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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."