MONDAY, June 23 (HealthDay News) -- U.S. researchers boosted the level of early-stage ovarian cancer detection by 20 percent through use of a blood test to detect a tumor marker as well as a woman's report of new-onset symptoms.

Using either test alone only uncovered about 60 percent of early-stage ovarian cancers in a high-risk group of women, while the two techniques together found 80 percent of early-stage tumors, according to finding published Monday in the online version of the journal Cancer.

"They appear to act complementary, and appear to be able to identify women who would not be identified by a blood sample alone, and conversely would not be identified by symptoms alone," said the study's lead author, M. Robyn Andersen, an associate member of the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center in Seattle.

More than 21,000 women are diagnosed with ovarian cancer annually, and more than 15,000 women die from the disease each year, according to the American Cancer Society (ACS). Currently, only about 20 percent of ovarian cancers are caught in their earliest, potentially curable stages, according to Andersen.

In 2006, Andersen's colleague, Dr. Barbara Goff, director of gynecologic oncology at the University of Washington School of Medicine, published the ovarian cancer symptom-screening index tool, in an effort to help women and doctors clarify which women might have a heightened risk of ovarian cancer.

Important symptoms include pelvic or abdominal pain, bloating, increased abdominal size, difficulty eating, or feeling full quickly. These symptoms must occur more than 12 times per month, and have just recently begun occurring (within the past year), to be considered positive on the symptom-screening tool. For example, if a woman has had abdominal pain for the past 10 years, it's probably not related to ovarian cancer, but to another disorder, such as irritable bowel syndrome.

For the current study, Andersen and her colleagues used the symptom-screening index and a blood test that looks for CA 125, a protein that is often elevated in ovarian cancer. However, CA 125 can sometimes be elevated in women who don't have ovarian cancer, the researchers noted.

The study involved 254 healthy women at high-risk for ovarian cancer because of family history, as well as 75 women about to undergo surgery to remove an ovarian cancer. The women were asked to fill out a questionnaire about their symptoms. All of the women also gave a blood sample to have their levels of CA 125 measured.

The two methods together correctly identified almost 90 percent of the ovarian cancers -- 80.6 percent of the early cancers and 95.1 percent of the later-stage cancers.

About 14 percent of women who had symptoms and had elevated levels of CA 125 did not have ovarian cancer, according to Andersen. These women received transvaginal ultrasound tests for follow-up, according to Andersen.

"This study continues to add on to the work that's been done, but we still have a long way to go with ovarian cancer," commented Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society.

None of the current screening tools is as accurate as the ACS and other experts would like them to be, she explained. Any of the tests alone misses a significant number of cancers, and unnecessarily worries women who don't have cancer. Saslow said transvaginal ultrasound can be a good test, but it has to be done by an experienced sonographer, and there are no current guidelines to define how much experience is enough.

Additionally, Saslow said that no research has been done to prove that early detection saves lives.

Andersen said the researchers recommend that if you have any of the symptoms of ovarian cancer, and they're new-onset symptoms, that you should discuss them with your doctor. But, she added that, "even with this specific pattern of symptoms, most women probably don't have ovarian cancer, just as most women with a breast lump don't have breast cancer."

More information

To read more about ovarian cancer detection, visit the American Cancer Society  .

MONDAY, June 9 (HealthDay News) -- The procedures used to open narrowed heart arteries work just as well in women as in men, and the results for both genders have improved steadily in recent years, new research finds.

The study in the June 17 issue of the Journal of the American College of Cardiology is a marker in a fading debate about the value for women of what cardiologists call percutaneous coronary intervention (PCI), in which a balloon-tipped catheter is inserted to open a blocked blood vessel. Older studies have reported a lower use of PCI for women and a higher death rate for those getting the intervention.

But looking at 25 years of PCI done on almost 19,000 people, Mayo Clinic cardiologists report increasing effectiveness for the most recent years and equal effectiveness for men and women when risk factors such age are taken into account.

"Women should feel reassured," study author Dr. Mandeep Singh, an associate professor of medicine, said in a statement. "Not only has there been significant improvement in PCI outcomes over time, women's outcomes are similar to those of men."

The Mayo researchers compared 7,904 people, 28 percent of them women, who had PCI between 1979 and 1995, with 10,981 people, 31 percent of them women, treated between 1996 and 2004. They found a reduction in the death rate in the 30 days after the procedure for men, from 2.8 percent in the early group to 2.2 percent in the more recent group; for women, it went from 4.4 percent in the early group to 2.9 percent in the later group.

Overall, the success rate in opening arteries was almost identical for both sexes, 89 percent for women, 90 percent for men.

The higher mortality rate for women could be explained by risk factors such as age, the report said. Women having PCI were an average of five years older than men. They were also significantly more likely to have severe chest pain, diabetes and high cholesterol.

"Improvements in procedure account for most of the gain in women," said Dr. Robert F. Wilson, a professor of interventional cardiology at the University of Minnesota, and co-author of an accompanying editorial. "One is the use of stents, because the results with stenting are better."

Stents are flexible tubes inserted after angioplasty to help keep arteries open.

"Also, anticoagulation has improved tremendously," Wilson said. "Women in general are more prone to bleeding complications, and our understanding of anticoagulation has improved over 10 years. We don't give as much of the drugs, and we have better drugs to give."

While the American Heart Association had to issue a 2005 statement saying that PCI was as helpful for women as men, "there is a growing consensus that it is as effective in women as in men," Wilson said.

Age accounts for much of the higher toll, and "heart disease tends to develop later in women, which is partly related to their hormonal condition," he said. "After menopause, the disease takes off."

The new report backs the findings of a study done in Pennsylvania several years ago, said Christopher Hollenbeak, an associate professor of surgery and public health sciences at Penn State University. That study, which he led, looked at data on more than 31,000 state residents who had PCI in 2000.

"The same conclusions they reached, we reached as well," Hollenbeak said. "When you control for the risk factors, much of the difference in outcomes goes away. Of course, we used one-year data, from 2000, and over time, physicians are changing the way they practice."

More information

Background on PCI for women is offered by the Cleveland Clinic  .

FRIDAY, June 6 (HealthDay News) -- A popular type of surgery for removing abnormal cells from the cervix -- a problem that could lead to cervical cancer if left untreated -- may put women at risk of pregnancy complications.

Women who had this procedure, known as loop electrosurgical excision procedure, or LEEP, were at greater risk of delivering preterm babies or having a low-birth-weight infant, according to British researchers.

Doctors should use caution in treating young women with mild cervical abnormalities or precancerous cells, the study authors concluded in a paper published recently in the medical journal The Lancet.

"Women should seek detailed information on efficacy but also on long-term pregnancy-related morbidity before they consent," lead study author Dr. Maria Kyrgiou of Central Lancashire Teaching Hospitals in Preston, Great Britain, told HealthDay.

LEEP is one of several surgical techniques for removing abnormal or precancerous cells from the cervix.

After numbing the cervix with local anesthesia, an electrically charged wire loop is inserted through the vagina, explains the American College of Obstetricians and Gynecologists. The loop, acting as a scalpel, cuts away a thin layer of tissue, removing the abnormal cells.

Other methods, including cold knife conization, laser ablation and laser conization, also remove or destroy suspect tissue while preserving cervical function, the British researchers noted. But the effect of these various treatments on future fertility and pregnancies has been unclear.

To assess the potential impact, Kyrgiou and her colleagues analyzed data from 27 previous studies.

Cold knife conization, which involves the excision of a cone-shaped piece of tissue, increased the likelihood of preterm birth and delivering a low-birth-weight infant by two-and-a-half times, and tripled the risk for Caesarean section, compared with women who did not have this procedure.

LEEP increased the risk of preterm delivery and delivering a low-birth-weight infant by 70 percent and 82 percent, respectively. It nearly tripled the likelihood of premature rupturing of the cervical membranes, the study authors found.

Laser conization, where a laser is used to cut away tissue, had similar outcomes, but the findings were not statistically significant.

Laser ablation, or using a laser to destroy abnormal tissue, was the only method that didn't increase pregnancy complications, the study authors said.

But at least two women's health experts cautioned about drawing conclusions from a study that involved pooling of data from multiple retrospective studies. And one warned about comparing obstetrical results among procedures used to treat different types of lesions, or tissue abnormalities.

"The appropriate study that would answer the question would be to compare LEEP and laser used for the same kind of lesion and the same size lesion done all at one institution," said Dr. Annekathryn Goodman, associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School.

That said, Goodman underscored the importance of tailoring the treatment to the type of lesion: "So, small lesions only need small procedures, and larger lesions need big procedures." And, she added, "If the wrong treatment is done, and the lesion is not completely removed, the woman is at high risk for developing a cancer."

In her view, LEEP should be limited to treating women with high-grade precancerous lesions.

Dr. Carolyn D. Runowicz, director of the Carole and Ray Neag Comprehensive Cancer Center at the University of Connecticut Health Center, agreed that LEEP is needed to treat women with significant lesions to prevent an invasive cervical cancer. Women should also get a second opinion before undergoing a procedure, she said.

But the larger message, according to Runowicz, is for patients to prevent these lesions by getting regular screenings for cervical cancer.

And with the U.S. Food and Drug Administration's 2006 approval of Gardasil, a vaccine to prevent cervical cancer, woman have a powerful weapon against lesions caused by the human papillomavirus (HPV).

"HPV vaccine is the answer," agreed Dr. Joan L. Walker, chief of gynecologic oncology at the University of Oklahoma Health Sciences Center.

More information

For more on LEEP, visit the American College of Obstetricians and Gynecologists  .

MONDAY, May 19 (HealthDay News) -- Women who want to keep their hearts in tip-top shape face the fewest challenges in Minneapolis, Washington, D.C., and San Francisco.

Those three cities top the list of the 10 most heart-healthy U.S. metropolitan areas for women, a list that's dominated by western communities.

But the list, released Monday by the American Heart Association, also found the 10 metropolitan areas -- mostly in the South and the Midwest -- that spell trouble, with Nashville, Tenn., St. Louis and Detroit deemed the least friendly major cities for women's heart health.

"It's fair to say that if you live in the least heart-healthy cities, there's a chance that you'll have a high (likelihood) of heart disease and stroke and may have a shortened lifespan," said Dr. Jennifer Mieres, a spokeswoman for the American Heart Association and director of nuclear cardiology at the New York University School of Medicine.

Heart disease is the leading killer of American women. An estimated one-third of women suffer from heart problems, according to the American Heart Association, which says cardiovascular disease kills more women than the next five most common causes of death combined.

The heart association's "Go Red For Women" campaign commissioned Sperling's BestPlaces, which ranks the best places to live in the United States, to conduct the study. It included an analysis of 22 factors affecting women's heart health, including rates of cardiovascular mortality, high blood pressure, exercise, and smoking.

The review, which also looked at factors like stress levels and the numbers of people who commute by bicycle or on foot, encompassed the 200 largest metropolitan areas in the country.

The most heart-friendly metro areas for women are:

1. Minneapolis-St. Paul-Bloomington, Minn.
2. Washington-Arlington-Alexandria, District of Columbia
3. San Francisco-San Jose-Oakland, Calif.
4. Denver-Aurora, Colo.
5. Boston-Cambridge-Quincy, Mass.
6. Seattle-Tacoma-Bellevue, Wash.
7. Portland-Vancouver-Beaverton, Ore.
8. San Diego-Carlsbad-San Marcos, Calif.
9. Los Angeles-Long Beach-Santa Ana, Calif.
10. Phoenix-Mesa-Scottsdale, Ariz.

Minneapolis-St. Paul, Boston and Phoenix have the lowest heart-disease mortality rates for women, while women in San Francisco, Denver and Los Angeles are the thinnest.

Women in San Francisco, San Diego and Washington, D.C., are the healthiest eaters, and those in Sacramento, Los Angeles and San Francisco smoke the least.

The least-friendly metropolitan areas for women are:

1. Nashville-Davidson-Murfreesboro, Tenn.
2. St. Louis, Mo.
3. Detroit-Warren-Livonia, Mich.
4. Pittsburgh, Pa.
5. Dallas-Fort Worth-Arlington, Texas
6. Columbus, Ohio
7. Cincinnati-Middletown, Ohio
8. Las Vegas-Paradise, Nev.
9. Cleveland-Elyria-Mentor, Ohio
10. Indianapolis, Ind.

The researchers reported that women in Cleveland, Columbus, Ohio, and San Antonio, Texas, are among the most overweight in the country.

Women smoke the most in Cincinnati, Nashville and Indianapolis, while they eat the least healthy food in St. Louis, Kansas City, Kan., and Milwaukee.

The heart-unhealthy cities seem to share some things in common, Mieres said, like a plethora of fast-food restaurants, a tendency for people to drive instead of walk, and high smoking rates.

They may also have fewer teaching hospitals and fewer doctors per capita, she said. "When you look at the middle of the country and the South, they are about a decade or five years behind in getting the message that simple changes in diet and activity can have an impact," she said.

However, living in one of these 10 cities doesn't guarantee an unhealthy future, Mieres said. "What we're trying to do is to get women across the country to recognize that whether or not you live in a heart-friendly city, heart disease can be prevented."

Dr. Nieca Goldberg, medical director of the Women's Health Program at New York University Medical Center, agreed. "The wrong take-away message is that you would have to move to prevent heart disease," she said.

Another cardiologist, Dr. Lori Mosca, director of preventive cardiology at New York-Presbyterian Hospital/ Columbia University Medical Center, said future studies should look at factors like air quality, bans on trans fat in restaurants, and the availability of fresh produce in inner cities.

"These are some of the environmental factors that may have a significant influence on heart disease that are within the social and political control of cities," Mosca said.

But the best advice remains: Eat healthy, get physically active, and track your blood pressure, cholesterol, glucose and weight and keep them in a healthy range.

More information

Learn more about heart disease in women from the American Heart Association  .