News in brief - June 21, 2004

Reports out on ovarian cancer screening, symptoms - Pharmacy records don't tell the whole story - Yo-yo dieting bad for immune system

Reports out on ovarian cancer screening, symptoms

The U.S. Preventive Services Task Force recommended against routine screening for ovarian cancer in a May report.

Although the task force found fair evidence that screening with serum CA-125 or transvaginal ultrasound can help detect ovarian cancer at an earlier stage, there was also only fair evidence that earlier detection would have a substantial effect on death rate.

Because of the low prevalence of ovarian cancer and the invasive nature of diagnostic testing after a positive screening test, the task force determined that the potential harm from screening could outweigh any benefits. However, the task force did indicate that screening could be beneficial for women with a family history of ovarian cancer.

Ovarian cancer is the fifth leading cause of death among women in the United States, accounting for 25,400 new cases and 14,300 deaths in 2003.

Meanwhile, a study in the June 8 Journal of the American Medical Association found that 80% to 90% of women with early stage ovarian cancer report symptoms for several months prior to diagnosis.

The finding has clinical implications because earlier detection and treatment leads to higher survival rates, said the researchers.

Women with malignant masses typically experience symptoms more frequently and more severely than do women with benign conditions. Women with ovarian cancer also have symptoms of recent onset and have multiple coexisting symptoms, said the researchers, calling into question whether ovarian cancer's title as the "silent killer" is appropriate.

Pharmacy records don't tell the whole story

Having elderly patients bring in all their medications rather than relying on medical records can be a better way to determine what drugs they are actually taking, according to a study in the April issue of The Gerontologist.

Researchers at Penn State University in State College asked patients, mostly women ages 65 to 91, to "brown bag" their medications. The drugs in the sack were more numerous than those included in pharmacy records.

Authors of the paper speculated that the discrepancy was a result of patients receiving drug samples, sharing medications with their friends or taking less of the drug in a single dose in order to stretch it out.

"Using the brown bag method of self-reporting could help doctors more accurately monitor medication compliance, guard against polypharmacy and prevent drug interactions," said Grace Caskie, PhD, lead author and a research associate at the Penn State Gerontology Center.

Researchers expressed significant concern about this phenomena because patients whose self-reporting least matched medications noted in their records also tended to be in poorer health.

Yo-yo dieting bad for immune system

Repeatedly losing and gaining weight reduces the number of natural killer cells that defend the body against viruses and cancer, according to the June Journal of the American Dietetic Assn.

Researchers at the Fred Hutchinson Cancer Research Center in Seattle recruited more than 100 overweight, sedentary, postmenopausal women to answer a questionnaire about weight loss and gain. Levels of NK cells were also measured. Women who had maintained a stable weight had higher levels of these cells while those who had ever lost 10 pounds had lower levels. Repeated weight loss was associated with lower numbers of these cells.

Authors of the paper said that maintaining a healthy weight was still better than carrying a few extra pounds, but that yo-yo dieting was a definite danger.

"There are indisputable health benefits to reducing body weight among those who are overweight and obese," said Cornelia Ulrich, PhD, lead author and assistant member of the Center's Public Health Sciences Division. "Our concern is really the pattern of weight cycling or yo-yo dieting that many Americans go through."