Cervical cancer screening for over 50-year-olds continues to find abnormalities even if they have clear results in their 40s, a new study published by The Institute of Cancer Research (ICR) in the British Journal of Cancer has revealed.

The results are from a cohort study of two million women aged between 20 and 64. Within this, the authors studied a sub-group of 57,000 women, 80 per cent of whom had at least two negative screening tests in their 40s and a further test over age 50 between 1988 and 2003. The study was funded by the Department of Health Policy Research Programme.

“This study will inform the discussion about whether or not to continue screening of women over the age of 50 with a prior history of negative screening tests. It shows that the NHS Cervical Cancer Screening is continuing to benefit older women. Nearly two thirds of serious pre-cancerous abnormalities (classified as CIN 3) currently detected in women over 50 would remain undetected without the provision of screening in this group,” Dr Roger Blanks from The Institute of Cancer Research and lead author of the study says.

Currently, women aged 25 to 49 are invited for screening every three years, and 50-64 every five years by the NHS Cervical Cancer Screening Programme.

The cohort study involved residents from four health authorities, now Primary Care Trusts, in the South of England (Berkshire, Oxfordshire, Somerset and Dorset), which have a lower than average risk of cervical cancer. This suggests that the rate of abnormalities that would be missed could be greater on a national scale.

However, benefits of screening women in their 50s need to be balanced against possible negative considerations such as over-diagnosis and potentially causing unnecessary anxiety, as well as the financial cost of screening.

“The risks of developing cervical cancer as women get older are moderately reduced, however the evidence shows that the risk of not detecting cancer or extensive pre-cancerous conditions justifies ongoing screening for this age group,” Dr Blanks says.

“Long-term follow up of this cohort study will enable further analysis of women with negative histories and help us determine if there are potentially very low risk groups for whom further screening may not be necessary.”

Health Minister Ann Keen says:

“The cervical screening programme in England is a great success, it is internationally recognised as world class and saves up to 4,500 lives every year.

“We welcome this new research that shows our policy of continuing to screen women up to age 64 is correct and contributes to the number of lives saved.”

“Women aged over 64 are invited for screening if they have never been screened or if their last three tests were not clear.

Around 2,700 women are diagnosed each year in the UK making it the second most common cancer in women under 35.

Approximately 1,000 women die from cervical cancer in the UK every year.

About 4.4 million women are invited for cervical cancer screening each year in England between the ages of 25 and 64.

The Institute of Cancer Research

The Institute of Cancer Research is Europe’s leading cancer research centre with expert scientists working on cutting edge research. In 2009, The ICR marks its 100 years of world leading research into cancer prevention, diagnosis and treatment.

Scientists at the ICR have identified more cancer related genes than any other organisation in world. These discoveries are allowing for scientists to develop new cancer treatments. The ICR is a charity that relies on voluntary income. It is one of the world’s most cost-effective major cancer research organisations with more than 95p in every £ directly supporting research. For more information visit http://www.icr.ac.uk.

About the British Journal of Cancer (BJC)

The BJC is owned by Cancer Research UK. Its mission is to encourage communication of the very best cancer research from laboratories and clinics in all countries. Broad coverage, its editorial independence and consistent high standards have made BJC one of the world’s premier general cancer journals. http://www.bjcancer.com

Source
British Journal of Cancer

The U.S. fda.gov/” rel=”nofollow”>Food and Drug Administration recently approved Avastin (bevacizumab) to treat patients with glioblastoma multiforme (GBM) when this form of brain cancer continues to progress following standard therapy.

GBM is a rapidly progressing cancer that invades brain tissue and can impact physical activities and mental abilities. It affects about 6,700 persons in the United States every year. Following initial treatment with surgery, radiation, and/or chemotherapy, the cancer nearly always returns.

“This type of cancer is very resistant to therapy and thus challenging to treat,” said Richard Pazdur, M.D., director of the Office of Oncology Drug Products in the FDA’s Center for Drug Evaluation and Research. “Avastin provides a therapy for patients with progressive GBM who have not responded to other medications.”

Avastin is a laboratory-produced molecule known as a monoclonal antibody that mimics the antibodies produced by the body’s immune system to defend against harmful substances. The medication inhibits the action of vascular endothelial growth factor that helps form new blood vessels. These vessels can feed a tumor, helping it to grow and can also provide a pathway for cancer cells to circulate in the body.

The drug was first approved in 2004 to treat metastatic cancer of the colon or rectum and has since been approved for treatment of non-squamous, non-small cell lung cancer and metastatic breast cancer.

In two clinical trials, about 25 percent of patients with GBM responded to Avastin with an average duration of response of about four months.

The most serious side effects associated with Avastin, in some cases resulting in death, are gastrointestinal perforation, wound healing complications, hemorrhage, and blood clots. Other serious side effects of Avastin are severe high blood pressure, nervous system and vision disturbances, decreased white blood cell counts, infection, stroke, myocardial infarction, and kidney problems.

The most common adverse reactions were nose bleeds, headache, high blood pressure, runny nose, excess proteins in the urine, taste alteration, dry skin, rectal bleeding, excessive tearing, and skin peeling.

Avastin is manufactured by Genentech Inc. of San Francisco.

Source
U.S. Food and Drug Administration

View drug information on Avastin.

An important analysis conducted by Children’s Hospital Oakland Research Institute scientists suggests the importance of ensuring optimal dietary intakes of vitamin K to prevent age-related conditions such as bone fragility, arterial and kidney calcification, cardiovascular disease, and possibly cancer (1). Vitamin K is concentrated in dark green plants such as spinach or Swiss chard, and is either not present or present in only small amounts in most multivitamin pills.

This finding comes from Associate Staff Scientist, Joyce McCann, PhD, and Senior Scientist, Bruce Ames, PhD, who analyzed data from hundreds of published articles dating back to the 1970’s. Their review was designed to test Dr. Ames’ “triage” theory that provides a new basis for determining the optimum intake of individual vitamins and minerals (also called micronutrients), and has major implications for preventive medicine. The analysis, which strongly supports his theory, will be published in the October 2009 issue of the American Journal of Clinical Nutrition.

Dr. Ames proposed the triage theory in 2006 (2,3) to explain numerous observations from his own lab and the scientific literature. The theory explains why diseases associated with aging like cancer, heart disease, and dementia (and the pace of aging itself) may be unintended consequences of mechanisms developed during evolution to protect against episodic vitamin/mineral shortages. If correct, the triage theory has widespread implications for public health because modest vitamin/mineral deficiencies are quite common. The theory also suggests a new scientifically based and consistent strategy for establishing optimal vitamin/mineral intake standards, and it provides a research strategy to uncover early biomarkers of chronic disease.

Vitamin K is known as the “Koagulation” vitamin because about half of the 16 known proteins that depend on vitK are necessary for blood coagulation. The other vitK-dependent proteins are involved in a variety of different functions involving the skeletal, arterial, and immune systems.

Average intakes of vitamin K in the United States and the United Kingdom are less even than currently recommended intakes, which are primarily based on levels to ensure adequate coagulation. McCann & Ames’ analysis supports recommendations by some experts that non-clotting functions requiring vitamin K may need higher intakes than are currently recommended.

McCann says, “Encouraging support for the triage theory from our vitamin K analysis suggests that experts aiming to set micronutrient intake recommendations for optimal function and scientists seeking mechanistic triggers leading to diseases of aging may find it productive to focus on micronutrient-dependent functions that have escaped evolutionary protection from deficiency.”

This vitamin K analysis is the first in a series of literature-based studies conducted by Drs. Joyce McCann and Ames to test the basic premises of the triage theory. As a reviewer of the manuscript notes, “…this review provides a unique perspective of consequences of vitamin K insufficiency and may serve as an important future reference, as new vitamin K dependent proteins are identified and new (non-clotting) functions of vitamin K are elucidated. More broadly, an assessment of micronutrient sufficiency from the perspective of triage theory may provide a valuable point of view, as current recommendations for nutrient intakes are reconsidered.”

References:

1. McCann, J. C., and Ames, B. N. (2009) Vitamin K, an example of triage theory: is micronutrient inadequacy linked to diseases of aging? AJCN 90 (4): Epub

2. Ames, B. N. (2006) Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. PNAS 103, 17589-94.

3. Ames, B. N., and McCann, J. C. (2009) Forword: Prevention of cancer, and the other degenerative diseases of aging, through nutrition. In Chemoprevention of cancer and DNA damage by dietary factors (S. Knasmuller, D. M. D. I. J. C. G., eds), WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim [This paper presents a short summary of the triage theory and the vitamin K analysis]

Source:
Erin Goldsmith

Children’s Hospital & Research Center at Oakland