American Institute for Cancer Research (AICR): CRU: Report: Obesity and 3 Daily Alcoholic Drinks Increase Liver Cancer Risk

The report also reaffirms the clear link between alcohol consumption and liver cancer, and for the first time quantifies the amount at which risk for liver cancer rises. “We now have a little more precision on the alcohol-liver cancer link,” said Hursting. “Getting above three drinks a day seems to dramatically impact the tumorigenic process and increase risk.”

via American Institute for Cancer Research (AICR): CRU: Report: Obesity and 3 Daily Alcoholic Drinks Increase Liver Cancer Risk.

More coffee!  Less beer!


OncoBriefs: Hookah Risk

OncoBriefs: Hookah Risk, Brain Cancer, Lung Cancer.

Urinary concentration of the benzene metabolite S-phenylmercapturic acid (SPMA) was more than four times greater in hookah smokers and two times greater in people exposed to secondhand hookah smoke, when compared with people who had no exposure. The findings put a damper on enthusiasm for hookah as a safer alternative to cigarettes, as reported online in Cancer Epidemiology, Biomarkers and Prevention.

Sleep Apnea Linked to Cancer

Sleep Apnea Linked to Cancer.

Moderate-to-severe OSA was associated with a 2.5-fold higher likelihood of incident cancer (95% CI 1.2-5.0) after adjustment for obesity and a full range of other factors, Nathaniel Marshall, PhD, of the University of Sydney Nursing School in Australia, and colleagues found.

Cancer mortality was 3.4 times more common (95% CI 1.1-10.2) in those with sleep apnea than with no sleep apnea during 20 years of follow-up, they reported in the April 15 issue of theJournal of Clinical Sleep Medicine.

Pancreatitis May Confer Higher Risk for Cancer

In an effort to quantify the relationship between acute pancreatitis and pancreatic cancer, Agarwal and colleagues reviewed inpatient and outpatient records for 495,504 patients who received care through the Veterans Health Administration from 2000 through 2007. The authors identified 5,720 patients who had one or more episodes of acute pancreatitis, 710 of whom subsequently had diagnoses of pancreatic cancer.

Median follow-up was 60 months for the entire cohort, 26 months for patients who developed pancreatic cancer, and 60 months for patients who did not develop pancreatic cancer.

The patient cohort was predominately male (89%). A third of the patients smoked, a fourth had a history of heavy alcohol use, and 3% had a history of gallstones.

The 710 patients included 86 who had one or more episodes of acute pancreatitis prior to cancer diagnosis. The authors found that 76 of the 86 patients had a least one episode of acute pancreatitis within 2 years of cancer diagnosis.

In 69 of the 76 cases, the preceding pancreatitis occurred within a year of pancreatic cancer diagnosis. In fewer than half of the cases (N=34), acute pancreatitis preceded pancreatic cancer diagnosis by 2 months or less.

via Pancreatitis May Confer Higher Risk for Cancer.

Nipple Aspirate Test Is Not An Alternative To Mammography

BACKGROUND: A nipple aspirate device is a type of pump used to collect fluid from a woman\’s breast. A nipple aspirate test can determine whether the fluid collected from the breast contains any abnormal cells.

RECOMMENDATION: Do not use a nipple aspirate test as a substitute for mammography or by itself for breast cancer screening or diagnosis.

via Safety Alerts for Human Medical Products > Nipple Aspirate Test: Safety Communication – Breast Cancer Screening Test Is Not An Alternative To Mammography.

Red Meat Tied to Cancer Risk in Some People

  • Red and processed meat consumption was significantly associated with colorectal cancer risk in patients who had a common gene mutation, researchers found.

  • Note that, if replicated, the findings suggest selected individuals at higher risk of colorectal cancer based on genomic profiling could be targeted for screening, diet modification, and other prevention strategies.

via Red Meat Tied to Cancer Risk in Some People.

To Revert Breast Cancer Cells, Squeeze

While the traditional view of cancer development focuses on the genetic mutations within the cell, Mina Bissell, Distinguished Scientist at the Berkeley Lab, conducted pioneering experiments that showed that a malignant cell is not doomed to become a tumor, but that its fate is dependent on its interaction with the surrounding microenvironment. Her experiments showed that manipulation of this environment, through the introduction of biochemical inhibitors, could tame mutated mammary cells into behaving normally.

via To revert breast cancer cells, give them the squeeze.

Melanoma on Rise with Indoor Tanning

Overall, there was a 20% increased risk for melanoma with any indoor tanning (RR 1.20, 95% CI 1.08 to 1.34), according to Mathieu Boniol, PhD, of the International Prevention Research Institute in Lyon, France, and colleagues.

But the risk nearly doubled when sunbed use began before age 35 (RR 1.87, 95% CI 1.41 to 2.48), they reported online in BMJ.

via Medical News: Melanoma on Rise with Indoor Tanning – in Oncology/Hematology, Skin Cancer from MedPage Today.

Flex Sigmoidoscopy and Colorectal Cancer

Teaching Topic
Flexible Sigmoidoscopy and Colorectal Cancer
Original Article

R.E. Schoen and Others

CME Exam  Comments

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Colorectal-cancer mortality and incidence are reduced with screening by means of fecal occult-blood testing. Endoscopic screening with flexible sigmoidoscopy or colonoscopy is more sensitive than fecal testing for the detection of adenomatous polyps, the precursor lesions of colorectal cancer.

Clinical Pearls
Clinical Pearl  What were the results of this randomized trial comparing flexible sigmoidoscopy to usual care for screening of colorectal cancer?

In this randomized study, flexible sigmoidoscopy, as compared with usual care, was associated with a 26% reduction in overall colorectal-cancer mortality and a 21% reduction in the incidence of colorectal cancer. Mortality related to distal colorectal cancer was reduced by 50%, and the incidence was reduced by 29%. A significant 14% reduction in the incidence of proximal colorectal cancer was observed, but there was no significant reduction in mortality related to proximal cancer.

Clinical Pearl  According to the authors, what were the numbers needed to invite for screening via flexible sigmoidoscopy to prevent one diagnosis of colorectal cancer and one colorectal-cancer death?

In this study, the number needed to invite for screening in order to prevent 1 case of colorectal cancer was 282 (95% CI, 210 to 427). The number needed to invite for screening to prevent 1 colorectal-cancer death was 871 (95% CI, 567 to 1874).

Morning Report Questions
Q. How did study participants differ from the usual-care group?

A. Participants in the intervention group were offered two screenings with flexible sigmoidoscopy, 3 to 5 years apart. Median follow up was 11.9 years. In the intervention group, 86.6% of participants (67,071) underwent at least one flexible sigmoidoscopic screening, and 50.9% (39,440) underwent two screenings. The estimated rate of endoscopy in the usual-care group during the screening phase was 25.8% (95% CI, 23.6 to 28.0) for flexible sigmoidoscopy, 34.4% (95% CI, 32.0 to 36.8) for colonoscopy, and 46.5% (95% CI, 43.9 to 49.1) for either flexible sigmoidoscopy or colonoscopy.

Q. How did screening-detected cancers differ from those diagnosed among participants who were never screened in terms of location and stage?

A. Screening-detected cancers accounted for 24.1% of colorectal cancers (244 of 1012) in the intervention group. Among participants with screening-detected cancers, 82.8% of the cancers were distal, whereas among participants who were never screened, 52.8% were distal, and among participants with cancers not detected by screening, 31.6% were distal (P<0.001). Participants with screening-detected cancers were more likely to have early-stage cancer (stage I or II) than participants who were never screened or those whose tumors were not detected by screening (75.4% vs. 50.9% and 50.7%, respectively; P<0.001).

Table 3. Colorectal-Cancer Incidence and Stage According to Means of Detection.