News in brief - April 11, 2005

45 the age for colorectal screening - NIAID begins trial of vaccine for avian flu - Gene variant could predict type 2 diabetes - Clinical trial participation increases chance of survival from cancer

45 the age for colorectal screening

New recommendations by the American College of Gastroenterology call for colorectal cancer screening to begin at age 45 rather than 50 for African-Americans. The younger age was called for because of the high incidence of colorectal cancer among this group, said the committee that drafted the recommendations.

In addition, colonoscopy should be the "first line" screening treatment rather than flexible sigmoidoscopy, because there is a greater prevalence of proximal or right-sided polyps and cancerous lesions among African-Americans. The right side of the colon, which includes the cecum, ascending colon and proximal transverse colon, cannot be reached by flexible sigmoidoscopy.

The recommendations are published in the March issue of the American Journal of Gastroenterology.

Colorectal cancer is the second leading cause of cancer deaths in the United States. African-Americans are diagnosed with colorectal cancer at a younger age than whites and also have a decreased survival rate compared with whites, said the committee that wrote the recommendations. Evidence also suggests that African-Americans are more responsive to screening recommendations from their personal physicians than from other sources, the committee said.

NIAID begins trial of vaccine for avian flu

Recruitment has begun for a safety trial of a vaccine to fight H5N1, avian influenza. The trial is being conducted by the National Institute of Allergy and Infectious Diseases.

Sites in Baltimore, Los Angeles and Rochester, N.Y., will enroll a total of 450 healthy adults.

"While there have been relatively few cases worldwide of H5N1 avian influenza infection in humans, the public health community is concerned that the virus will develop the capability of efficiently spreading from human to human and thus create a risk for a worldwide pandemic," said NIAID Director Anthony S. Fauci, MD.

The phase 1 trial will test the vaccine's safety and ability to generate an immune response in healthy adults ages 18 to 64. If the vaccine is shown to be safe in adults, there are plans to test it in children and the elderly.

Between January 2004 and March 11, 2005, there were 69 confirmed cases of avian flu and 46 deaths in humans reported to the World Health Organization. To date, there have been only a few cases where human-to-human transmission of the virus may have occurred. But public health experts fear that the virus could evolve into one that is more easily transmitted between people.

Gene variant could predict type 2 diabetes

A polymorphism in a gene that plays a role in digesting starch and sugar may predispose people to develop type 2 diabetes, according to a paper published in the this month's Diabetes.

Authors suggest that this study might lead to predictive genetic testing that could indicate the need to make lifestyle changes to reduce the chance of developing the condition.

"The implication from our study is that if a person has this gene variation, then -- without waiting for the development of insulin resistance -- he or she should be encouraged to follow lifestyle changes that could help prevent the onset of diabetes," said Nicola Abate, MD, lead author and associate professor of internal medicine at the University of Texas Southwestern Medical Center.

Researchers analyzed the genes of South Asians living in Chennai, India, as well as South Asians and Caucasians living in Dallas, Texas. Those with and without the disease were included in the study. Subjects with the ENPP1 K121Q gene polymorphism were 30% more likely to have diabetes.

Authors said this further confirmed the role that this gene has in the development of this disease but that more work was needed before it was used for predictive testing.

Clinical trial participation increases chance of survival from cancer

Older adolescents and young adults with cancer are less likely to participate in clinical trials -- a variable that may contribute to the fact that they are less likely to survive their disease than either children and older adults, according to a study published in the May 1 issue of Cancer.

Researchers studied data from the National Cancer Institute's Surveillance, Epidemiology and End Results Program regarding those ages 15 to 45 years old with bone and soft-tissue sarcomas to determine why this age group has had fewer mortality gains over the past 25 years than any other age group. They found that lower survival rates correlated with lower participation rates in clinical trials.

Authors suggested that this age group is less likely to be treated at large health centers with trials available. They suggested making these trials more accessible to this demographic.