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Ultraprocessed foods linked to ovarian and other cancer deaths, study finds

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CNN
 — 

Eating more ultraprocessed foods raises the risk of developing and dying from cancer, especially ovarian cancer, according to a new study of over 197,000 people in the United Kingdom, over half of whom were women.

Overly processed foods include prepackaged soups, sauces, frozen pizza and ready-to-eat meals, as well as hot dogs, sausages, french fries, sodas, store-bought cookies, cakes, candies, doughnuts, ice cream and many more.

“Ultra-processed foods are produced with industrially derived ingredients and often use food additives to adjust colour, flavour, consistency, texture, or extend shelf life,” said first author Dr. Kiara Chang, a National Institute for Health and Care Research fellow at Imperial College London’s School of Public Health, in a statement.

“Our bodies may not react the same way to these ultra-processed ingredients and additives as they do to fresh and nutritious minimally processed foods,” Chang said.

However, people who eat more ultra-processed foods also tend to “drink more fizzy drinks and less tea and coffee, as well as less vegetables and other foods associated with a healthy dietary pattern,” said Duane Mellor, a registered dietitian and senior teaching fellow at Aston Medical School in Birmingham, UK, in an email.

“This could mean that it may not be an effect specifically of the ultra-processed foods themselves, but instead reflect the impact of a lower intake of healthier food,” said Mellor, who was not involved in the study.

The study, published Tuesday in the journal eClinicalMedicine, looked at the association between eating ultraprocessed foods and 34 different types of cancer over a 10-year period.

Researchers examined information on the eating habits of 197,426 people who were part of the UK Biobank, a large biomedical database and research resource that followed residents from 2006 to 2010.

The amount of ultraprocessed foods consumed by people in the study ranged from a low of 9.1% to a high of 41.4% of their diet, the study found.

Eating patterns were then compared with medical records that listed both diagnoses and deaths from cancer.

Each 10% increase in ultraprocessed food consumption was associated with a 2% increase in developing any cancer, and a 19% increased risk for being diagnosed with ovarian cancer, according to a statement issued by Imperial College London.

Deaths from cancers also increased, the study found. For each additional 10% increase in ultraprocessed food consumption, the risk of dying from any cancer increased by 6%, while the risk of dying from ovarian cancer rose by 30%, according to the statement.

“These associations persisted after adjustment for a range of socio-demographic, smoking status, physical activity, and key dietary factors,” the authors wrote.

When it comes to death from cancer among women, ovarian cancer is ranked fifth, “accounting for more deaths than any other cancer of the female reproductive system,” noted the American Cancer Society.

“The findings add to previous studies showing an association between a greater proportion of ultra-processed foods (UPFs) in the diet and a higher risk of obesity, heart attacks, stroke, and type 2 diabetes,” said Simon Steenson, a nutrition scientist at the British Nutrition Foundation, a charity partially supported by food producers and manufacturers. Steenson was not involved in the new study.

“However, an important limitation of these previous studies and the new analysis published today is that the findings are observational and so do not provide evidence of a clear causal link between UPFs and cancer, or the risk of other diseases,” Steenson said in an email.

People who ate the most ultraprocessed foods “were younger and less likely to have a family history of cancer,” Chang and her colleagues wrote.

High consumers of ultraprocessed foods were less likely to do physical activity and more likely to be classified as obese. These people were also likely to have lower household incomes and education and live in the most underprivileged communities, the study found.

“This study adds to the growing evidence that ultra-processed foods are likely to negatively impact our health including our risk for cancer,” said Dr. Eszter Vamos, the study’s lead author and a clinical senior lecturer at Imperial College London’s School of Public Health in a statement.

This latest research is not the first to show an association between a high intake of ultraprocessed foods and cancer.

A 2022 study examined the diets of over 200,000 men and women in the United States for up to 28 years and found a link between ultraprocessed foods and colorectal cancer — the third most diagnosed cancer in the United States — in men, but not women.

And there are “literally hundreds of studies (that) link ultraprocessed foods to obesity, cancer, cardiovascular disease, and overall mortality,” Marion Nestle, the Paulette Goddard professor emerita of nutrition, food studies and public health at New York University told CNN previously.

While the new UK-based study cannot prove causation, only an association, “other available evidence shows that reducing ultra-processed foods in our diet could provide important health benefits,” Vamos said.

“Further research is needed to confirm these findings and understand the best public health strategies to reduce the widespread presence and harms of ultra-processed foods in our diet,” she added.

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Weight loss surgery extends lives, study finds

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CNN
 — 

Weight loss surgery reduces the risk of premature death, especially from such obesity-related conditions as cancer, diabetes and heart disease, according to a new 40-year study of nearly 22,000 people who had bariatric surgery in Utah.

Compared with those of similar weight, people who underwent one of four types of weight loss surgery were 16% less likely to die from any cause, the study found. The drop in deaths from diseases triggered by obesity, such as heart disease, cancer and diabetes, was even more dramatic.

“Deaths from cardiovascular disease decreased by 29%, while deaths from various cancers decreased by 43%, which is pretty impressive,” said lead author Ted Adams, an adjunct associate professor in nutrition and integrative physiology at the University of Utah’s School of Medicine.

“There was also a huge percentage drop — a 72% decline — in deaths related to diabetes in people who had surgery compared to those who did not,” he said. One significant downside: The study also found younger people who had the surgery were at higher risk for suicide.

The study, published Wednesday in the journal Obesity, reinforces similar findings from earlier research, including a 10-year study in Sweden that found significant reductions in premature deaths, said Dr. Eduardo Grunvald, a professor of medicine and medical director of the weight management program at the University of California San Diego Health.

The Swedish study also found a significant number of people were in remission from diabetes at both two years and 10 years after surgery.

“This new research from Utah is more evidence that people who undergo these procedures have positive, beneficial long-term outcomes,” said Grunvald, who coauthored the American Gastroenterological Association’s new guidelines on obesity treatment.

The association strongly recommends patients with obesity use recently approved weight loss medications or surgery paired with lifestyle changes.

“And the key for patients is to know that changing your diet becomes more natural, more easy to do after you have bariatric surgery or take the new weight loss medications,” said Grunvald, who was not involved in the Utah study.

“While we don’t yet fully understand why, these interventions actually change the chemistry in your brain, making it much easier to change your diet afterwards.”

Despite the benefits though, only 2% of patients who are eligible for bariatric surgery ever get it, often due to the stigma about obesity, said Dr. Caroline Apovian, a professor of medicine at Harvard Medical School and codirector of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston. Apovian was the lead author for the Endocrine Society’s clinical practice guidelines for the pharmacological management of obesity.

Insurance carriers typically cover the cost of surgery for people over 18 with a body mass index of 40 or higher, or a BMI of 35 if the patient also has a related condition such as diabetes or high blood pressure, she said.

“I see patients with a BMI of 50, and invariably I will say, ‘You’re a candidate for everything — medication, diet, exercise and surgery.’ And many tell me, ‘Don’t talk to me about surgery. I don’t want it.’ They don’t want a surgical solution to what society has told them is a failure of willpower,” she said.

“We don’t torture people who have heart disease: ‘Oh, it’s because you ate all that fast food.’ We don’t torture people with diabetes: ‘Oh, it’s because you ate all that cake.’ We tell them they have a disease, and we treat it. Obesity is a disease, too, yet we torture people with obesity by telling them it’s their fault.”

Most of the people who choose bariatric surgery — around 80% — are women, Adams said. One of the strengths of the new study, he said, was the inclusion of men who had undergone the procedure.

“For all-causes of death, the mortality was reduced by 14% for females and by 21% for males,” Adams said. In addition, deaths from related causes, such as heart attack, cancer and diabetes, was 24% lower for females and 22% lower for males who underwent surgery compared with those who did not, he said.

Four types of surgery performed between 1982 and 2018 were examined in the study: gastric bypass, gastric banding, gastric sleeve and duodenal switch.

Gastric bypass, developed in the late 1960s, creates a small pouch near the top of the stomach. A part of the small intestine is brought up and attached to that point, bypassing most of the stomach and the duodenum, the first part of the small intestine.

In gastric banding, an elastic band that can be tightened or loosened is placed around the top portion of the stomach, thus restricting the volume of food entering the stomach cavity. Because gastric banding is not as successful in creating long-term weight loss, the procedure “is not as popular today,” Adams said.

“The gastric sleeve is a procedure where essentially about two-thirds of the stomach is removed laparoscopically,” he said. “It takes less time to perform, and food still passes through the much-smaller stomach. It’s become a very popular option.”

The duodenal switch is typically reserved for patients who have a high BMI, Adams added. It’s a complicated procedure that combines a sleeve gastrectomy with an intestinal bypass, and is effective for type 2 diabetes, according to the Cleveland Clinic.

One alarming finding of the new study was a 2.4% increase in deaths by suicide, primarily among people who had bariatric surgery between the ages of 18 and 34.

“That’s because they are told that life is going to be great after surgery or medication,” said Joann Hendelman, clinical director of the National Alliance for Eating Disorders, a nonprofit advocacy group.

“All you have to do is lose weight, and people are going to want to hang out with you, people will want to be your friend, and your anxiety and depression are going to be gone,” she said. “But that’s not reality.”

In addition, there are postoperative risks and side effects associated with bariatric surgery, such as nausea, vomiting, alcoholism, a potential failure to lose weight or even weight gain, said Susan Vibbert, an advocate at Project HEAL, which provides help for people struggling with eating disorders.

“How are we defining health in these scenarios? And is there another intervention — a weight neutral intervention?” Vibbert asked.

Past research has also shown an association between suicide risk and bariatric surgery, Grunvald said, but studies on the topic are not always able to determine a patient’s mental history.

“Did the person opt for surgery because they had some unrealistic expectations or underlying psychological disorders that were not resolved after the surgery? Or is this a direct effect somehow of bariatric surgery? We can’t answer that for sure,” he said.

Intensive presurgery counseling is typically required for all who undergo the procedure, but it may not be enough, Apovian said. She lost her first bariatric surgery patient to suicide.

“She was older, in her 40s. She had surgery and lost 150 pounds. And then she put herself in front of a bus and died because she had underlying bipolar disorder she had been self-medicating with food,” Apovian said. “We as a society use a lot of food to hide trauma. What we need in this country is more psychological counseling for everybody, not just for people who undergo bariatric surgery.”

Managing weight is a unique process for each person, a mixture of genetics, culture, environment, social stigma and personal health, experts say. There is no one solution for all.

“First, we as a society must consider obesity as a disease, as a biological problem, not as a moral failing,” Grunvald said. “That’s my first piece of advice.

“And if you believe your life is going to benefit from treatment, then consider evidence-based treatment, which studies show are surgery or medications, if you haven’t been able to successfully do it with lifestyle changes alone.”

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Many women underestimate breast density as a risk factor for breast cancer, study shows

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CNN
 — 

Dense breast tissue has been associated with up to a four times higher risk of breast cancer. However, a new study suggests few women view breast density as a significant risk factor.

The study, published in JAMA Network Open, surveyed 1,858 women ages 40 to 76 years from 2019 to 2020 who reported having recently undergone mammography, had no history of breast cancer and had heard of breast density.

Women were asked to compare the risk of breast density to five other breast cancer risk factors: having a first-degree relative with breast cancer, being overweight or obese, drinking more than one alcoholic beverage per day, never having children and having a prior breast biopsy.

“When compared to other known and perhaps more well-known breast cancer risks, women did not perceive breast density as significant of a risk,” said Laura Beidler, an author of the study and researcher at the Dartmouth Institute for Health Policy and Clinical Practice.

For example, the authors report that dense breast tissue is associated with a 1.2 to four times higher risk of breast cancer compared with a two times higher risk associated with having a first-degree relative with breast cancer – but 93% of women said breast density was a lesser risk.

Dense breasts tissue refers to breasts that are composed of more glandular and fibrous tissue than fatty tissue. It is a normal and common finding present in about half of women undergoing mammograms.

The researchers also interviewed 61 participants who reported being notified of their breast density and asked what they thought contributes to breast cancer and how they could reduce their risk. While most women correctly noted that breast density could mask tumors on mammograms, few women felt that breast density could be a risk factor for breast cancer.

Roughly one-third of women thought there was nothing they could do to reduce their breast cancer risk, although there are several ways to reduce risk, including maintaining a healthy, active lifestyle and minimizing alcohol consumption.

Breast density changes over a woman’s lifetime, and is generally higher in women who are younger, have a lower body weight, are pregnant or breastfeeding, or are taking hormone replacement therapy.

The level of breast cancer risk increases with the degree of breast density; however, experts aren’t certain why this is true.

“One hypothesis has been that women who have more dense breast tissue also have higher, greater levels of estrogen, circulating estrogen, which contributes to both the breast density and to the risk of developing breast cancer,” said Dr. Harold Burstein, a breast oncologist at the Dana-Farber Cancer Institute who was not involved in the study. “Another hypothesis is that there’s something about the tissue itself, making it more dense, that somehow predisposes to the development of breast cancer. We don’t really know which one explains the observation.”

Thirty-eight states currently mandate that women receive written notification about their breast density and its potential breast cancer risk following mammography; however, studies have shown that many women find this information confusing.

“Even though women are notified usually in writing when they get a report after a mammogram that says, ‘You have increased breast density,’ it’s kind of just tucked in there at the bottom of the report. I’m not sure that anyone is explaining to them, certainly in person or verbally, what that means,” said Dr. Ruth Oratz, a breast oncologist at NYU Langone’s Perlmutter Cancer Center who was not involved in the study.

“I think what we’ve learned from this study is that we have to do a better job of educating not only the general public of women, but the general public of health care providers who are doing the primary care, who are ordering those screening mammograms,” she added.

Current screening guidelines recommend women of average risk of breast cancer undergo breast cancer screening every one to two years between ages 50 to 74 with the option of beginning at age 40.

Because women with dense breast tissue are considered to have higher than average cancer risks, the authors of the study suggest women with high breast density may benefit from supplemental screening like breast MRI or breast ultrasound, which may detect cancers that are missed on mammograms. Currently, coverage of supplemental screening after the initial mammogram varies, depending on the state and insurance policy.

The authors warn that “supplemental screening not only can lead to increased rates of cancer detection but also may result in more false-positive results and recall appointments.” They say clinicians should use risk assessment tools when discussing tradeoffs associated with supplemental screening.

“Usually, it’s a discussion between the patient, the clinical team, and the radiologist. And it’ll be affected by prior history, by whether there’s anything else of concern on the mammogram, by the patient’s family history. So those are the kinds of things we discuss frequently with patients who are in such situations,” Burstein said.

Breast cancer screening recommendations differ between medical organizations, and experts say women at higher risk due to breast density should discuss with their doctor what screening method and frequency are most appropriate.

“I think it’s really, really important that everyone understands – and this is the doctors, the nurses, the women themselves – that screening is not a one size fits all recommendation. We cannot just make one general recommendation to the entire population because individual women have different levels of risks of developing breast cancer,” Oratz said.

For the nearly one-third of women with dense breast tissue that reported there was nothing they could do to prevent breast cancer, experts say there are some steps you can take to reduce your risk.

“Maintaining an active, healthy lifestyle and minimizing alcohol consumption address several modifiable factors. Breastfeeding can decrease the risk. On the other hand, use of hormone replacement therapy increases breast cancer risk,” said Dr. Puneet Singh, a breast surgical oncologist at the MD Anderson Cancer Center who was not involved in the study.

The researchers add that there are approved medications, such as tamoxifen, that can be given for those at significantly increased risk that may reduce the chances of breast cancer by about half.

Finally, breast cancer doctors say that in addition to appropriate screening, knowing your risk factors and advocating for yourself can be powerful tools in preventing and detecting breast cancer.

“At any age, if any woman feels uncomfortable about something that’s going on in her breast, if she has discomfort, notices a change in the breast, bring that to the attention of your doctor and make sure it gets evaluated and don’t let somebody just brush you off,” Oratz said.

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Some people may be able to stretch out the time between colonoscopies, study suggests

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CNN
 — 

A new study raises the question whether some people can wait longer than the recommended 10years to repeat a colonoscopy after a negative initial screening for colorectal cancer.

The study, published in JAMA Internal Medicine, looked at 120,000 people 65 and older in Germany from 2013 to 2019 who had a colonoscopy 10 or more years after an initial negative screening, and it compared them with all colonoscopy screenings conducted on people 65 or older in that time period – most of whom were being screened for the first time.

It found the presence of precancerous or cancerous growths was 40% to 50% lower among the repeat screeners, finding advanced growths or cancers in only 4% to 5% of women and 5% to 7% of men 10 or more years after a negative colonoscopy.

The researchers also evaluated whether the number of abnormal growths differed between men and women, finding the prevalence 40% higher in men.

When looking by age, detection rates were highest among individuals 75 years or older.

The authors conclude that the current 10-year screening intervals for colonoscopies are safe, and they also suggest that extending the intervals may be warranted in some instances, especially for females and younger people without gastrointestinal symptoms.

“For instance, women at younger screening ages with no finding at index colonoscopy could possibly be screened at prolonged intervals or, alternatively, be offered less invasive methods, such as stool tests, while maintaining the 10-year interval for men and women at older ages,” the study authors wrote.

Colorectal cancer is the second leading cause of cancer deaths in the United States. It is also one of the most preventable cancers with effective screening tests like colonoscopies that can detect early disease.

Death rates from colorectal cancer have decreased over recent decades, largely due to colonoscopies.

Current guidelines recommend screening for colorectal cancer in all adults 45 to 75 years old. The recommendations were recently changed to start screening at 45 instead of 50 years of age in response to more cancer being diagnosed at younger ages. If the screening is negative, patients don’t need another one for 10 years.

Dr. Douglas Owens, a health policy professor at Stanford University and a former chair of the US Preventive Services Task Force, which makes US cancer screening recommendations, said there is promise to the findings.

“(Colorectal cancer) is not like other cancers where there are big harms from over screening potentially. Here they are small, but they’re not zero, and it comes from the colonoscopy. So, if you could get the same benefit at a lower number of colonoscopies, that would be a win,” Owens said.

Owens would like to see more research on extending the screening intervals, as would Dr. Robert Bresalier, a professor of gastrointestinal oncology at MD Anderson Cancer Center.

“There’s good evidence that screening colonoscopy in asymptomatic individuals at 10-year intervals is effective and cost effective. And I think I’m not ready to change. I would not be ready to change practice in terms of extending the interval based on the study, but it is comforting and provides additional data to strengthen the concept of adhering to these guidelines,” Bresalier said. “The overall message from this study is we can feel comfortable with the current guidelines.”

The study authors note the study’s finding don’t extend to individuals who might need to undergo a colonoscopy at earlier intervals to assess symptoms they might be having, such as rectal bleeding, or individuals who are at higher risk of colorectal cancer. They say generalizing their findings should be done cautiously.

Experts maintain that colonoscopies are one of the most important preventive services and for all eligible groups to get tested.

“(This study) supports the importance of screening for colon cancer and that there are many ways, many effective ways to do that,” Owens said.

Although colonoscopy is considered the gold standard for colon cancer screening, there are alternatives. Other screening options include annual fecal occult blood tests which look for blood in the stool.

“The main thing is to get screened. It doesn’t matter if you use a stool test or you get a colonoscopy, pick one. Pick whichever one suits your preferences, but do it,” Owens said.

More than a quarter of eligible Americans don’t get screened for colorectal cancer, and public health advocates urge Americans to get screened.

“Right now, the biggest impact we can have – and relevant to this discussion — is screening. So if you haven’t been screened and you’re in that age relevant group, you should get screened. And that clearly has a larger impact, and the biggest impact we can do right now in terms of influencing death of colorectal cancer,” Bresalier said.

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US cancer death rate drops 33% since 1991, partly due to advances in treatment, early detection and less smoking, new report says

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CNN
 — 

The rate of people dying from cancer in the United States has continuously declined over the past three decades, according to a new report from the American Cancer Society.

The US cancer death rate has fallen 33% since 1991, which corresponds to an estimated 3.8 million deaths averted, according to the report, published Thursday in CA: A Cancer Journal for Clinicians. The rate of lives lost to cancer continued to shrink in the most recent year for which data is available, between 2019 and 2020, by 1.5%.

The 33% decline in cancer mortality is “truly formidable,” said Karen Knudsen, chief executive officer of the American Cancer Society.

The report attributes this steady progress to improvements in cancer treatment, drops in smoking and increases in early detection.

“New revelations for prevention, for early detection and for treatment have resulted in true, meaningful gains in many of the 200 diseases that we call cancer,” Knudsen said.

In their report, researchers from the American Cancer Society also pointed to HPV vaccinations as connected to reductions in cancer deaths. HPV, or human papillomavirus, infections can cause cervical cancer and other cancer types, and vaccination has been linked with a decrease in new cervical cancer cases.

Among women in their early 20s, there was a 65% drop in cervical cancer rates from 2012 through 2019, “which totally follows the time when HPV vaccines were put into use,” said Dr. William Dahut, the society’s chief scientific officer.

“There are other cancers that are HPV-related – whether that’s head and neck cancers or anal cancers – so there’s optimism this will have importance beyond this,” he said.

The lifetime probability of being diagnosed with any invasive cancer is estimated to be 40.9% for men and 39.1% for women in the US, according to the new report.

The report also includes projections for 2023, estimating that there could be nearly 2 million new cancer cases – the equivalent of about 5,000 cases a day – and more than 600,000 cancer deaths in the United States this year.

During the early days of the Covid-19 pandemic, many people skipped regular medical exams, and some doctors have seen a rise in advanced cancer cases in the wake of pandemic-delayed screenings and treatment.

The American Cancer Society researchers were not able to track “that reduction in screening that we know we all observed across the country during the pandemic,” Knudsen said. “This time next year, I believe our report will give some initial insight into what the impact was in the pandemic of cancer incidence and cancer mortality.”

The new report includes data from national programs and registries, including those at the National Cancer Institute, the US Centers for Disease Control and Prevention and the North American Association of Central Cancer Registries.

Data showed that the US cancer death rate rose during most of the 20th century, largely due to an increase in lung cancer deaths related to smoking. Then, as smoking rates fell and improvements in early detection and treatments for some cancers increased, there was a decline in the cancer death rate from its peak in 1991.

Since then, the pace of the decline has slowly accelerated.

The new report found that the five-year relative survival rate for all cancers combined has increased from 49% for diagnoses in the mid-1970s to 68% for diagnoses during 2012-18.

The cancer types that now have the highest survival rates are thyroid at 98%, prostate at 97%, testis at 95% and melanoma at 94%, according to the report.

Current survival rates are lowest for cancers of the pancreas, at 12%.

The finding about a decreasing cancer death rate shows “the continuation of good news,” said Dr. Otis Brawley, an oncology professor at Johns Hopkins University who was not involved in the research.

“The biggest reason for the decline that started in 1991 was the prevalence of smoking in the United States started going down in 1965,” said Brawley, a former chief medical officer of the American Cancer Society.

“That’s the reason why we started having a decline in 1991, and that decline has continued because the prevalence of people smoking in the United States has continued to go down,” he said. “Now, in certain diseases, our ability to treat has improved, and there are some people who are not dying because of treatment.”

Although the death rate for cancer has been on a steady decline, the new report also highlights that new cases of breast, uterine and prostate cancer have been “of concern” and rising in the United States.

Incidence rates of breast cancer in women have been increasing by about 0.5% per year since the mid-2000s, according to the report.

Uterine corpus cancer incidence has gone up about 1% per year since the mid-2000s among women 50 and older and nearly 2% per year since at least the mid-1990s in younger women.

The prostate cancer incidence rate rose 3% per year from 2014 through 2019, after two decades of decline.

Knudsen called prostate cancer “an outlier” since its previous decline in incidence has reversed, appearing to be driven by diagnoses of advanced disease.

On Thursday, the American Cancer Society announced the launch of the Impact initiative, geared toward improving prostate cancer incidence and death rates by funding new research programs and expanding support for patients, among other efforts.

“Unfortunately, prostate cancer remains the number one most frequently diagnosed malignancy amongst men in this country, with almost 290,000 men expected to be diagnosed with prostate cancer this year,” Knudsen said. Cancer diagnosed when it is confined to the prostate has a five-year survival rate of “upwards of 99%,” she said, but for metastatic prostate cancer, there is no durable cure.

“Prostate cancer is the second leading cause of cancer death for men in this country,” she said. “What we’re reporting is not only an increase in the incidence of prostate cancer across all demographics but a 5% year-over-year increase in diagnosis of men with more advanced disease. So we are not catching these cancers early when we have an opportunity to cure men of prostate cancer.”

Breast, uterine and prostate cancers also have a wide racial disparity, in which communities of color have higher death rates and lower survival rates.

In 2020, the risk of overall cancer death was 12% higher in Black people compared with White people, according to the new report.

“Not every individual or every family is affected equally,” Knudsen said.

For instance, “Black men unfortunately have a 70% increase in incidence of prostate cancer compared to White men and a two- to four-fold increase in prostate cancer mortality as related to any other ethnic and racial group in the United States,” she said.

The data in the new report demonstrates “important and consistent” advances against cancer, Dr. Ernest Hawk, vice president of cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center, said in an email.

“Cancer is preventable in many instances and detectable at an early stage with better outcomes in many others. When necessary, treatments are improving in both their efficacy and safety. That’s all great news,” Hawk wrote.

“However, it’s well past time for us to take health inequities seriously and make them a much greater national priority. Inequities in cancer risks, cancer care and cancer outcomes are intolerable, and we should not be complacent with these regular reminders of avoidable inequities,” he said. “With deliberate and devoted effort, I believe we can eliminate these disparities and make even greater progress to end cancer.”

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Jill Biden ‘feeling well’ after two cancerous lesions removed during hospital trip

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CNN
 — 

First lady Dr. Jill Biden on Wednesday spent several hours at Walter Reed National Military Medical Center, undergoing a scheduled outpatient procedure that revealed a second area of concern for skin cancer.

According to a letter issued by White House physician Dr. Kevin O’Connor, Biden had a Mohs surgery to remove and examine a lesion above her right eye, which was recently discovered during a routine skin cancer checkup.

“The procedure confirmed the small lesion was basal cell carcinoma,” O’Connor wrote in the letter. “All cancerous tissue was successfully removed, and the margins were clear of any residual skin cancer cells.”

However, during a pre-operative consultation, O’Connor noted “an additional area of concern was identified on the left side of the first lady’s chest.”

This area was also treated with Mohs surgery on Wednesday, prolonging the length of the overall procedure and keeping the first lady, who was accompanied by President Joe Biden through most of the day, at Walter Reed longer than a White House official had previously indicated to CNN.

The chest lesion was also confirmed to be basal cell carcinoma, according to O’Connor, and was “successfully removed.”

A separate small lesion on the first lady’s left eyelid was also found during the operation and was removed, O’Connor wrote. That lesion was sent for “standard microscopic examination.”

The statement noted that the first lady, 71, was experiencing “some facial swelling and bruising” as a result of the surgery, but that she is in “good spirits” and “feeling well.” The first lady will remain at Walter Reed until later Wednesday evening, a White House official told CNN, and is scheduled to depart the medical center separately from the president, who returned to the White House in the late afternoon.

O’Connor’s letter about Jill Biden’s surgery noted that basal cell carcinoma lesions “do not tend to ‘spread’ or metastasize, as some more serious skin cancers such as melanoma or squamous cell carcinoma are known to do.”

CORRECTION: An earlier version of this story incorrectly stated the area from which one of the cancerous lesions had been removed. One of the cancerous lesions was removed from above Jill Biden’s right eye.

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Democratic Rep. Jamie Raskin announces he has ‘serious but curable form of cancer’

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CNN
 — 

Democratic Rep. Jamie Raskin of Maryland announced on Wednesday that he has a “serious but curable form of cancer” and will begin outpatient treatment.

In a statement, Raskin said, “After several days of tests, I have been diagnosed with diffuse large B cell lymphoma, which is a serious but curable form of cancer. I am about to embark on a course of chemo-immunotherapy on an outpatient basis at Med Star Georgetown University Hospital and Lombardi Comprehensive Cancer Center. Prognosis for most people in my situation is excellent after four months of treatment.”

The Maryland Democrat serves on the House Select Committee investigating the January 6, 2021, attack on the US Capitol. He also was the lead impeachment manager of former President Donald Trump’s second impeachment trial in 2021 and was just elected by his colleagues to serve as the top Democrat on the House Oversight Committee.

“I plan to get through this and, in the meantime, to keep making progress every day in Congress for American democracy,” Raskin said in the statement.

He noted that he expects “to be able to work through this period but have been cautioned by my doctors to reduce unnecessary exposure to avoid COVID-19, the flu and other viruses.”

According to the American Cancer Society, diffuse large B cell lymphoma “tends to grow quickly” and is frequently treated with chemotherapy through a four-drug regimen administered in cycles three weeks apart. It can be cured in about half of all patients, but it largely depends on factors including the stage when the disease is caught, the society notes.

This story is breaking and has been updated.

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Only 14% of diagnosed cancers in the US are detected by screening, report says

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CNN
 — 

A small proportion – 14.1% – of all diagnosed cancers in the United States are detected by screening with a recommended screening test, according to a new report.

The remaining diagnosed cancers tend to be found when someone has symptoms or seeks imaging or medical care for other reasons, suggests the report, posted online Wednesday by researchers at the nonprofit research organization NORC at the University of Chicago.

“I was shocked that only 14% of cancers were detected by screening. I think, for many people, we talk so much about cancer screening that we imagine that that’s how all cancers are diagnosed. We talk about mammograms and colonoscopies all the time,” said Caroline Pearson, an author of the report and senior vice president at the organization.

Yet “the vast majority of cancer types don’t have screening tests available,” Pearson said.

The technical report notes that just four types of cancer – breast, cervical, colorectal and lung – have screening tests recommended for use by the US Preventive Services Task Force, and the percent of cancers detected by screening varies across those types: 61% of breast, 52% of cervical, 45% of colorectal and 3% of lung cancers. The report also includes data on prostate cancer, even though screening for prostate cancer is not broadly recommended, and the data suggests that 77% of prostate cancers are detected by screening.

The report, which has not been published in a peer-reviewed journal, is based on data from 2017. But Pearson said that since then, studies have shown that the rates of cancer screenings declined during the early days of the Covid-19 pandemic. She suspects that the percentage of cancers detected by screening could now be even lower than what was found in the new report.

“I definitely think that the percent of cancers detected by screening would have been lower as a result of the pandemic. We know that people missed a tremendous number of recommended screenings, and we are seeing those cancers showing up at later stages in clinical settings,” Pearson said. “So with the reduction in screenings, we get fewer cancers diagnosed that way, and that is certainly something that we would pick up in the data.”

For the new report, Pearson and her colleagues developed a model to calculate the percentage of cancers detected by screening, using data from the National Cancer Institute on the incidence of diagnosed cancers, national screening rates from the National Health Interview Survey, testing rates from the US Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, and several studies on the rate at which cancers are detected.

There has not been much data in the medical literature on cancers that are detected by screening, she said, adding that she hopes the report draws attention to the importance of cancer screening, the need for more tests and the need for more data on how cancers are diagnosed, including the important role that screening tests play in catching cancers early.

“We would benefit from much more robust data and analysis to really understand how cancer is affecting different populations and how we can improve equity,” Pearson said. “For the researchers of the world, I would love for people to dig into some of these estimates and some of the geographic variations that we’re seeing to understand how we can begin to shape the public policy environment to improve treatment across the country and improve screening across the country.”

Dr. Otis Brawley, an oncology professor at Johns Hopkins University, said he was not surprised by the findings in the new report – especially because some cancer screening tests can be improved in their performance.

“Everyone has been led to believe that screening is better than it actually is,” said Brawley, who was not involved in the new report. “We need to invest in research to try to find better tests.”

In the case of breast cancer, for instance, “clinical trials tell us screening prevents 25% of those destined to die of breast cancer from dying of breast cancer,” he said. “In the US, about 60% of women aged 50 to 70 get screened. That means we can only prevent about 15% of the deaths destined to occur. It also means a lot of patients are diagnosed with cancer after a negative screening test.”

People in the United States could benefit from following cancer prevention measures – such as getting screened and maintaining a healthy lifestyle – but the public can also benefit from better screening tests themselves, Brawley said.

“We spend so much time pushing screening and pushing screening tests – yes, they do save lives, but we need to be able to save more lives,” he said. “We need better.”

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How to screen for colon cancer

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Colon cancer has claimed another life. Emmy Award and Golden Globe winner Kirstie Alley, best known for her roles in the television sitcoms “Cheers” and “Veronica’s Closet,” died Monday at age 71 after battling cancer that was “recently discovered,” according to a family statement.

A representative for Alley confirmed to CNN via email on Tuesday that she had been diagnosed with colon cancer prior to her death.

Colorectal cancer, which includes colon and rectal cancers, is the second most common cause of death from cancer in 2022, outranked only by lung and bronchus cancer, according to the National Cancer Institute Surveillance, Epidemiology and End Results Program.

Regular checkups are the best way to keep colon cancer at bay, according to the US Preventive Services Task Force. The task force lowered the age to begin screening for colon and rectal cancer to 45 last year after a worrisome spike in cases of colorectal cancer in people younger than 50.

The new recommendations apply to everyone ages 45 to 75, including people with no symptoms, no prior diagnosis, no family history of colon or rectal disease, and no personal history of polyps, which are all key risk factors. Polyps are bumps or tiny mushroom-like stalks that grow inside the colon or rectum.

If these growths are not found and removed, they can turn cancerous.

Adults ages 76 to 85 years can also be screened, depending on their overall health, prior screening history and personal preferences, the task force said.

Colorectal cancer screening can occur in several ways, including simple mail-in tests that look for blood or cancer cells in a sample of stool collected by the patient. However, all stool tests can have false-positive test results, which would likely require a more invasive test to rule out cancer, according to the American Cancer Society.

Stool tests: While a stool test is the least invasive option, it does have to be done at least once a year, the society said. No anti-inflammatory pain relievers can be taken for seven days prior to a stool test, while red meats such as beef, lamb or liver and any citrus or vitamin C supplements should be avoided for at least three days.

If the test finds something of concern, “you will still need a colonoscopy to see if you have cancer,” according to ACS. However, hidden bleeding in the stool does not automatically signal cancer, as ulcers, hemorrhoids and other conditions can also cause rectal bleeding.

DNA stool test: A DNA stool test is another option, the society said. Because colorectal cancer cells can have DNA mutations, the test can screen for those genetic abnormalities. This test only needs to be done once every three years, but an entire stool sample must be collected and mailed.

Patients may have insurance coverage issues because the test is fairly new, ACS said. Again, if anything suspicious is found, a colonoscopy will still be required.

For all of the following tests, the colon must be clean and free of stool matter, which requires at-home bowel prep. Ways to empty the bowels include pills, drinking a laxative solution or the use of an enema the night before the procedure.

This process has become much easier over the years with the advent of new kits that don’t require as much liquid laxative, so talk to your doctor about your options, ACS suggested.

Colonoscopy: One of the most widely used tests, this procedure allows a doctor access to the entire length of the colon and rectum with a colonoscope, a “flexible, lighted tube about the thickness of a finger with a small video camera on the end,” ACS said.

Typically, the patient is under light sedation during the whole procedure, waking up with no knowledge of the process. Watching on video in real time as the scope moves through the intestine, the doctor can stop and insert small instruments into the scope to take a sample or even remove any suspicious polyps.

Virtual colonscopy: This test uses computer programs that take X-rays and a computed tomography (CT) scan to make three-dimensional pictures of the inside of the colon and rectum.

The test does not require sedation. However, it does require the same bowel prep as a regular colonoscopy. After the patient drinks a contrast dye, a small, flexible tube will be inserted into the rectum, followed by pumped air expand the rectum and colon for better pictures.

As with all CT scans, this procedure exposes the patient to a small amount of radiation and can cause cramping until the air exits the body, the society said. If a suspicious mass is detected, a colonoscopy will still be needed to remove the mass.

Flexible sigmoidoscopy: This test inserts the same flexible camera tube into the lower part of the colon. However, because the tube is only 2 feet (60 centimeters) long, this test only allows the doctor to examine the entire rectum and less than half of the colon — any polpys in the upper colon will be missed. This test is not often used in the United States, the society said.

Many people avoid a colonoscopy, partly due to the preparation, so as a way of encouraging people to get screened, former “Today” host Katie Couric broadcast her entire procedure in 2000 — from prep the night before to a mildly sedated Couric watching the procedure as it unfolded.

“I have a pretty little colon,” Couric said with a sleepy chuckle as she watched the video projection from the scope inside her colon. “You didn’t put the scope in yet, did you?” asked Couric, whose husband, Jay Monahan, had died from colon cancer at age 42 in 1998.

“Yes! We’re doing the examination. We’re almost done,” said her physician, the late Dr. Kenneth Forde, who taught for nearly 40 years at Vagelos College of Physicians and Surgeons at Columbia University in New York City.

More recently, actors Ryan Reynolds and Rob McElhenney videotaped parts of their colonoscopies to raise public awareness after Reynolds lost a bet.

“Rob and I both, we turned 45 this year,” Reynolds said in the video. “And you know, part of being this age is getting a colonoscopy. It’s a simple step that could literally — and I mean, literally — save your life.”

Doctors found both actors had polyps that were removed during the screening.

“It’s not every day that you can raise awareness about something that will most definitely save lives. That’s enough motivation for me to let you in on a camera being shoved up my a–,” Reynolds said.

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