Study Links the Pill (Pre-’75) to Breast Cancer
Women who took birth control pills before 1975 and who have a family history of breast cancer have a higher risk of developing breast cancer, researchers said last week. Such women should be “particularly vigilant” in using mammograms and self-examinations to check for breast cancer, they concluded.
Researchers found that women who took the pill and whose mothers or sisters had breast cancer were three times more likely to develop breast cancer than women with the same family history who didn’t take the pill. And if at least five family members had breast or ovarian cancer, pill users faced an 11-fold higher risk.
The study, conducted by doctors at the Mayo Clinic Cancer Center in Rochester, N.Y., was reported in the Oct. 11 Journal of the American Medical Assn. (https://jama.ama-assn.org). Epidemiologist Thomas A. Sellers and his colleagues studied 3,396 blood relatives of 426 women originally diagnosed with breast cancer between 1944 and 1952. They concluded that the risks were associated with the earliest forms of the pill--which contained higher levels of estrogens and progestins, which are believed to increase breast cancer risk--because they found no increased risk among granddaughters of the original cancer patients. But critics noted that the granddaughters, whose ages now average 43, may simply be too young yet for breast cancer to have developed and urged that further studies be conducted.
The increased risk seems to be associated with the mutated breast cancer genes BRCA-1 and 2 and thus raises troubling questions for women with the mutations. Birth control pills are one of the few proven methods of reducing the risk of ovarian cancer among such women, Dr. Wylie Burke of the University of Washington wrote in an editorial. Ovarian cancer is harder to detect and often more lethal than breast cancer, he noted, so the decision whether to use the pill involves a complex balancing of risks.
Research Discounts Iron as a Heart Risk Factor
Contrary to the long-held belief of many physicians, high iron levels in the blood are not associated with an increased risk of heart disease, according to a new study. Many researchers had thought that high consumption of iron represented a problem for men--but not for women, who lose much of their iron through menstruation--and some have suggested clinical trials of potential therapies, such as dietary restriction and phlebotomy (bloodletting).
Epidemiologist Christopher Sempos and his colleagues at the University of Buffalo studied 1,604 people, about half men and half women, who were enrolled in a national nutritional survey between 1976 and 1980. Their blood iron levels were determined by measuring levels of ferritin, one of the chief forms in which iron is transported in the body.
They reported in the October Annals of Epidemiology that they found no association between high ferritin levels and an increased risk of heart disease or death from any cause.
Gene May Play a Role in Sinus Infections
Some people who suffer repeated sinus infections may be predisposed to them because they carry the mutated gene that causes cystic fibrosis, according to researchers at the Johns Hopkins University School of Medicine. People with two copies of the mutated gene, called CFTR--one inherited from each parent--develop cystic fibrosis. The patients studied in the Hopkins report have only one copy of the CFTR gene and thus do not have cystic fibrosis, but they do seem to share some traits with CF victims. CF patients are known to have chronic sinusitis problems.
Dr. Garry R. Cutting and his colleagues studied 147 patients who sought treatment because of repeated sinus attacks. They found that 10 of them, or 7%, had a mutated version of the CFTR gene. In a similar group of healthy people, only two of them had the mutated gene, they reported in the Oct. 11 Journal of the American Medical Assn.
Arthritis Drug Maker Warns of Ill Effects
The maker of the drug Enbrel last week warned that rheumatoid arthritis patients taking the drug should be on the alert for symptoms of nerve-damaging “demyelinating disorders” and a blood problem called dyscrasia. The warning followed reports that 11 patients taking the drug, which is made by Immunex Corp., had developed the demyelinating disorder, similar to multiple sclerosis. The company noted that other drugs that operate via the same biological pathway previously have been found to worsen the symptoms of multiple sclerosis in patients with the disease.
European regulators had warned the previous week that they had received 10 reports of dyscrasia, including some deaths, among Enbrel users. Dyscrasia is caused by the loss of certain types of blood cells and is characterized by fever, bruising and bleeding.
Hand Washing May Get Short Shrift at Hospitals
The risk to patients of hospital-borne infections have long been known, as well as the benefits of hand washing by hospital workers in reducing that risk.
Even so, many hospital workers are reluctant to sanitize their hands between patients, and physicians, who are supposed to know better, are the worst offenders.
Dr. Didier Pittet and his colleagues at the University of Geneva initiated an infection control program at the University of Geneva Hospitals with a special emphasis on bedside, alcohol-based hand disinfection.
When the study was begun in 1994, only 48% of personnel disinfected their hands between patients. By the end of 1997, they reported in the Oct. 14 Lancet (https://www.thelancet.com), the proportion had increased to 66%. During the same period, the incidence of nosocomial (hospital-induced) infections dropped from 17% to 10%. But physicians, despite the program, sanitized their hands only about once in every nine opportunities. Although the research was conducted in Switzerland, experts believe hand-washing practices are similar in the United States.
Panel Implicates Agent Orange in Diabetes
There is “limited and suggestive” evidence that exposure to dioxin in the defoliant Agent Orange can produce diabetes, an expert panel convened by the National Academy of Sciences said Wednesday. The conclusion is likely to eventually add diabetes to the short list of diseases for which Vietnam veterans can automatically receive compensation.
An estimated 2.6 million Americans served in Southeast Asia between 1962 and 1975, and an estimated 8% to 11% of them already have diabetes. Because the risk of diabetes increases with age, many more are likely to develop the disease.
Other diseases officially designated as herbicide-associated are chloracne (a skin condition); porphyria cutanea tarda (a metabolic disorder); soft-tissue sarcomas; Hodgkin disease; multiple myeloma; respiratory cancers (including lung cancer); prostate cancer; and non-Hodgkin’s lymphoma. Spina bifida in the children of veterans also is considered to be associated with Agent Orange exposure and can be grounds for compensation payments.
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Medical writer Thomas H. Maugh II can be reached at thomas.maugh@latimes.com.
