Download Articles June 10, 2012-June 16, 2012 Metformin May Reduce Risk

Articles
June 10, 2012-June 16, 2012
Metformin May Reduce Risk Of Invasive Breast Cancer In Older Women With
Diabetes.
HealthDay (6/12, Gray) reports, "A widely prescribed drug, metformin, may lower
the risk of invasive breast cancer in postmenopausal women with diabetes,"
according to a study published online in the Journal of Clinical Oncology.
Investigators "looked at relationships among diabetes, metformin use and breast
cancer among over 68,000 women between 50 and 79 years old in the national
Women's Health Initiative project." The investigators "found that the incidence of
invasive breast cancer was 25 percent lower in women with diabetes who were
taking metformin than it was in women who weren't taking the drug."
Insulin Glargine May Not Be Linked To Increased Cancer Risk.
The Wall Street Journal (6/12, Dooren, Loftus, Subscription Publication) reports that
several studies published online in the New England Journal of Medicine and presented
at the American Diabetes Association meeting suggest that Sanofi SA's Lantus (insulin
glargine) may not be linked to an increased risk of cancer.
Bloomberg News (6/12, Torsoli) reports, "The studies, which analyzed data on
more than 615,000 patients, independently compared the use of Lantus with other longacting insulins in diabetics, the American Diabetes Association said in a statement."
Investigators "looked at the association between insulin use and all cancers and
analyzed the individual risks for breast, colorectal and prostate cancer, the ADA said."
Just "one study, from Kaiser Permanente, found a 'suggestion' of a relationship between
Lantus and a 'modest' increase in breast cancer risk, but only in new insulin users,
according to the statement."
Reuters (6/12) points out that in 2009, several studies linked Lantus to an
increased risk of cancer. HealthDay (6/12, Reinberg) also covers the story.
Persistent Dental Plaque May Increase Risk Of Dying Early From Cancer.
Bloomberg News (6/12, Kitamura) reports, "Persistent dental plaque may increase the
risk of dying early from cancer, according to authors of a study published in the journal
BMJ Open." Investigators found that "dental-plaque levels were higher in the 35 people
who died from cancer than in the rest of the 1,400 study participants tracked over 24
years in Sweden."
The UK's Press Association (6/12) reports, "The average age of death was 61 for
the women and 60 for the men. The women would have been expected to live around
13 years longer, and the men an additional 8.5 years, so their deaths could be
considered premature, say the authors."
Report: Younger Cancer Survivors Often Face Other Health Problems Later In
Life.
HealthDay (6/12, Dallas) reports, "Many teens and young adults who survive cancer
face other challenges later in life, such as unhealthy behaviors, chronic medical
conditions and poor quality of life, according to a new report" published online in
Cancer. CDC researchers looked at data on younger cancer survivors, and compared it
to data on individuals who had not been treated for cancer. Investigators found that "the
cancer survivors...had a higher prevalence of chronic illnesses: 14 percent had heart
disease compared to seven percent of those without cancer; 35 percent had high blood
pressure compared to 29 percent of those with no history of cancer; and 15 percent had
asthma compared to eight percent of those who did not have cancer." Young cancer
survivors "also had a higher prevalence of disability compared to those with no history
of cancer (36 percent vs. 18 percent)." Additionally, a higher percentage of cancer
survivors said that they had experienced poor mental health.
Study: Use Of CT, MRI On The Rise.
A study on the increase in imaging received a moderate amount of coverage in print
and online, but was not covered on any of last night's national news broadcasts. Most
sources point to the health risks associated with increased exposure to radiation from
certain types of scans.
The Los Angeles Times (6/13, Bardin) reports, "The use of CTs, MRIs and other
advanced medical imaging tests has soared over the last 15 years, according to new
research that raises questions about whether the benefits of all these scans outweigh
the potential risks from radiation exposure and costs to the healthcare system."
Researchers looked at "data from patients enrolled in six large health maintenance
organizations," and "found that doctors ordered CT scans at a rate of 149 tests per
1,000 patients in 2010, nearly triple the rate of 52 scans per 1,000 patients in 1996."
Meanwhile, "MRI use nearly quadrupled during the period, jumping from 17 to 65 tests
per 1,000 patients."
The New York Times (6/13, A18, Gee, Subscription Publication) reports, "The
study, published online on Tuesday in the Journal of the American Medical Association,
says that while advanced medical imaging has undoubted benefits, allowing problems
to be diagnosed earlier and more accurately, its value needs to be weighed against
potential harms, which include a small cancer risk from the radiation." Earlier this year,
"a group of nine medical specialty boards recommended that doctors perform 45
common tests and procedures less often, with imaging prominent among them." One of
these boards, "the American Academy of Allergy, Asthma and Immunology, said a CT
scan was not needed for cases of uncomplicated acute rhinosinusitis, or sinus infection,
while another board, the American Society of Clinical Oncology, said doctors should cut
back on CT and PET scans for early prostate and breast cancers that are unlikely to
metastasize."
The Huffington Post (6/13, Pearson) reports, meanwhile, that "the American
College of Radiology, for example, has called for a stop in imaging among patients with
uncomplicated headaches."
Bloomberg BusinessWeek (6/13, Ostrow) reports, "Paul Ellenbogen, chairman of
the American College of Radiology Board of Chancellors, said in a statement that the
group advises clinicians to prescribe advanced imaging only to those with a clear
medical need. Those receiving the highest doses of radiation are most likely cancer
patients or those with chronic conditions who required multiple scans, he said."
WebMD (6/13, Goodman) reports that Bibb Allen, MD, vice chairman of the
American College of Radiology, said, "We should make ourselves aware as providers,
make our patients aware, and make our referring physicians aware that there are risks
to the population from radiation."
On its website, ABC News (6/13) reports, "The use of magnetic resonance imaging
(MRI) and ultrasound also increased, according to the study." However, "those tests are
not associated with radiation exposure."
HealthDay (6/13, Dotinga) reports that the study's lead author, Dr. Rebecca SmithBindman, "said the scan rates in the HMOs in the study were a bit lower than in
traditional fee-for-service systems, but the growth rates were the same."
MedPage Today (6/13, Phend) reports, "Expanding indications, patient and
physician demand, medical uncertainty, and defensive medicine likely all
contributed to those trends, Smith-Bindman's group noted."
Look Again: The Importance of Second Opinions in Breast Pathology
Ira J. Bleiweiss, et al.
J Clin Oncol 30:2175-2176, 2012
Choosing the Best Trastuzumab-Based Adjuvant Chemotherapy
Regimen: Should We Abandon Anthracyclines?
Harold J. Burstein, et al.
J Clin Oncol 30:2179-2182, 2012
Adoption of Gene Expression Profile Testing and Association With
Use of Chemotherapy Among Women With Breast Cancer
Michael J. Hassett, et al.
J Clin Oncol 30:2218-2226, 2012
Impact of Routine Pathology Review on Treatment for NodeNegative Breast Cancer
Hagen F. Kennecke, et al.
J Clin Oncol 30:2227-2231, 2012
Decline in the Use of Anthracyclines for Breast Cancer
Sharon H. Giordano, et al.
J Clin Oncol 30:2232-2239, 2012
Cost Of Cancer Medications Becoming A Larger Issue In Treatment Decisions.
Reuters (6/15, Beasley) reports that the cost of cancer medications is becoming a
larger issue in treatment decisions. The article points out that 44 studies
presented at the recent American Society of Clinical Oncology meeting
addressed the cost-effectiveness issue. One study at the meeting found that
about one in five patients with late-stage cancer did not receive treatment
because of issues such as lower income or lack of health insurance, among
others.
Number Of Cancer Survivors In US Expected To Surge To 18 Million By 2022.
The CBS News (6/15, Jaslow) "HealthPop" blog reports, "The number of cancer
survivors living in the US is expected to surge by one-third come 2022, with about 18
million people expected to survive the disease." The new report, called "Cancer
Treatment and Survivorship Facts and Figures," found "that even though cancer
incidence rates are decreasing, the number of survivors is growing due to the aging and
growth of the population, as well as improved rates in cancer survival." This report,
published in CA: A Cancer Journal for Clinicians, "is the first of its kind collaboration
from the American Cancer Society and the National Cancer Institute."
According to the CNN (6/15, Wilson) "The Chart" blog, "The report...says currently
one in three women and one in two men in the US will develop cancer during their
lifetime."
Fox News (6/15, Crees) reports, "The most common types of cancers among male
survivors in 2012 are prostate cancer (43 percent), colorectal cancer (9 percent) and
melanoma (7 percent)." Meanwhile, "the most common types of cancers among female
survivors are breast cancer (41 percent), uterine (8 percent) and colorectal (8 percent)."
AFP (6/15) reports, "'There are 58,510 survivors of childhood cancer living in the
United States, and an additional 12,060 children will be diagnosed in 2012,' said the
study."
According to Reuters (6/15, Sherman), the report argues that this increase makes
it even more imperative that healthcare providers are aware of the health needs of this
population.
HealthDay (6/15, Reinberg) reports that "Dr. Anthony D'Amico, chief of radiation
oncology at Brigham and Women's Hospital, in Boston, said he is concerned that the
data reflect patients who were treated needlessly and are included in these numbers."
The Minneapolis Star Tribune (6/15, Stoxen) "Health Check" blog also covers the story.
Genome Screening Of Healthy People May Warn Of Cancer Risk.
Bloomberg News (6/15, Lauerman) reports that a recent study appearing in the
American Journal of Human Genetics suggests that "screening the genomes of healthy
people may give important clues about their cancer risk." The story quotes Leslie
Biesecker, chief of the genetics disease research branch at the Human Genome
Research Institute, as saying, "The current medical approach for finding susceptibility to
disease requires that you or your family members have the condition or have died of it.
This suggests that it doesn't have to be that way, that we can find susceptibility before
all that suffering."
Physician Says Cancer Patients Deserve Right To Choose Treatments.
In the New York Times (6/14) "Well" blog, Barron H. Lerner, MD, PhD, professor of
medicine and public health at Columbia University Medical Center, writes about
"Babette Rosmond, a diminutive New York City writer and editor," who, in the 1970s,
advocated for women to be able to choose less aggressive treatment for breast cancer.
According to Lerner, "What Ms. Rosmond demanded of her doctors -- the right to
choose her cancer treatment -- is now the minimum that cancer patients deserve."
Illinois Governor Approves Medicaid Cuts, Cigarette Tax.
The Chicago Sun-Times (6/15, McKinney) reports that Illinois Gov. Pat Quinn on
Thursday signed "a $2.7 billion package of cuts and taxes designed to repair a longterm deficit in the state's Medicaid program." Quinn "signed five bills, including a tax
increase on cigarettes of $1 a pack and $1.6 billion in Medicaid spending reductions.
The cuts will mean leaner services for the state's 2.7 million Medicaid patients. More
than 25,000 working parents will lose state-funded insurance coverage." The Sun Times
notes that advocates for the poor criticizes the move, saying Quinn and lawmakers
"could have closed corporate 'loopholes' to make up for Medicaid shortfalls rather than
wringing savings from the state's most vulnerable populations."
The AP (6/15) reports that the cuts include reducing payments to some nursing
homes and hospitals, "eliminating extras like regular dental care for adults," limiting
eyeglasses to one pair every two years, and limiting patients "to four prescription drugs
per month without prior state approval." Reuters (6/15) also covers this story.
Report: Many Americans Did Not Receive Routine Preventive Services Before
2010.
The Los Angeles Times (6/15, Brown) "Booster Shots" blog reports, "Before 2010,
nearly half of Americans did not receive routine clinical preventive services that are
known to save lives, researchers at the US Centers for Disease Control and Prevention
reported Thursday" in the Morbidity and Mortality Weekly Report. The "researchers said
the purpose of their investigations was to establish a baseline for use of preventive
services before implementation of the healthcare reforms in the Affordable Care Act."
The ACA "could impact future prevention trends because it requires many health
insurance plans to provide preventive services without cost-sharing, they reported."
CDC director Dr. Thomas R. Frieden wrote, in the report's foreword, that "the findings of
this report indicate that tens of millions of people in the United States have not been
benefiting from key preventive clinical services, and that there are large disparities by
demographics, geography, and health care coverage and access in the provision of
these services."
Modern Healthcare (6/15, Barr, Subscription Publication) reports, "Among the
findings were that slightly less than half of patients with diagnosed ischemic
cardiovascular disease were prescribed aspirin or other anti-platelet drugs and that
despite improvements in hypertension treatment and control, slightly less than half of
those with high blood pressure had it under control, according to the report."
According to HealthDay (6/15, Preidt), the report also indicated that "fewer than
one in 13 tobacco users were prescribed medications to help them quit their habit."
MedPage Today (6/15, Fiore) reports, "In terms of breast cancer screening, about
20% of women ages 50 to 74 hadn't had a mammogram in the past two years, and use
was lower among American Indian/Alaska Native women, as well as those with less
education, lower household income, and a lack of health insurance." Meanwhile,
"despite large increases in colorectal cancer screening use in recent years, the
researchers said, about a third of patients ages 50 to 75 weren't up-to-date with their
screening." The researchers "also found that only 28% of adults under age 65 were
vaccinated against influenza, and about 20% of people who have HIV remain
undiagnosed."