News from Cancer

ULTRASOUND OUTPERFORMS SYMPTOM ANALYSIS IN DETECTING OVARIAN CANCER Doctors at the University of Kentucky Chandler Medical Center-Markey Cancer Center compared symptom analysis to ultrasound in predicting ovarian cancer. They selected 272 women participating in annual trans-vaginal screening (TVS) from 31,748 women enrolled in a free screening project at the university, comparing symptom results to ultrasound and surgical pathology findings. They found TVS performed better than symptoms analysis for detecting malignancies (73.3% versus 20% sensitivity). While symptoms analysis performed better for distinguishing benign tumors (91.3% versus 74.4% specificity), adding symptom analysis to TVS actually resulted in poorer identification of malignancy (sensitivity = 16.7%), even as it improved the ability to distinguish benign tumors (specificity = 97.9%). The authors say the data indicates that while symptoms do identify ovarian malignancies, they are not as accurate as TVS. They add that informative symptoms can be expected to be absent in 80 percent of ovarian malignancies.

Article: "The Search for Meaning --- Symptoms & TVS Screening." Edward J. Pavlik, Brook A. Saunders, Stacey Doran, Katherine W. McHugh, Frederick R. Ueland, Christopher P. DeSimone, Paul D. DePriest, Rachel A. Ware, Richard J. Kryscio, and John R. van Nagell, Jr. CANCER; Published Online: July 13, 2009 (DOI: 10.1002/cncr.24407); Print Issue Date: August 15, 2009

Contact: Keith L. Hautala, University of Kentucky Public Relations, Phone: (859) 323-6363 EXT. 231 or keith.hautala@uky.edu.

Editorial: "The search for meaning---symptoms and TVS screening for ovarian cancer – Silent no more." Ilana Cass, M.D. CANCER; Published Online: July 13, 2009 (DOI: 10.1002/cncr.24403); Print Issue Date: August 15, 2009

RACIAL DISPARITIES IN COLORECTAL CANCER SURVIVAL DISSIPATE AFTER ADJUSTING FOR OTHER DEMOGRAPHIC AND CLINICAL FACTORS

Colorectal cancer (CRC) is the third leading cause of cancer death in both men and women and the second leading cause of cancer death when both sexes are combined. African Americans have lower survival rates compared to whites. Researchers at Barbara Ann Karmanos Cancer Institute, in Detroit, Michigan in Detroit sought to investigate the effect of demographics, clinical factors and socioeconomic status (SES) on racial disparities in CRC survival in the Detroit Metropolitan Area. The study population included 9,078 individuals with primary invasive CRC identified between 1988 and 1992 through the Surveillance, Epidemiology, and End Results (SEER) program. They found African Americans were more likely to be diagnosed with stage IV disease and to reside within poor census tracts compared to whites. After adjusting for age, marital status, gender, SES group, stage, and treatment, race was no longer significantly associated with overall survival. Similar results were seen with CRC-specific survival. They conclude racial disparities in CRC survival dissipate after adjusting for other demographic and clinical factors. These results can potentially affect medical guidelines regarding screening and treatment, and possibly influence public health policies that can have a positive impact on equalizing racial differences in access to care.

Article: "Racial Differences in Colorectal Cancer Survival in the Detroit Metropolitan Area." Ben Yan, Anne-Michelle Noone, Cecilia Yee, Mousumi Banerjee, Kendrea Schwartz, and Michael S. Simon. CANCER; Published Online: July 13, 2009 (DOI: 10.1002/cncr.24408); Print Issue Date: August 15, 2009

Contact: Patricia Ellis, Manager, Media Relations Karmanos Cancer Institute, 313-576-8629 office, 313-410-3417 mobile, or ellisp@karmanos.org

INCREASE IN THYROID CANCER NOT EXPLAINED BY SCREENING ALONE

Studies have reported an increasing incidence of thyroid cancer since 1980. One possible explanation for this trend is increased detection through more widespread and aggressive use of screening tests. Researchers at the American Cancer Society analyzed thyroid cancer incidence between 1988 and 2005 using the National Cancer Institute's (NCI's) Surveillance Epidemiology and End Results (SEER) dataset. They found incidence rates increased for all sizes of tumors, suggesting that screening is not the only explanation for the rise. The highest rate of increase was for primary tumors smaller than 1.0 cm, which rose nearly 10 percent per year among men from 1997 and 2005, and nearly 9 percent/year from 1988 to 2005 among women. Incidence of tumors 4 cm or larger increased more than 3.5 percent per year from 1988 to 2005 among men and 5.7 percent per year from 1988 to 2005 among women. The authors conclude that incidence rates of differentiated thyroid cancers of all sizes increased between 1988 and 2005 in both men and women, and that the increased incidence across all tumor sizes suggests that increased detection through testing is not the sole explanation. Other explanations, including environmental influences and molecular pathways, should be investigated.

Article: "Increasing Incidence of Differentiated Thyroid Cancer in the US (1988-2005)." Amy. Y. Chen, Ahmedin Jemal, and Elizabeth M. Ward. CANCER; Published Online: July 13, 2009 (DOI: 10.1002/cncr.24416); Print Issue Date: August 15, 2009

Contact: David Sampson, American Cancer Society, david.sampson@cancer.org

HEAVY, DAILY DRINKING INCREASES RISK OF HIGH-GRADE PROSTATE CANCER; MAKES PREVENTIVE DRUG INEFFECTIVE

Current research is inconclusive regarding the relationship between alcohol consumption and prostate cancer risk. Researchers led by Zhihong Gong Ph.D. of the University of California San Francisco, examined the associations of total alcohol, type of alcoholic beverage, and drinking pattern with risks of total, low- and high-grade prostate cancer. They used data from more than 10,000 men participating in the Prostate Cancer Prevention Trial (PCPT). They found participants who reported heavy alcohol consumption (≥50 g alcohol/day) and regular heavy drinking (≥4 drinks/day on ≥5 days per week) were twice as likely or more to be diagnosed with high-grade prostate cancer (RR: 2.01, and 2.17, respectively). Less heavy drinking was not associated with risk. They also compared drinking patterns with treatment outcome among men enrolled on this placebo-controlled trial of the drug finasteride. They found finasteride's ability to lower prostate cancer risk was blocked in men drinking < 50g alcohol per day. They conclude heavy, daily drinking increases the risk of high-grade prostate cancer and that heavy drinking made finasteride ineffective for reducing prostate cancer risk.

Article: "Alcohol Consumption, Finasteride and Prostate Cancer Risk: Results from the Prostate Cancer Prevention Trial." Zhihong Gong, Alan R. Kristal, Jeannette M. Schenk, Catherine M. Tangen, Phyllis J. Goodman, and Ian M. Thompson. CANCER; Published Online: July 13, 2009 (DOI: 10.1002/cncr.24423); Print Issue Date: August 15, 2009

Contact: Kristen Lidke Woodward, Senior Media Relations Manager, Fred Hutchinson Cancer Research Center. Phone: 206-667-5095, Email: kwoodwar@fhcrc.org

Source: American Cancer Society