. It occurs in roughly 5 percent of all pregnancies in the United States. Mothers with diabetes during pregnancy are also at increased risk for preeclampsia, a potentially fatal disorder involving dangerously high blood pressure. Babies born to mothers with diabetes — when they reach adulthood — are at higher risk for obesity as well as diabetes, high blood pressure, and heart disease.
The seven-year study involved more than 23,000 pregnant women at 15 centers in 9 countries.
The results of the Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study appear in the May 8 New England Journal of Medicine. The researchers were led by Boyd E. Metzger, M.D. Professor of Medicine at the Northwestern University Feinberg School of Medicine in Chicago.
Dr. Metzger explained that before the current study, physicians were not sure at which point elevated maternal blood sugar posed a risk for the baby. Frequently, high maternal blood sugar levels accompany such conditions as obesity, high blood pressure and older maternal age — all known to increase the likelihood for Caesarean delivery. For this reason, it wasn’t known whether the increased risk for Caesarean delivery and other problems seen with mild elevations in blood sugar during pregnancy were caused by the elevated blood sugar levels, or by these accompanying conditions. In their study, however, the researchers made adjustments for these accompanying conditions and found that the higher blood sugar levels still conveyed increased risks.
To conduct the study, the researchers performed an oral glucose tolerance test on each woman, from the 24th through the 32nd week of pregnancy. For the test, the women fasted, after which their blood glucose level was measured. Next, the women drank a glucose solution, and then their blood glucose was measured at predetermined intervals. Women with blood sugar levels high enough to raise safety concerns were referred for treatment and were not included in the study. The remaining women were observed throughout the study until they gave birth.
The researchers found that the higher the mother's blood sugar levels, the greater the chances that they would deliver by Caesarean section. In addition, the higher the mother's blood sugar levels, the more likely the infants were to have high insulin levels and low blood sugar levels at birth. Both conditions indicate exposure to high glucose levels in the womb. Moreover, the higher the mother’s blood sugar levels, the more likely the women were to develop preeclampsia, and the more likely their infants were to be born prematurely, and to experience shoulder dystocia. So, for example, women with the lowest fasting blood sugar levels gave birth to abnormally large babies roughly 5 percent of the time, while women with the highest blood sugar level gave birth to large babies 26 percent of the time.
"These relationships are continuous and generally increase incrementally over the range of blood glucose levels we saw in the study," he said.
Time Stamp: 5/8/2008 at 1:26:46 PM UTC
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