© 2005 Oxford University Press
IN THIS ISSUE
Inflammatory Breast Cancer Incidence and SurvivalInflammatory breast cancer (IBC) appears to be a distinct subtype of breast cancer different from non-inflammatory locally advanced breast cancer (LABC). To investigate incidence and survival trends for IBC, non-T4 breast cancer, and LABC, Hance et al. (p. 966) examined 180,224 female breast cancer cases reported to the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) cancer registries from 1988 through 2000. Incidence rates of IBC increased, whereas incidence rates of LABC and non-T4 breast cancer decreased over the same study period. Despite modest improvements in survival throughout the 1990s, women diagnosed with IBC were also found to have poorer survival than women diagnosed with either LABC or non-T4 breast cancer. The authors conclude that the incidence of IBC continues to rise while survival outcomes remain poor for women diagnosed with IBC compared with women diagnosed with other subtypes of breast cancer, underscoring the importance of accurate diagnosis.
Employment Outcomes of Men Treated for Prostate Cancer
Although some organizations recommend routine prostate cancer screening for men younger than 65 years of age who may still be employed, little is known about how prostate cancer and its treatment affect their employment status. Bradley et al. (p. 958) explored employment outcomes at 6 and 12 months after diagnosis of 267 patients with prostate cancer who were diagnosed at 30–65 years of age. They found that at 6 months after diagnosis prostate cancer patients were less likely to be working than men in the control group, but at 12 months after diagnosis this difference disappeared. Some patients reported that prostate cancer and its treatment interfered with their ability to perform physical and cognitive tasks at work 12 months after diagnosis. The authors conclude that prostate cancer and its treatment appear to have an impact on employment.
In an editorial, Talcott (p. 948) notes that a broader medical intervention assessment should now include how chronic diseases and their treatment affect patients' quality of life. Because nearly all patients with clinically localized prostate cancer survive at least a decade, he points out that, if treatment options have similar outcomes but different side effects, then knowledge of the consequences of each treatment may help patients choose their treatment, given their own circumstances, goals, and preferences.
Aspirin, Other NSAIDs, and Prostate Cancer Risk
To determine whether an association between prostate cancer incidence and the use of nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, exists, Jacobs et al. (p. 975) followed 70,144 men in the American Cancer Society's Cancer Prevention Study II Nutrition Cohort from 1992–1993 through August 31, 2001. During this time period, 4853 men in the study developed prostate cancer. The authors found no association between current use of aspirin or other NSAIDs and prostate cancer risk; however, long-duration regular use of aspirin or other NSAIDs (30 or more pills per month for 5 or more years) was associated with a reduced risk of prostate cancer. The absolute rate of prostate cancer (standardized to the age distribution of study participants using 5-year age categories) was 1013 per 100,000 personyears among men who had never reported NSAID use, and 847 per 100,000 personyears among long-duration regular NSAID users. The authors conclude that these results support the hypothesis that long-duration regular NSAID use is associated with a modestly reduced risk of prostate cancer.
k-ras, b-raf, and p53 Status and Bevacizumab Response
A recent phase III trial showed that the addition of bevacizumab, a monoclonal antibody to vascular endothelial growth factor-A, to first-line irinotecan, 5-flurouracil, and leucovorin prolonged survival in patients with metastatic colorectal cancer. To determine whether mutation status of k-ras, b-raf ,or p53 or P53 expression could predict which colorectal cancer patients were more likely to respond to bevacizumab, Ince et al. (p. 981) evaluated tumors available from a subset of patients from the same phase III trial. The increase in median survival associated with the addition of bevacizumab did not differ by mutation or expression status in any of the biomarkers in these 295 patients. The authors conclude, based on their results, that k-ras, b-raf, and p53 status do not predict patient response to bevacizumab.
Flexible Sigmoidoscopy Acceptance in a Clinical Trial
Whether screening flexible sigmoidoscopy, performed once and then again after 3–5 years, reduces colorectal cancer mortality in community practice is an important question for health care policymakers that is being addressed in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. Weissfeld et al. (p. 989) report results from the baseline flexible sigmoidoscopy examination of PLCO trial participants. Nearly 65,000 subjects, 83.5% of the PLCO intervention group, underwent flexible sigmoidoscopy screening, and nearly three-quarters of the 15,000 subjects in whom a mass was detected had follow-up lower endoscopy. Cancer and adenoma detection yields were similar to those in other studies. Given the high acceptance of flexible sigmoidoscopy screening and the observed detection rates in a large, geographically diverse population in which diagnostic follow-up was managed by community practitioners, the authors conclude that the PLCO trial results should approximate those that could be expected from a screening flexible sigmoidoscopy intervention targeting the general U.S. population.
MC1R, ASIP, and DNA Repair and Melanoma Risk
Specific genetic variants of the melanocortin-1 receptor (MC1R) gene have been associated with fair pigmentation and melanoma risk, and a polymorphism of the Agouti Signaling Protein (ASIP) has been associated with dark pigmentation in Northern Europeans. Landi et al. (p. 998) examined whether MC1R and ASIP genotypes were associated with melanoma risk and disease progression in a Mediterranean population of 267 familial and sporadic melanoma patients and 382 control subjects. They found a two- to fourfold increased risk of sporadic and familial melanoma in individuals who carried MC1R variant genotypes when compared with carriers of the wild-type MC1R genotype. They also report that individuals who carry MC1R variant genotypes were more likely to have thick melanomas than those with wild-type MC1R genotype. In contrast, no association with the ASIP polymorphism was observed.
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||