Rates of Cervical Cancer in the U.S. underestimated

A May 2014 study says the cervical cancer rates in black women and women in their 60s are understated because they include those who have had hysterectomies

Rates of cervical cancer are higher than previously reported, according to a May 2014 study, specifically among older women and black women.

Abstract:

TIMEHealth logo
A May 2014 study says the cervical cancer rates in black women and women in their 60s are understated because they include those who have had hysterectomies.

BACKGROUND:
Invasive cervical cancer is thought to decline in women over 65 years old, the age at which cessation of routine cervical cancer screening is recommended. However, national cervical cancer incidence rates do not account for the high prevalence of hysterectomy in the United States.

METHODS:
Using estimates of hysterectomy prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), hysterectomy-corrected age-standardized and age-specific incidence rates of cervical cancer were calculated from the Surveillance, Epidemiology, and End Results (SEER) 18 registry in the United States from 2000 to 2009. Trends in corrected cervical cancer incidence across age were analyzed using Joinpoint regression.

RESULTS:
Unlike the relative decline in uncorrected rates, corrected rates continue to increase after age 35-39 (APC(CORRECTED) = 10.43) but at a slower rate than in 20-34 years (APC(CORRECTED) = 161.29). The highest corrected incidence was among 65- to 69-year-old women, with a rate of 27.4 cases per 100,000 women as opposed to the highest uncorrected rate of 15.6 cases per 100,000 aged 40 to 44 years. Correction for hysterectomy had the largest impact on older, black women given their high prevalence of hysterectomy.

CONCLUSIONS:
Correction for hysterectomy resulted in higher age-specific cervical cancer incidence rates, a shift in the peak incidence to older women, and an increase in the disparity in cervical cancer incidence between black and white women. Given the high and nondeclining rate of cervical cancer in women over the age of 60 to 65 years, when women are eligible to exit screening, risk and screening guidelines for cervical cancer in older women may need to be reconsidered.

Sources and more information:
  • Rates of Cervical Cancer Are Underestimated, Study Says,
    Time, May 12, 2014.
  • Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009, NCBI PMID: 24821088, 2014 Jul 1;120(13):2032-8. doi: 10.1002/cncr.28548. Epub 2014 May 12.
    Full study on ReadCube.

Dr. Philippe Grandjean on Chemical Brain Drain

By the Collaborative on Health and the Environment

How the Next Generation’s Brain Functions are Endangered by EDCs and Other Environmental Chemicals.

Dr. Philippe Grandjean suggests that new scientific insights reveal that the next generation’s brain functions are endangered by environmental chemicals. The fetus is not protected by the placenta and therefore shares the mother’s cumulated exposures to toxic chemicals. Infants and children are likewise exposed to a cocktail of foreign substances against which the body has no innate defense. Prenatal and early postnatal brain development is an extremely complex process that we now know is uniquely vulnerable. Lead, mercury and a few other substances have long been known to be toxic to brain development. Recent research suggests that many chemicals, perhaps thousands, may cause similar effects because they can gain access to the developing brain and exert their toxicity to brain cells. This new insight needs to be translated into public policy to protect the brain functions of the next generation. On this call Dr. Grandjean discussed what he terms “chemical brain drain” and how we might work to protect the brain health of future generations.

Sources:

  • Dr. Philippe Grandjean on Chemical Brain Drain: How the Next Generation’s Brain Functions are Endangered by EDCs and Other Environmental Chemicals, healthandenvironment.org, Apr 16, 2014.
  • Watch it on Full Screen or via SlideShare.
  • Meet DES Daughter Network on SlideShare.
Additional resources of interest:

Stand with Breakthrough BC and demand a fair price for life-extending drugs

Call for the UK Government to demand a fair price from pharmaceutical companies and create a system of access and approval that will ensure cancer patients get the drugs they need at prices the NHS can afford

The Facts

  • Over the last two years, a number of secondary breast cancer drugs have been rejected for use on the NHS on the basis of cost.
  • These drugs have been proven to give women with secondary breast cancer more freedom from side effects and, crucially, more precious time with their families.
  • Some of these drugs have been made available through a special fund – the Cancer Drugs Fund – in England. But they are not available in Wales, Northern Ireland or Scotland.
  • The system isn’t working. And breast cancer patients and their families are paying the price. We can’t afford not to act.

Help Breakthrough BC change the System

Breakthrough BC logo image
Call for the UK Government to demand a fair price from pharmaceutical companies and create a system of access and approval that will ensure cancer patients get the drugs they need at prices the NHS can afford.
  • Every breast cancer patient should have access to the best available treatments, wherever they live in the UK.
  • We urgently need to change the way the system works so that all women in the UK with breast cancer get the best treatments, at prices the NHS is able to pay.
  • The pharmaceutical industry needs to work with government to make sure the prices it sets for new drugs are affordable to the NHS.
  • The UK Government must fix the system and with a general election approaching, we need all three major parties to commit to tackling the problem.
  • Sign up to show your support.
Sources and more information:
  • DEMAND A FAIR PRICE FOR LIFE-EXTENDING DRUGS,
    Breakthrough BC, Join our Campaign.
  • Cancer Drugs Fund ‘papers over cracks’, says charity,
    BBC News, 29 October 2014.
  • NHS Cancer Drugs Fund ‘no longer fit for purpose’, charity warns, independent, 29 October 2014.

About the No Advertising Please Campaign

Doctors who see med reps are more likely to prescribe more drugs, more expensively

Australian leaders in Evidence Based Medicine (EBM) discuss why they are supporting the NoAdsPlease campaign.
Video Published on 9 Oct 2014 by No Advertising Please.

  • Pharmaceutical companies employ marketing representatives to influence doctors’ prescribing habits. Doctors who see these drug reps are more likely to prescribe more medication, more expensively and less according to accepted guidelines.  No Advertising Please encourages doctors to avoid using drug representatives as their ‘educational’ resource, by pledging to not see drug reps at their practice for one year.
  • Watch more pharma videos on our YouTube channel.

Will Google X lab succeed in detecting disease early with nanoparticles and reinvent health care?

Google X Team Hopes to Develop Nanoparticles to Provide Early Detection of Cancer, Other Diseases

Sometimes moon shots come in small packages — small enough to float in the bloodstream and send out alerts when danger is afoot. That was Andrew Conrad’s vision when he came to Google X in March 2013 after a storied medical research career. Now he is revealing details of that vision — and reporting that experiments are well under way in realizing it. ”

image of detecting disease early with nanoparticles
Google X Team Hopes to Develop Nanoparticles to Provide Early Detection of Cancer, Other Diseases.

Continue reading ““We’re Hoping to Build the Tricorder”,
on Medium by Steven Levy on Oct 28.

Related press releases:
  • Google is developing cancer and heart attack detector,
    BBC News, 28 October 2014.
  • Google’s Newest Search: Cancer Cells, WSJ, Oct. 29, 2014.
  • Google’s Cancer-Detecting Nanoparticles: Are There Drawbacks?, LiveScience, October 30, 2014.

The Influence of Prenatal DES Exposure on the Associations of Reproductive Factors and Osteoporosis

Prenatal DES exposure may reduce osteoporosis protection

DES Follow-up Study Summary

National Cancer Inst logo image
Lifetime cumulative exposure to estrogens is protective against osteoporosis ; prenatal exposure to estrogen appears to modify these associations.

Included in this study were 5,573 women who participated in the NCI DES Follow-up Study between 1994 and 2006. Data on reproductive history and medical conditions were collected on the first follow-up questionnaire in 1994 and subsequently on the 1997, 2001, and 2006 questionnaires.

The results of the study showed that women who had fewer than 25 years of menstruation (between the start of menstrual cycles and menopause) had a higher incidence of osteoporosis when compared with women who menstruated for 35 years or more. The association of years of menstruation with osteoporosis was shown observed in both DES-exposed and unexposed women, but was stronger among women who had not been prenatally exposed to DES.

The study’s results support the hypothesis that total lifetime exposure to estrogens that occur naturally through a woman’s reproductive years protects against the development of osteoporosis. Furthermore, prenatal exposure to estrogen, in the form of DES, may reduce this protection, although we do not yet know how.

2014 Study Abstract:

CONTEXT:
Estrogen is critical for bone formation and growth in women. Estrogen exposures occur throughout life, including prenatally, and change with reproductive events, such as menarche and menopause.

OBJECTIVE:
The objective of this study was to investigate the association between age at menarche, age at menopause, and years of menstruation with incidence of osteoporosis and assess the impact of prenatal exposure to diethylstilbestrol (DES), a synthetic estrogen, on such associations.

DESIGN, SETTING, AND PARTICIPANTS:
Participants were 5573 women in the National Cancer Institute Combined Cohort Study of DES (1994-2006). Data on reproductive history and medical conditions were collected through questionnaires at baseline in 1994 and subsequently in 1997, 2001, and 2006. Age-stratified Cox regression models were used to calculate multivariable incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Effect measure modification by prenatal DES exposure was assessed using cubic restricted spline regression models.

MAIN OUTCOME MEASURE:
Osteoporosis was the main outcome measure.

RESULTS:
The IRRs for osteoporosis incidence with age at menarche less than 11 years and age at menopause of 50 years or younger were 0.82 (CI 0.59, 1.14) and 0.61 (CI 0.40, 0.92), respectively. Fewer than 25 years of menstruation was associated with an increased incidence of osteoporosis (IRR 1.80; CI 1.14, 2.86) compared with 35 years or more of menstruation. Associations were stronger among women who had not been prenatally exposed to DES.

CONCLUSIONS:
Our data support the hypothesis that lifetime cumulative exposure to estrogens is protective against osteoporosis. Furthermore, prenatal exposure to estrogen appears to modify these associations, although the mechanism by which this occurs is unknown.

Sources:

  • Menarche, menopause, years of menstruation, and the incidence of osteoporosis: the influence of prenatal exposure to diethylstilbestrolNCBI, PMID: 24248183, 2014 Feb;99(2):594-601. doi: 10.1210/jc.2013-2954. Epub 2013 Nov 18. Full text link.
  • NCI, DES Follow-up Study Published Papers.
More DES DiEthylStilbestrol Resources

Pesticide Levels on Food Unknown ; FDA and USDA Monitoring Programs must improve says U.S. GAO

GAO recommends that FDA improve its methodology and FDA and USDA disclose limitations in their monitoring and data collection efforts

The U.S. Food and Drug Administration does not perform enough pesticide residue tests — on either imported or domestic foods – to say whether the American food supply is safe, according to federal auditors.

The U.S. Government Accountability Office (GAO) report, which was released Thursday, said FDA is testing less than one-tenth of 1 percent of all imported fruits and vegetables and less than 1 percent of domestic fruits and vegetables.

GAO Highlights

U.S. GAO logo image
FDA and USDA monitor certain foods for pesticide residues. In 2012, FDA reported testing less than 0.1% of imported shipments. GAO recommends that FDA improve its methodology and FDA and USDA disclose limitations in their monitoring and data collection efforts.

What GAO Found:
The Food and Drug Administration’s (FDA) most recent data from 2008 through 2012 show that pesticide residue violation rates in 10 selected fruits and vegetables were low, but FDA’s approach to monitoring for violations, which targets commodities it has identified as high risk, has limitations. Among other things, GAO found that FDA tests relatively few targeted (i.e., non-generalizable) samples for pesticide residues. For example, in 2012, FDA tested less than one-tenth of 1 percent of imported shipments. Further, FDA does not disclose in its annual monitoring reports that it does not test for several commonly used pesticides with an Environmental Protection Agency (EPA) established tolerance (the maximum amount of a pesticide residue that is allowed to remain on or in a food)—including glyphosate, the most used agricultural pesticide. Although FDA is not required by law to select particular commodities for sampling or test for specific pesticides, disclosing this limitation would help meet Office of Management and Budget (OMB) best practices for conducting and reporting data collection and help users of the reports interpret the data. Also, FDA does not use statistically valid methods consistent with OMB standards to collect national information on the incidence and level of pesticide residues. FDA officials said that it would be costly to calculate national estimates for the foods it regulates because it would require a large number of samples for a wide array of products, but did not provide documentation on the cost of doing so or an assessment of the trade-offs of doing less targeting and more random sampling. Limitations in FDA’s methodology hamper its ability to determine the national incidence and level of pesticide residues in the foods it regulates, one of its stated objectives.
For domestic and imported meat, poultry, and processed egg products, the U.S. Department of Agriculture’s (USDA) Food Safety and Inspection Service’s (FSIS) most recent available data from 2000 through 2011 show the agency found a low rate of pesticide residue violations, but its data had limitations. Specifically, for this period, FSIS did not test meat, poultry, and processed egg products for all pesticides with established EPA tolerance levels. Like FDA, FSIS is not required by law to test the foods it samples for specific pesticides, but disclosing this limitation in annual reports would meet OMB reporting best practices. Since 2011, FSIS has increased the number of pesticides it has tested for and samples it has taken and engaged with EPA on changes to FSIS’s monitoring program to better provide EPA with data it needs to assess the risks of pesticides.
The most recent data from USDA’s Agricultural Marketing Service’s (AMS) annual survey of highly consumed commodities, including fruits and vegetables, show that, from 1998 through 2012, pesticide residue detections varied by commodity and were generally well below tolerance levels. EPA and others praise AMS’s data collection efforts as providing valuable information on the incidence and level of pesticide residues in foods. In addition, while the sampling methodology used by AMS in the Pesticide Data Program meets many of OMB’s best practices for conducting and releasing information to the public concerning a data collection effort, it does not meet several others, such as some principles of probability sampling that are important for ensuring that the data the agency collects are nationally representative. As AMS does not disclose these limitations in its annual monitoring reports, users of the data may misinterpret information in these reports and draw erroneous conclusions based on the data.

Why GAO Did This Study:
From 1970 to 2007, hundreds of millions of pounds of pesticides were applied annually to U.S. food crops to protect them from pests. To protect consumers, EPA sets standards—known as tolerances—for pesticide residues on foods. FSIS monitors meat, poultry, and processed egg products to ensure they do not violate EPA’s tolerances, and FDA monitors other foods, including fruits and vegetables. AMS gathers annual residue data for highly consumed foods, although not for enforcement purposes.
GAO was asked to review federal oversight of pesticide residues in food. This report examines (1) what FDA data show with respect to pesticide residue violations in the foods that it regulates; (2) what FSIS data show with respect to pesticide residue violations in the foods that it regulates; and (3) what AMS data show with respect to pesticide residue levels in fruits and vegetables. For each agency, GAO examined limitations, if any, in the agencies’ monitoring of foods for pesticide residues. GAO analyzed FDA, FSIS, and AMS pesticide residue data, including their reliability, reviewed agency methods for sampling foods for testing, and interviewed agency officials.

What GAO Recommends:
GAO recommends that FDA improve its methodology and FDA and USDA disclose limitations in their monitoring and data collection efforts. FDA said it will consider methodological changes and will disclose limitations. USDA agreed with GAO’s recommendations.

Sources and more information:

  • GAO Report to the Ranking Member, Subcommittee on Environment and the Economy, Committee on Energy and Commerce, House of Representatives, GAO-15-38, October 2014.
  • Pesticide levels on food unknown due to poor government testing, The Washington Post, November 7 2014.
  • FDA and USDA Should Strengthen Pesticide Residue Monitoring Programs and Further Disclose Monitoring Limitations,
    GAO press release, Nov 6, 2014.

Adult exposure to bisphenol A alters male sexual behavior

The neural circuitry underlying male sexual behavior is vulnerable to chronic adult exposure to low dose of BPA

Abstract

TheEndocrineSociety logo image
The neural circuitry underlying male sexual behavior is vulnerable to chronic adult exposure to low dose of BPA.

There are human reproduction concerns associated with extensive use of bisphenol A (BPA) – containing plastic and, in particular, the leaching of BPA into food and beverages. In this context, it remains unclear whether and how exposure to BPA interferes with the developmental organization and adult activation of male sexual behavior by testosterone.

We evaluated the developmental and adult exposure to oral BPA at doses equivalent to the no-observed-adverse-effect-level (5 mg/kg body weight per day) and tolerable daily intake (TDI) (50 μg/kg body weight per day) on mouse sexual behavior and the potential mechanisms underlying BPA effects. Adult exposure to BPA reduced sexual motivation and performance at TDI dose only.

Exposed males took longer to initiate mating and reach ejaculation despite normal olfactory chemoinvestigation. This deficiency was not restored by sexual experience and was associated with unchanged circulating levels of testosterone. By contrast, developmental exposure to BPA at TDI or no-observed-adverse-effect-level dose did not reduce sexual behavior or alter the neuroanatomical organization of the preoptic area. Disrupting the neural androgen receptor resulted in behavioral and neuroanatomical effects similar to those induced by adult exposure to TDI dose. Moreover, adult exposure of mutant males to BPA at TDI dose did not trigger additional alteration of sexual behavior, suggesting that BPA and neural androgen receptor mutation share a common mechanism of action.

This shows, for the first time, that the neural circuitry underlying male sexual behavior is vulnerable to chronic adult exposure to low dose of BPA and suggests that BPA could act in vivo as an antiandrogenic compound.

Sources and more information:

  • Adult exposure to bisphenol A alters male sexual behavior,
    INRA, 10/31/2014.
  • Vulnerability of the neural circuitry underlying sexual behavior to chronic adult exposure to oral bisphenol a in male mice, NCBI Endocrinology, PMID: PubMed 24265451, 2014 Feb;155(2):502-12. doi: 10.1210/en.2013-1639. Epub 2013 Nov 21.

The Beaver’s Moon #FullMoonEngageMe Social Media Event N°7 #EmpireAvenue #SocialNetworking

From the 6th until the 10th of November : join our free social media event taking place at each Full Moon – via #EAv – and give a boost to your social networking!

The Full Frosty Beaver’s Moon

The Full Frosty Beaver's Moon image
From the 6th until the 10th of November : join our free social media event taking place at each Full Moon – via #EAv – and give a boost to your social networking!

There are native American names for the full moons that you can find here, here or here.

November month full moon was named Beaver’s Moon because this was the time to set beaver traps before the swamps froze, to ensure a supply of warm winter furs. November’s full moon is also known as the Frost Moon.

#FullMoonEngageMe Social Media Event N°7 Schedule

The event will start on Thursday 6th of November at +/- 18:30 UTC and will last until Monday the 10th in HERE.

What is this about?

A great opportunity for you to super charge your social networking, to meet Empire Avenue Leaders, to connect with top social media engagers and more… May 2014 initial SoMe event was followed by the strawberry, the buck, the sturgeon, the harvest and the hunter‘s moons.
In the Empire Avenue EAv Gangstas community, you can still access May‘s, June‘s, July‘s, August‘s, September and October‘s conversation threads.

Questions?
  • Please read our FAQs and use the comment section to ask any question about the event.
  • You can join – for FREE – Empire Avenue at anytime – before and after any FullMoon EngageMe Social Media Event.
    You can use this link – with no strings attached – to get some extra “eaves” at start !
    See you soon 😉

Open Payments (commonly known as the Sunshine Act)

The federally run program that collects information about the financial relationships between doctors, hospitals and the pharmaceutical industry

CMSGov logo
Open Payments is the federally run program that collects the information about these financial relationships that the Centers for Medicare and Medicaid Services makes available to you.

Sometimes, doctors and hospitals have financial relationships with health care manufacturing companies. These relationships can include money for research activities, gifts, speaking fees, meals, or travel. The Social Security Act requires CMS – the Centers for Medicare & Medicaid Services – to collect information from applicable manufacturers and group purchasing organizations (GPOs) in order to report information about their financial relationships with physicians and hospitals. Open Payments is the federally run program that collects the information about these financial relationships and makes it available to you.

More information: