Earlier this month, I presented the updated colon cancer screening guidelines and commented how virtual colonoscopy may improve screening rates due to its less invasive nature than the traditional colonoscopy. My premise was that patient discomfort served as a primary deterrent to higher rates of colonoscopy use. Data from a recently published Vanderbilt study, however, beg to differ and suggest that other factors account for the inadequate rates of colon cancer screening in the United States.
The study population was derived from the Southern Community Cohort Study (SCCS), a large research endeavor to characterize cancer trends and disparities across racial and socioeconomic backgrounds. The group comprises 51,454 patients (ages 40-79 years) collected from 48 community health centers. The exclusion criteria for this particular study included the following: race other than African-American or Caucasian; uncertainty of whether the patient has had a sigmoidoscopy or colonoscopy; and, uncertainty of family cancer history. This left 41,830 participants, who were surveyed on personal demographics, personal history of colorectal polyps, family history of colon cancer, patterns of undergoing screening endoscopy, and last visit to a health care provider.
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Late last year, I met my new 64 year-old clinic patient who just moved into town. During a brief discussion about preventive health, I asked her when she had her last colonoscopy for colon cancer screening. She emphatically responded: “Never. I will probably be dead in 10 years anyway [from an unrelated cause]“. Her view on life may have been surprising, but her reluctance to obtain a colonoscopy wasn’t. Who could blame her? The prospect of having a scope inserted into the rectum and advanced through the colon is not appealing. Fortunately, there are alternate modalities for colon cancer screening, two of which (stool DNA and virtual colonoscopy) have just been added to official guidelines.
A consortium of specialty organizations (American Cancer Society, US Multi-Society Task Force on Colorectal Cancer, and American College of Radiology) recently published in CA: A Cancer Journal for Clinicians1 the first consensus guidelines for colorectal cancer (CRC) screening. The guidelines are designed for asymptomatic average-risk adults over the age of 50; these criteria exclude individuals with a personal or family history of CRC, adenomas, inflammatory bowel disease (IBD), or other genetic risk factors.
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Posted February 10th, 2008 in
Oncology,
Research,
Technology
It was not long ago when mobile phones were considered luxury items or tools reserved for corporate executives. A decade and a half later, every Joe, Jane, and their child now sport a cell phone or some multimedia-capable variant thereof. Fortunately for the general populace and myself, a recent case-control study done in Japan has shown no significant relationship between mobile phone use and brain cancer. There have been many other studies with similar findings, but this is the first to further analyze the spatial relationship between radiofrequency exposure and tumor location.
The case population included 322 patients newly diagnosed with a brain tumor (88 with glioma, 132 with meningioma, and 102 with a pituitary adenoma). They were pooled from neurosurgery departments throughout Tokyo and 25 neighboring cities. The control group comprised of 683 healthy volunteers who were randomly contacted by cell phone. From both groups, the study participants were interviewed on their patterns of cell phone use: type of phone, length of use, average duration per call, frequency of calls, etc. Use of cordless telephones was also considered. The study further analyzed the 3D spatial relationship between source of radiofrequency exposure and location of tumor. These data were used to estimate a specific absorption rate (SAR) within the tumor.
The study did not find a significant increase in the odds (presented as odds ratio with 95% confidence interval) of the three tumor types with typical use of mobile phones. There was no significant difference found in incidence of tumor with increased cumulative time of use. There was also no substantial increase in risk when analyzing subgroups according to mean levels of maximal SAR. The researchers therefore conclude that there was “no increase in overall risk of glioma or meningioma in relation to regular mobile phone use among [their] Japanese subjects“.
It is interesting to note how the general public had embraced mobile phones long before learning of its relative safety. Could this be attributed to our collective state of denial (”it won’t affect me“), the immense utility and convenience of the device overweighing any potential health risks, or the sheer skill of the Sprint-Verizon-Cingular- marketing machine? Fortunately, most research studies have so far dismissed links between mobile phone emissions and brain cancer. But what if they didn’t?
Related Post: Mobile phones are safe in hospitals
- Takebayashi T, Varsier N, Kikuchi Y, Wake K, Taki M, Watanabe S, Akiba S, Yamaguchi N. Mobile phone use, exposure to radiofrequency electromagnetic field, and brain tumour: a case-control study. Br J Cancer 2008;98:652-9.
Posted January 16th, 2006 in
Epidemiology,
Oncology
The National Cancer Institute recently published the 2005 update of the Cancer Trends Progress Report. The document tracks several key measures related to cancer, including health habits, early screening, diagnosis, treatment, and mortality. The good news is that death rates for the most common cancers (prostate, breast, lung, and colorectal) have continued to decline. These positive trends may stem from continual health promotion, more aggressive cancer screening, and advancing treatment regimens. The bad news is that cancer is now the leading cause of death for people under 85, and the incidence of the most common cancers (prostate, female breast, and lung) continues to increase.
Confused? Be careful to differentiate the mortality rate (deaths per 100,000 people per year) from the incidence (new cases per 100,000 people per year). Early screening has permitted doctors to catch cancers at earlier, less severe, and more treatable stages. In other words, even though the number of cancer cases continues to increase, early intervention is influencing the odds of survival.
