News in brief - April 24, 2006

Half of cancer deaths preventable - Sleep disorder training shorted - HPV vaccine has long-term benefits

Half of cancer deaths preventable

At least 50% of all deaths from cancer could have been prevented if commonly accepted screening modalities were fully used and healthier lifestyles were more prevalent, according to an annual report from the American Cancer Society.

"Cancer Prevention & Earlier Detection Facts & Figures, 2006," published this month, found that tobacco consumption was at its lowest level since World War II, but its use still was causing 170,000 cancer deaths annually. Nearly 190,000 cancer deaths were related to poor nutrition, physical inactivity and obesity.

The Society also is raising alarms about the use of common cancer screening tests. They have made a significant difference in cancer mortality, but access is far from universal. For example, only 55% of women over the age of 40 reported receiving a mammogram within the past year, and 79% had a Pap smear in the past three years.

"Although we are winning the war on cancer, this is a remarkable opportunity to save hundreds of thousands of lives and to reduce suffering from this disease with lifestyle changes and an increased use of proven screening strategies," said ACS President Carolyn D. Runowicz, MD.

Sleep disorder training shorted

Medical students generally receive only four hours of instruction in sleep medicine, an amount woefully inadequate to cover disorders that affect 50 million to 70 million Americans, according to a report released April 4 by the Institute of Medicine.

The report identified sleep disorders as chronic insomnia, sleep apnea and restless leg syndrome. "Although sleep research and care for individuals with sleep disorders have expanded over the past several years, we currently don't have the capacity to adequately diagnose and treat all who suffer from these problems," said Harvey Colten, MD, former vice president and senior associate dean for academic affairs at Columbia University Medical Center in New York. Colten was chair of the committee, which was composed primarily of physicians who issued the report.

Instruction in sleep medicine should be part of undergraduate and postgraduate training for those pursuing health care careers, particularly those specializing in psychiatry, pulmonology, neurology, nursing, psychology and other specialties involved in the diagnosis and treatment of sleep disorders, the report said. The American Academy of Sleep Medicine, the National Institutes of Health, the National Sleep Foundation and the Sleep Research Society co-sponsored the report.

Meanwhile, in a study published in the April 15 American Journal of Respiratory and Critical Care Medicine, patients with severe sleep-disordered breathing -- those who stopped breathing for 10 seconds or longer at a time -- were found to be two to four times more likely to experience complex, abnormal heart rhythms while sleeping than individuals without the problem.

The stoppages decrease the amount of oxygen and increase the level of carbon dioxide in the blood and brain.

HPV vaccine has long-term benefits

A vaccine against the virus that causes cervical cancer could protect women for up to 4½ years, according to a study published online April 6 by The Lancet.

Researchers continued to follow 800 women from an earlier trial that found the human papillomavirus vaccine to be safe and effective. The women had received three doses of HPV-16/HPV-18 vaccine or placebo.

The new study found that the vaccine has a good long-term safety profile and provides substantial long-term protection against cancerous cell changes associated with high-risk HPV types.

While the vaccine targets HPV-16 and HPV-18, which cause an estimated 70% of cervical cancer cases, it also was found to provide protection from infection with HPV-45 and HPV-31, the third- and fourth-most prevalent oncogenic types of HPV.

"These findings set the stage for the wide-scale adoption of HPV vaccination for prevention of cervical cancer," said lead author Diane Harper, MD, MPH, professor in Dartmouth Medical Schools' Dept. of OB/GYN and Dept. of Community and Family Medicine in Lebanon, New Hampshire.

Food and Drug Administration approval of the vaccine is expected by the end of the year.