More pre-cancerous polyps were found in colonoscopies performed with deep sedation primarily using Propofol than with milder sedation in which patients remained conscious, according to a recent study conducted by Katherine Hoda, M.D. of Oregon Health and Science University. This improvement in cancer detection will save lives and reduce the number of patients requiring surgery and chemotherapy.

The retrospective review of nearly 105,000 procedures shows doctors found polyps larger than 9mm or suspected colorectal tumors at a 25% higher rate in patients under deep sedation. This research bolsters the findings of studies completed by the University of Pennsylvania and State University of New York. Those studies tracked facilities that switched from having the GI doctor perform the colonoscopy and also deliver the sedatives, to having an Anesthesiologist administer Propofol. The findings revealed the number and percentage of patients who had a polyp detected improved up to 43%.

Despite the improved results evident from these studies, occasional insurance companies have resisted payment for anesthesia and anesthesiologists for colonoscopies.

“25% and 43% improvements in cancer detection can’t be ignored,” says Dr. Marc E. Koch, founder and CEO of Somnia Anesthesia. “Propofol can help improve outcomes, but only if it is administered correctly. For safety reasons, and now for clinical outcome reasons, a sleep this deep must be administered and supervised by an Anesthesiologist or CRNA.” Propofol’s label states it should be administered by a person trained in general anesthesia - who is not performing the surgical procedure.

“Catching cancer sooner clearly saves lives, but what is often overlooked is the benefit to the healthcare system,” says Dr. Stanford Plavin, Vice Chairman of PreventingColorectalCancer.org. “The cost of having an Anesthesiologist or CRNA administer Propofol is dwarfed by what patients and the healthcare system save when cancer is averted or detected so early.”

For more information visit: http://www.somniainc.com and http://www.preventingcolorectalcancer.org.

Source
Somnia Anesthesia

Dr. Denis Therien, Vice-Principal (Research and International Relations) of McGill University has welcomed the Canada Foundation for Innovation’s (CFI) investment of $32,649,184 supporting five projects led by Dr. David Plant, Dr. Paul Lasko, Dr. David Thomas, Dr. Vincent Giguère and Dr. Chao-Jin (C.J.) Li. The Quebec government also confirmed it would match that funding.

“We are very pleased to see such a solid commitment to supporting research at the university level, from both the federal government and the government of Quebec, which provides matching funds,” said Therien. “These are important projects by world-class researchers in areas that will profoundly affect the human condition. We are delighted that the CFI and government of Quebec have shown such confidence in the work of McGill’s researchers and we are most thankful for this important continuing support.”

McGill’s projects include:

* Laboratories for Broadband Optical and Wireless Systems (LBOWS), an ambitious initiative designed to allow communications networks built in the 20th century to handle the connectivity needs of the 21st. LBOWS is led by Dr. David Plant, chair of the Department of Electrical and Computer Engineering. Received $5,518,560 from CFI.

* McGill/IRCM Research Group on Embryology and Disease (MIRGED), is a unique collaboration between three separate McGill research groups plus the l’Institut de recherches cliniques de Montreal (IRCM). Led by Dr. Paul Lasko, Chair of the Department of Biology, MIRGED will use state-of-the-art technology to answer fundamental questions about the biology of various human pathologies. Received $4,307,709.

* The Disease to Therapy Initiative, led by Dr. David Y. Thomas, Chair of the Department of Biochemistry and Canada Research Chair in Molecular Genetics is an ambitious project designed to respond to a major public health problem. The researchers will work to develop new medications to treat certain infections and chronic diseases which do not receive sufficient attention from the pharmaceutical industry. Received $10,632,949.

* Metabolism and Cancer: from Obesity to Cachexia, is a major collaborative project teaming researchers doing fundamental research in metabolism and clinicians to probe the links between the progression of cancer, obesity and cachexia. The project is headed by Dr. Vincent Giguère of the Department of Biochemistry working at the Rosalind and Morris Goodman Cancer Centre. Received $3,869,519.

* Toward a Healthy Environment: Green Chemistry and Green Chemicals is a comprehensive project intended to transform the field of organic chemistry. Dr. C.J. Li, Canada Research Chair in Green Chemistry, virtually co-invented green chemistry, a movement that discovers new chemical reactions which allow chemists to switch from harmful petrochemicals and solvents to environmentally sound alternatives like water. Received $8,320,447.

“The CFI’s support of cutting-edge research infrastructure has transformed Canada’s research landscape and increased the country’s international competitiveness,” said Dr. Eliot Phillipson, President and CEO of the CFI. “Investments like these have allowed McGill to become a destination of choice for some of the world’s top research talent.”

Funding for these projects is part of a major $666,128,376 investment announced today by the CFI to support 133 projects at 41 institutions across the country. $247,664,977 was awarded under the Leading Edge Fund (LEF), designed to enable institutions to build on and enhance already successful and productive initiatives supported by past CFI investment. Another $264,741,466 million was awarded under the New Initiatives Fund (NIF), designed to enhance Canada’s capacity in promising new areas of research and technology development. Finally, $153,721,933 was awarded under the Infrastructure Operating Fund, which assists institutions with the incremental operating and maintenance costs associated with the new infrastructure.

Raymond Bachand, Quebec’s Minister of Finance and Minister of Economic Development, Innovation and Foreign Trade, announced today that the province would contribute nearly $117 million to support the CFI program at universities in the province. Of that total, 30 346 908 is destined for McGill’s projects.

A complete list of projects funded today by the CFI can be found here .

Source:
Mark Shainblum
McGill University

SAN FRANCISCO, June 23 — Cancer is the second leading cause of death among schizophrenia patients, with a 50% higher mortality rate than in the general population, researchers found.

• Explain to interested patients that many studies have found a higher risk of premature death in schizophrenia patients than in the general population.
• Note that the study looked at mortality from cancer rather than cancer incidence.

Overall mortality among schizophrenics was nearly four times as high as in the general population, according to Frederic Limosin, MD, PhD, of the University of Reims and Robert Debre Hospital in Reims, France, and colleagues.

They reported in the August 1 issue of CANCER.

Their prospective cohort study revealed that lung cancer accounted for the largest proportion of cancers among men with schizophrenia, while breast cancer was most common among women.

“The continuing cultural stigma associated with schizophrenia can lead to barriers to access to medical care for these patients and may also contribute to diagnostic or treatment delays,” the researchers wrote.

The findings emphasize the need for greater attention to cancer prevention and early detection in patients with schizophrenia, they said.

“It appears essential for psychiatrists to be attentive to the medical care of schizophrenic patients and to evaluate their compliance to therapy for somatic disease,” Dr. Limosin’s group said.

Prior epidemiologic studies — most retrospective — have yielded widely conflicting results on mortality in schizophrenia.

So, Dr. Limosin’s group recruited 122 public departments of adult psychiatry in France to provide data on all patients seen over a three-month period in 1993.

From this group, 3,470 patients with schizophrenia were followed for 11 years, during which 13.9% died.

This mortality rate was significantly higher than seen in an age- and sex-adjusted sample of the French general population: 3.6 for men (95% CI 3.3 to 3.9) and 4.3 for women (95% CI 3.7 to 5.1).

The absolute mortality rate by cause of death was:

• 4.2% from suicide
• 2.2% from cancer
• 2.0% from cardiovascular disease
• 2.5% from unknown causes
• 1.4% from accidental or nonsuicidal poisoning

The researchers focused in on cancer-specific mortality, which had an overall adjusted standardized mortality ratio (SMR) of 1.5 among schizophrenia patients compared with the general population (95% CI 1.2 to 1.9).

Taken together, cancers caused more deaths among women with schizophrenia than among general population women (SMR 1.9, 95% CI 1.4 to 2.8), whereas the trend (1.4) was not significant among men.

Breast cancer was the major contributor to this excess cancer-related mortality among women with schizophrenia.

It accounted for 39% of cancers among women with schizophrenia and was almost three times as common as a cause of death in schizophrenia as in the female general population (SMR 2.8, 95% CI 1.6 to 4.9).

For men with schizophrenia, lung cancer was the most common of the cancer localizations, accounting for half of cases, and was twice as likely to cause death as in the general population (SMR 2.2, 95% CI 1.6 to 3.3).

Years of tobacco consumption were significant independent predictors in lung cancer mortality in schizophrenia (P<0.0001). Age at baseline was an independent risk factor for both breast cancer and lung cancer mortality in schizophrenia (P=0.04 and P=0.0004, respectively).

The researchers noted that smoking was significantly more prevalent among the schizophrenia cohort than in the general French population (56.3% versus 33.0%, P<0.001).

“In view of the sex distribution of cancer locations, this over-mortality due to cancer in schizophrenic women may suggest that breast cancer in schizophrenic women may be more often misdiagnosed and/or worse treated than lung cancer in schizophrenic men,” Dr. Limosin’s group suggested.

One possible explanation is that lung cancer symptoms — such as coughing — are more easily detected by family and medical staff than signs of breast cancer, allowing earlier treatment and thus better outcomes, they said.

Another possibility is a difference in lung cancer histologic subtype in schizophrenia, although no evidence is available to assess this, they said.

Other malignancies with higher mortality rates in schizophrenia were ear-nose-throat, testicular, and some digestive cancers in men and colon and stomach cancers in women.

Dr. Limosin and colleagues cautioned that the study was limited by availability of mortality data, but not cancer incidence or histologic data.

The study was supported by the General Direction of Health and grants from the Foundation for Medical Research. The researchers reported no conflicts of interest.

Primary source: CANCER

Source reference:

Tran E, et al “Cancer mortality in patients with schizophrenia: An 11-year prospective cohort study” Cancer 2009;115. DOI: 10.1002/cncr.24383