Other highlights in the April 21 JNCI

04/15/04

Clinical Trial Participants Often Do Not Receive Trial Results

Most oncology physicians and nurses do not share the results of clinical trials with their patients who are participants, even though they believe that their patients want the results and that routinely offering results would not have a negative effect on patients.

To examine the issue, Ann H. Partridge, M.D., M.P.H., of the Dana-Farber Cancer Institute in Boston, and colleagues surveyed oncology clinicians, including physicians and nurses, to discover their attitudes about disseminating results to clinical trial participants and whether they ever do so.

Although 80% of those who responded to the survey indicated that trial results should be offered to patients in the trials and 72% indicated that their patients wanted to know the results of the trial, 62% responded that they offer trial results to patients less than one-fifth of the time. The top three concerns responders had about offering trial results to patients were the potential negative effect on the patient, that the patient may have difficulty in interpreting the results, and consumption of resources, including time and money. Of concern, about 15% of responders believed that an obligation to offer study results to participants would make them less likely to enroll patients in studies.

Contact: Bill Schaller, Dana-Farber Cancer Institute, (617)632-5357, William_schaller@dfci.harvard.edu

Tamoxifen Use Associated With Lower Breast Density

A new study demonstrates that tamoxifen treatment is associated with a reduction in mammographic breast density, an effect particularly pronounced in women aged 45 years and younger. Increased mammographic breast density has been identified as a risk factor for breast cancer.

Tamoxifen has been shown to lower the risk of breast cancer in high-risk women, but the drug's effect on breast density in healthy women has not been known. To investigate this, Jack Cuzick, Ph.D., of Cancer Research UK in London, and colleagues analyzed mammograms from 818 breast cancer-free women from the International Breast Cancer Intervention Study 1, a trial that tested tamoxifen's ability to prevent breast cancer in healthy women at high risk of the disease.

Treatment with tamoxifen was associated with reduced breast density, most of which occurred within the first 18 months of treatment. In women aged 45 years and younger, breast density was reduced by 13.4% on average compared with only 1.1% in women older than 55 years. The researchers hypothesize that premenopausal women experienced a larger reduction because premenopausal estrogen levels are higher and so the antiestrogenic effect of tamoxifen will be greater.

Contact: Press Office, Cancer Research UK, +44 (0) 207 061 8300, pressoffice@cancer.org.uk

Low Categories of Benign Breast Disease Still Increase Risk of Breast Cancer

There are several breast abnormalities that are not cancerous, but some of these benign conditions are associated with a greater risk of breast cancer than others. A new study has found that even women with low-category benign breast diseases are at an increased risk of breast cancer compared with women without the disease.

Jiping Wang, M.D., Ph.D., of the University of Pittsburgh, and colleagues looked at medical records for 11,307 women from the Breast Cancer Prevention Trial, 1376 of whom had the low-category benign breast disease. Women with the disease were 60% more likely than women without the disease to develop invasive breast cancer. Women with benign breast disease aged 50 years or older had a 95% increased risk of developing invasive breast cancer compared to women without benign breast disease.

Contact: Lori Garvey, National Surgical Breast and Bowel Project, (412)330-4621, lori.garvey@nsabp.org

HPV Vaccination with Cervical Cancer Screening Could Cut Cancer Risk

Combining human papillomavirus (HPV) vaccination with cervical cancer screening could reduce a woman's lifetime risk of cervical cancer by 94%, according to a new study that uses a model to predict the clinical benefits and cost-effectiveness associated with various screening and vaccination strategies.

HPV causes nearly all cervical cancers. Screening with the Pap test can prevent cervical cancer, but it is not available to all women or used regularly by those with access to it. An HPV vaccine is currently being tested in clinical trials and may be available to the public soon.

To estimate the effectiveness of the HPV vaccine in areas such as the United States where there are established screening programs, Sue J. Goldie, M.D., M.P.H., of the Harvard School of Public Health, and colleagues constructed a computer model of the natural history of HPV and cervical cancer. If the vaccine is 90% effective, combining administration of the HPV vaccine at age 12 years with cervical cancer screening every 3 years starting at age 25 could reduce a woman's lifetime risk of cervical cancer by 94%. The combination of vaccination and less-frequent screening, the researchers conclude, would likely be a cost-effective use of health care resources.

Contact: Kevin Myron, Harvard School of Public Health, (617)432-3952, Kmyron@hsph.harvard.edu

Also in the April 21 JNCI:
Species of Chlamydiae May Be Associated With Ocular Lymphoma: http://www.eurekalert.org/emb_releases/2004-04/jotn-cim041504.php

Clinic-based Intervention Program Improves Smoking Cessation Rates, Study Says: http://www.eurekalert.org/emb_releases/2004-04/jotn-cip041504.php

Source: Eurekalert & others

Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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