The American Cancer Society - the nation’s leading voluntary health organization and largest non-governmental funder of cancer research and discovery - will present its Corporate Impact Awards June 19 during the Society-hosted Corporate Impact Conference in Chicago. The awards will recognize companies’ engagement in targeted efforts to significantly impact cancer’s effect on the workplace, where disease-related expenditures and lost productivity costs annually surpass $228 billion; in contributing funds to the American Cancer Society to fight the disease; and in addressing responsible community involvement.

The following five companies will be honored with the 2009 Corporate Impact Awards for their leadership in addressing cancer in the workplace, improving the health of their workforces, and encouraging employee engagement in the fight against the disease: Walgreens (award of excellence), Abbott (employee giving), Wal-Mart Stores, Inc. (employee engagement), Archer Daniels Midland (tobacco control), and GE Energy (cancer control).

“These five companies have distinguished themselves in aligning with the American Cancer Society’s mission of saving lives. With their commitment to lessening the effect of cancer on their workforces, improving workplace productivity and investing in the fight against cancer through contributions and responsible investment in their communities, these companies are substantially invested in changing the course of cancer,” said American Cancer Society Chief Executive Officer John R. Seffrin, Ph.D. “The commitment these companies have made toward reducing the cancer burden will help us to achieve our vision of a world with less cancer and more birthdays.”

Walgreens will receive the Corporate Impact: Award of Excellence - the award of distinction among the five presented - for its leadership in corporate and employee giving, customer engagement and volunteerism. Walgreens demonstrates a significant commitment to employee health and wellness benefits, policies, programs and promotion. Its leadership has been paramount in the founding of the American Cancer Society’s CEOs Against Cancer, which works with the Society to provide businesses with information about cancer-related programs and services as well as initiatives that promote healthy employee lifestyles.

Walgreens encourages healthy employee behavior through its smoke-free worksites and by making available the American Cancer Society Quitline, through which employees may obtain counseling to help with their tobacco cessation attempt.

Company employees receive access to cancer screenings that provide opportunities for early detection, and any employee diagnosed with cancer also receives access to quality treatment and clinical trials, if applicable.

The company encourages its employees to volunteer for numerous Society fundraising initiatives, including the American Cancer Society Relay For Life®, where more than 600 teams now participate nationwide. Walgreens includes the Society as a highlighted strategic employee giving choice within the company’s “Charity Choice Campaign.” Additionally, Walgreens is active in a variety of initiatives that directly connect the company and its customers with the opportunities for involvement with the American Cancer Society.

The Corporate Impact: Employee Giving Award will be presented to Abbott for its leadership in providing an integrated giving platform that empowers employee choice, enabled by the company’s comprehensive support, marketing and measurement program to encourage employee giving and to recognize them for their generosity. Abbott also incorporates best practices to drive charity giving and campaign growth, which now involves 75 percent of employees. Over the last five years, employee giving to the American Cancer Society has increased by 160 percent. Abbott also provides multi-level access to American Cancer Society information regarding its mission and numerous patient/caregiver services.

Wal-Mart Stores, Inc., will receive the Corporate Impact: Employee Engagement Award for its work in developing substantial employee volunteerism with a number of American Cancer Society initiatives, including Relay For Life and Making Strides Against Breast Cancer. The award also addresses how Wal-Mart’s corporate culture supports and encourages volunteerism through activities that unite the company, employees and retirees in ways that integrate with the company’s overall goals for corporate philanthropy and corporate citizenship. Wal-Mart also enables employees to help determine where its corporate contributions are channeled, based upon eligible organizations for which employees volunteer.

The Corporate Impact: Excellence in Tobacco Control Award will be presented to Archer Daniels Midland (ADM) for its implementation of a global smoke-free worksite policy and its offering of cost-free, domestic employee access to Quitline. The company hosts an annual summit for all ADM human resources vendors, including the American Cancer Society, to address service offerings and vendor cross promotion. All ADM employees complete a Health Risk Assessment and partner with a health coach to address specific actions, including tobacco cessation. Many ADM locations offer fitness facilities and other health maintenance options for employees. Additionally, ADM provides health benefits to its independent contractors, with Quitline access under consideration.

GE Energy will receive the Corporate Impact: Excellence in Cancer Control Award, for its effectiveness in providing employees with information about the health benefits of four cancer prevention behaviors: physical activity, nutrition, tobacco and cancer screening. The company offers its employees a variety of physical fitness options, including onsite fitness centers and employee reimbursement for use of offsite facilities, as well as programs that track employee progress; healthy food choices for onsite dining and a free weight reduction program offering; a smoke-free environment in all buildings and free access to Quitline; and cost incentives for employees to engage in cancer screenings, ranging from no out-of-pocket expense to capped expense, dependent upon the employee choice of GE Energy health insurance plans.

Source
American Cancer Society

DALLAS, June 25 — The risk of venous thromboembolism (VTE) after bariatric surgery persists for at least a year after the procedure, according to a review of medical records of 17,000 patients.

• Explain to patients that the risk of venous clot formation lasts for at least a year after obesity surgery.
• Note that this study was published as an abstract and presented at a conference. The data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

The incidence of VTE rose from 0.88% during hospitalization to 3.42% at 12 months, Michael Schweitzer, MD, of Johns Hopkins, reported here at the American Society of Metabolic and Bariatric Surgery meeting.

The rates of pulmonary embolism and deep vein thrombosis (DVT) also increased out to a year.

“Since most bariatric patients receive VTE prophylaxis only during the index admission, strategies need to be developed to address the high rate of VTE events that occur after discharge,” said Dr. Schweitzer.

“By targeting patients at high risk, extended thromboprophylaxis may help minimize the occurrence or impact of VTE events.”

Several reports in the medical literature have cited VTE as a leading cause of death after bariatric surgery. Reported rates have ranged from 0.2% to 3.8%.

Most of the reports have fallen into two categories: (1) Single-center patient series with variable follow-up and small numbers (2) Large series that have focused primarily on VTE during hospitalization.

“Several reports have indicated that the majority of VTEs occur after discharge from the hospital and may be missed or not accounted for,” said Dr. Schweitzer.

Given the background of the issue, investigators hypothesized that the risk of VTE after bariatric surgery extends well beyond the initial hospitalization.

To test the hypothesis they retrospectively reviewed data from a private insurance claims database comprising 3.4 million patients.

Dr. Schweitzer and colleagues identified all patients who underwent laparoscopic adjustable gastric band and gastric bypass procedures from 2002 to 2005. Eligible patients had continuous insurance coverage for at least six months prior to surgery and six months after surgery.

The primary outcome was the cumulative incidence of VTE during hospitalization and at one, six, and 12 months after surgery.

The search of the database identified 17,434 bariatric surgery patients, 82% of whom were women with a mean age of 43 years.

Dr. Schweitzer reported that 63% of patients had open gastric bypass surgery, while 33% had laparoscopic gastric bypass, and 4% had laparoscopic adjustable gastric band procedures.

The analysis showed that 0.88% of patients had a VTE event during hospitalization, increasing to 2.17% at one month, 2.99% at six months, and 3.42% at 12 months.

Rates for pulmonary embolism over the same time period were 0.36%, 0.83%, 1.14%, and 1.23% respectively. The deep venous thrombosis incidence increased from 0.52% in hospital to 1.34% at one month, 1.84% at six months, and 2.19% at 12 months.

In a multivariate analysis, the strongest risk factor for VTE during the first six months after surgery was a history of VTE.

Dr. Schweitzer said that 20% of patients who had VTE after bariatric surgery had experienced a prior VTE, compared with 2.3% of patients who did not have a VTE after weight-loss procedures. The difference translated into almost an eight-fold greater risk of VTE (P<0.001).

Male sex, age ³55, and length of hospital stay of five days or longer also increased the risk of VTE. Smoking increased the risk only slightly.

Analysis of VTE rates by type of bariatric procedure showed that laparoscopic adjustable gastric banding was associated with a significantly lower incidence (0.8%) than either laparoscopic or open gastric bypass (2.7%, 3.3%, respectively, P<0.01).

Current recommendations currently call for continuation of VTE prophylaxis for the first month after surgery. Whether prophylaxis should continue beyond that requires a randomized clinical trial to provide answers, said Dr. Schweitzer.

Dr. Schweitzer and co-investigators reported no disclosures.

Primary source: American Society of Metabolic and Bariatric Surgery

Source reference:
Steele K, et al “Long-term risk of venous thromboembolism following bariatric surgery” Surg Obesity Related Dis 2009; 5(35 Suppl): Abstract PL111.

PRINCETON, JUNE 26 — People who consume large amounts of fat, especially from red meat and dairy products, are more likely to contract pancreatic cancer, according to a National Institutes of Health study.

Men and women who consumed large amounts of saturated fat were 36% more likely to suffer from pancreatic cancer (95% CI 1.14 to 1.62, P<.001 for trend), researchers reported online in the Journal of the National Cancer Institute.

The study found that the link between fat intake and cancer was strongest for saturated fat from animal food sources, which were associated with a 43% increase in cancer risk (95% CI 1.20 to 1.70, P<0.001 for trend). The relationship was particularly strong for red meat and dairy products (HR 1.27 and 1.19, respectively).

• Inform interested patients that research suggests diets high in fat, especially fat from meat and dairy products, are linked to increased risk of pancreatic cancer.
• Note that the accompanying editorial argued more evidence was needed to confirm the importance of animal fats in the development of pancreatic cancer.

“We observed positive associations between pancreatic cancer and intakes of total, saturated, and monounsaturated fat overall, particularly from red meat and dairy food sources,” wrote Rachael Z. Stolzenberg-Solomon, PhD, of the agency’s Division of Cancer Epidemiology and Genetics, and colleagues.

“We did not observe any consistent association with polyunsaturated, saturated, or monounsaturated fat from plant food sources. Altogether, these results suggest a role for animal fat in pancreatic carcinogenesis,” they concluded.

In an accompanying editorial, Brian M. Wolpin, MD, MPH, of the Dana Farber Cancer Institute in Boston and Meir J. Stampfer, MD, DrPH, of the Harvard School of Public Health, cautioned that more research is needed to confirm that consuming animal fat puts people at higher risk for pancreatic cancer.

“The available epidemiological and laboratory evidence are insufficient to confirm the importance of animal fats, per se, or even that meat is the important factor, as opposed to other dietary or lifestyle preferences associated with meat consumption,” they wrote.

For this study, NIH researchers analyzed a cohort of more than 500,000 people from the National Institutes of Health-AARP Diet and Health Study.

Participants completed a food frequency questionnaire in 1995 and 1996 and were then followed prospectively to track a variety of health outcomes, including pancreatic cancer.

Over an average follow-up of 6.3 years, 865 men and 472 women were diagnosed with exocrine pancreatic cancer (45.0 and 34.5 cases per 100,000 person-years, respectively).

Among the participants who consumed the highest amounts of total fats, the rate of cancer was 53% higher for men and 23% higher for women, compared to participants with the lowest fat diets.

Combining the data for men and women, the researchers found that total fat consumption was associated with 23% higher rates of pancreatic cancer (95% CI 1.03 to 1.46, P=0.03 for trend), while high intake of monosaturated fats was associate with 22% higher cancer rates (95% CI 1.02 to 1.46, P=0.05).

“An association between saturated fat from red meat and pancreatic cancer was seen in men only — consistent with what was reported in this cohort for red meat consumption — whereas the association with saturated fat overall and from dairy products did not differ between men and women,” Stolzenberg-Solomon and her colleagues wrote.

They theorized that the association between fat intake and pancreatic cancer could be related to the exocrine function of the pancreas, which excretes enzymes such as lipases that digest fat.

“Fats and fatty acids contained in chyme enter the duodenum, which releases cholecystokinin to stimulate pancreatic enzyme secretion and pancreatic hypertrophy and hyperplasia,” they wrote, “which could in turn increase the susceptibility of the pancreas to other carcinogens.”

They also note that studies have linked saturated fat to insulin resistance and that diabetes and insulin resistance have been associated with increased pancreatic cancer risk.

In their editorial, Wolpin and Stampfer, praised the NIH researchers for adding evidence for the health benefits of diets low in meat and saturated fat, and for offering potential clues to the mechanisms underlying pancreatic cancer.

“Pancreatic cancer is the fourth leading cause of cancer-related mortality in the U.S., and 80 to 85% of patients have incurable disease at the time of diagnosis,” they wrote.

“Furthermore, more than 95% of patients diagnosed with pancreatic cancer will ultimately die from the disease, highlighting the urgent need for novel insights into pancreatic tumorigenesis.”

However, the editorialists also called for studies that dig deeper into the mystery of pancreatic cancer, suggesting that researchers collaborate to increase the numbers of participants in studies.

They also suggested a greater use of banked plasma, germline DNA, and tumor tissue from study participants to advance understanding of pancreatic cancer pathogenesis.

Overall, they called on scientists, “to push our research efforts in novel directions and provide hope for meaningful progress in this highly lethal disease.”

The National Cancer Institute funded this study. The researchers reported no conflicts of interest.

Primary source: Journal of the National Cancer Institute

Source reference:

Theibaut C, et al “Dietary fatty acids and pancreatic cancer in the NIH-AARP diet and health study” J Natl Cancer Inst 2009; 101: 1001-11.