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Diabetes Increases Men's Risk of Liver, Pancreatic Cancer, Study Finds
Men who reported they have diabetes and take medication for it are at four
times the risk of developing liver cancer compared with men without diabetes,
according to study results presented last week at the American Association of
Cancer Research (AACR) "Frontiers in Cancer Prevention Research" conference.
The case-control study - which involved nearly 3,300 men in Montreal, Canada,
newly diagnosed with 1 of 12 types of cancer, and more than 500 healthy
controls - also found that men who reported having diabetes and taking medication
for it had more than two and a half times the risk of developing pancreatic
cancer compared with men who did not have diabetes. Overall, 24 percent of
liver cancer patients, 16 percent of pancreatic cancer patients, and 8 percent
of controls reported having diabetes. No association was found between diabetes
and melanoma, non-Hodgkin's lymphoma, and stomach, colon, and prostate cancer.
Men were asked about medication use for diabetes to minimize misclassification
of disease. When only accounting for self-reports of diabetes without
medication use, the associations between diabetes and liver and pancreatic
cancer were reduced to three times the risk of developing liver cancer and two
times the risk of developing pancreatic cancer. The study confirms earlier
findings of a link between diabetes and liver and pancreatic cancers, said
study leader Dr. Marie-Claude Rousseau of the University of Montreal. The next
steps, she added, are to define the biological mechanisms by which diabetes may
cause cancer, "if it's indeed causal," and perhaps focusing on liver and
pancreatic cancer, "since these are the [cancers] coming most consistently from
the literature."
Height May Be Another Risk
Factor for Prostate Cancer
At the AACR prevention research conference last week, researchers from NCI and
the Finnish National Public Health Institute presented data showing that, in
male smokers, greater adult height is associated with an increased risk of
prostate cancer. The data come from more than 29,000 participants in the
Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, which examined
the long-term effects of vitamin supplements in Finnish male smokers between
1985 and 1993, and is continuing to follow participants. The men, aged 50 to 69
years, had their height and weight measured by a specially trained nurse, gave
information on demographic, smoking, and medical factors, and completed a
detailed food frequency questionnaire at the start of the ATBC study. After
17.4 years, a total of 1,346 cases of prostate cancer were identified. This
analysis showed that, compared with the shortest men in the study, the risk for
prostate cancer was approximately 20 percent higher among the tallest men. The
tallest men also had a two-fold higher risk of advanced disease. "Our results
help to clarify previous inconsistencies in the literature, and offer some
insights into the etiology of prostate cancer," says Dr. Margaret Wright, one
of the lead investigators from NCI's Division of Cancer Epidemiology and
Genetics. "The possibility that height may be associated with prostate cancer
risk should be studied further to evaluate whether taller men are particularly
susceptible to advanced disease, but not early cancer."
Ductal Lavage May Not
Detect Breast Cancer
Ductal lavage, a method for collecting cells from breast milk ducts, was
thought to have potential as a screening tool for breast cancer after a
previous study showed that milk ducts may contain diseased cells. But a study
in the October 20 Journal of the National Cancer Institute shows that the
method may not be sensitive enough for effective breast cancer screening. The
research was sponsored by Cytyc Corporation, the Bluhm Family Program for
Breast Cancer Prevention and Early Detection, and NCI. In this pilot study,
researchers performed ductal lavage on 44 breasts from 39 women prior to
mastectomy. Thirty-two of the women already had been diagnosed with breast
cancer, but seven had not yet been diagnosed and were undergoing mastectomy for
prophylactic reasons. Analysis of the cells from ductal lavage showed poor
agreement, in terms of cancer detection, when compared with the results of
microscopic examination of breast tissue. Cancer cells were detected with the
ductal lavage screen in only about half of the cases. The researchers speculate
that this may be because ducts that produced fluid were not proximal to the
site of cancer, because ducts that contained cancer failed to yield fluid, or
because the cancerous ducts that yielded fluid showed benign or mildly atypical
cells. "Although further studies are warranted in women with early lesions,"
the authors write, "our results and those of others indicate that ductal lavage
should not be recommended to high-risk women as a technique to detect cancer
earlier than imaging modalities."
Stroke After Breast Cancer Linked to Chemotherapy, But Not to Tamoxifen
In two recent clinical trials, a disproportionate number of strokes occurred
among women who received tamoxifen, a nonsteroidal hormone used to treat and
prevent breast cancer, raising concerns that the hormone may be to blame. To
examine this possibility, researchers from Kaiser Permanente Southern
California and the Keck School of Medicine at the University of Southern
California conducted a case-control study, funded by NCI, of first stroke after
breast cancer. Study results appeared in the October 20 Journal of the National
Cancer Institute. All of the women in the study had been diagnosed with a first
invasive breast cancer at Kaiser Permanente Southern California, and had a
stroke some time later. The researchers matched medical records of 353 control
patients to the records of 179 case patients, and also conducted interviews to
determine the women's breast cancer treatment history, medical and reproductive
history, and smoking status. Analysis showed that neither tamoxifen nor
radiation therapy was associated with the women's strokes, but that
chemotherapy was. They give several possible explanations for the increased
risk of stroke, including blood clots resulting from occult malignancies in
women with aggressive cancer who are more likely to receive chemotherapy, as
well as atherosclerotic disease resulting from the chemotherapeutic agents.
"Although this study cannot generate specific recommendations," the authors
wrote, "it seems logical that women with a history of chemotherapy may benefit
from approaches to reduce stroke risk."
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