Posts Tagged "Mortality"

Statin use is associated with a significant reduction in cancer mortality, conclude two separate studies, one in women, and the other in men. Both were presented here at the American Society of Clinical Oncology (ASCO) 2015 Annual Meeting.

Specifically, statin use was associated with a 22% reduction in deaths from various cancer types in women and a 55% reduction in deaths from bone/connective tissue cancers. The study in men looked at statin use together with the antidiabetes medication metformin and found a 40% reduction in prostate cancer mortality, with the effect more pronounced in men with obesity/metabolic syndrome.

As for how such an effect is achieved, the researchers speculate that statins interfere with cell growth and metastasis by blocking cholesterol production, thereby affecting molecular pathways and the inflammatory response.

The results in women were presented by Ange Wang, BSE, from Stanford University School of Medicine, in California.

Dr. Wang and colleagues examined data from the Women’s Health Initiative, a 15-year research program involving postmenopausal women aged 50 to 79 years who were enrolled between 1993 and 1998 at 40 centers in the United States.

They determined the association between patients’ never having used statins, current statin use, and past statin use, as well as the incidence and number of deaths from cancer among 146,326 women. The median follow-up period was 14.6 years.

The researchers took into account a number of potential confounding factors, including age, race/ethnicity, education, smoking, body mass index, physical activity, family history of cancer, and current healthcare provider.

Among the participants, there were 23,067 cases of incident cancer for which complete follow-up data were available. There were 7,411 all-cause deaths, including 5,837 deaths from cancer, 613 cardiovascular deaths, and 961 deaths from other causes. In all, 3,152 cancer deaths were included in the analysis, of which 708 were among current statin users and 2443 among patients who had never used statins.

Source: Medscape

 

Running for only a few minutes a day or at slow speeds may significantly reduce a person’s risk of death from cardiovascular disease compared to someone who does not run, according to a study published today in the Journal of the American College of Cardiology.

Exercise is well-established as way to prevent heart disease and it is component of an overall healthy life, but it is unclear whether there are health benefits below the level of 75 minutes per week of vigorous-intensity activity, such as running, recommended by the U.S. government and World Health Organization.

Researchers studied 55,137 adults between the ages of 18 and 100 over a 15-year period to determine whether there is a relationship between running and longevity. Data was drawn from the Aerobics Center Longitudinal Study, where participants were asked to complete a questionnaire about their running habits. In the study period, 3,413 participants died, including 1,217 whose deaths were related to cardiovascular disease. In this population, 24 percent of the participants reported running as part of their leisure-time exercise.

Compared with non-runners, the runners had a 30 percent lower risk of death from all causes and a 45 percent lower risk of death from heart disease or stroke. Runners on average lived three years longer compared to non-runners. Also, to reduce mortality risk at a population level from a public health perspective, the authors concluded that promoting running is as important as preventing smoking, obesity or hypertension. The benefits were the same no matter how long, far, frequently or fast participants reported running. Benefits were also the same regardless of sex, age, body mass index, health conditions, smoking status or alcohol use.

The study showed that participants who ran less than 51 minutes, fewer than 6 miles, slower than 6 miles per hour, or only one to two times per week had a lower risk of dying compared to those who did not run. DC (Duck-chul) Lee, Ph.D., lead author of the study and an assistant professor in the Iowa State University Kinesiology Department in Ames, Iowa, said they found that runners who ran less than an hour per week have the same mortality benefits compared to runners who ran more than three hours per week. Thus, it is possible that the more may not be the better in relation to running and longevity.

Researchers also looked at running behavior patterns and found that those who persistently ran over a period of six years on average had the most significant benefits, with a 29 percent lower risk of death for any reason and 50 percent lower risk of death from heart disease or stroke.

“Since time is one of the strongest barriers to participate in physical activity, the study may motivate more people to start running and continue to run as an attainable health goal for mortality benefits,” Lee said. “Running may be a better exercise option than more moderate intensity exercises for healthy but sedentary people since it produces similar, if not greater, mortality benefits in five to 10 minutes compared to the 15 to 20 minutes per day of moderate intensity activity that many find too time consuming.”

The U.S. government recommends that American adults eat 5 to 13 servings of fruits and vegetables depending on your age, gender, and activity level, but a new Harvard School of Public Health study suggests we don’t get additional health benefits if we eat more than five servings a day.

After analyzing 16 studies involving 833,000 participants who filled out dietary surveys, the researchers from Harvard and China discovered that each daily serving of produce was associated with a five percent lower risk of dying from heart disease or cancer during the studies, which lasted up to 25 years. Eating five servings a day, for example, lowered the risk of dying by 25 percent — but so did eating six or seven servings, according to the results published Tuesday in the British Medical Journal.

“The reduction in mortality plateaued at five [servings] a day, and five a day is a good target to achieve maximum health benefits in reducing mortality,” said study coauthor Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health, via email from China.

Is there any harm to over-indulging on the kale, celery, and sliced strawberries?

Likely not, since the research didn’t find any negative health effects in those who ate six or more servings a day, according to Hu. What’s more, it couldn’t prove that eating five servings of produce a day actually prevented deaths, but rather found it was statistically associated with a lower mortality risk.

Still, it’s a smart move to “diversify plant-based foods,” Hu said, adding nuts, legumes, and whole grains to those salads. That will ensure that you get a wider range of nutrients, which often interact in the body to have a synergistic effect on disease prevention.

Source: Boston Globe

For the first time, updated results from the European Randomized Study of Screening for Prostate Cancer (ERSPC), the largest randomized prostate cancer screening trial in the world, show a significant survival advantage with prostate-specific antigen (PSA) screening for men from 50 to 74 years of age.

The new data come from a follow-up of 13 years, and were presented during a late-breaking abstract session here at the European Association of Urology 29th Annual Congress. An initial analysis of the ERSPC results, reported in 2009, provided the first proof that PSA screening saves lives from prostate cancer.

This update “offers the most robust data yet in support of the effectiveness of PSA-based early detection efforts to reduce prostate cancer metastases and mortality,” said Matthew Cooperberg, MD, MPH, associate professor of urology, epidemiology, and biostatistics at the University of California, San Francisco, who was asked by Medscape Medical News for comment.

According to Dr. Cooperberg, who was not involved in the research, the ERSPC, together with the Göteborg trial “provides the only contemporary insights on the question of benefits of early detection.”

He said that the screening study conducted in the United States — the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial — “is now broadly acknowledged only to address the question of annual vs opportunistic screening, given a screening rate of more than 75% in the usual care arm.”

The updated ERSPC results were presented by Jonas Hugosson, MD, professor of urology at the Sahlgrenska Academy, University of Gothenburg, in Sweden. He cautioned that screening with the PSA test “should not start too late,” emphasizing that the weight of screening benefits fall to men whose screening begins before the age of 60.

“In our data from the Göteborg Trial, the Swedish arm of ERSPC, we found a prostate cancer mortality reduction of 20% in men who started PSA screening after age 60, while men who started to screen before age 60 had a reduction of 50%,” Dr. Hugosson told Medscape Medical News.

The ERSPC, which began 20 years ago, was a randomized study of more than 180,000 men, only half of whom underwent regular PSA testing. Results from the 11-year follow-up of the ERSPC were published in 2012.

The gap between screened and unscreened groups is decreasing; the relative risk for prostate cancer between the screening and control groups at 9-year follow-up was 1.91, at 11-year follow-up was 1.66, and at a median of 13 years of follow-up was 1.57, Dr. Hugosson reported.

However, he noted, “we still have a 57% increased incidence of prostate cancer in the screening group, compared with the control group.”

This is one of the downsides of PSA screening — the risk for overdiagnosis of prostate cancer that might not affect the individual’s health in the time he has left to live. However, once it is detected, it might be treated, or at least followed with further screening.

The most recent update from the trial shows that the absolute difference in prostate cancer mortality per 1000 patient-years has increased from 9 years (0.31 vs 0.37) to 11 years (0.35 vs 0.46) to 13 years (0.43 vs 0.54). However, the difference in the relative risk for mortality has stabilized in favor of screening; it was 0.85 at 9 years, 0.78 at 11 years, and 0.79 at 13 years.

The number of men needed to invite for screening to prevent 1 prostate cancer death has decreased from 979 at 9 years and is 781 at 13 years. The number needed to diagnose to prevent 1 death has decreased from 35 at 9 years to 27 at 13 years.

As previously reported by this group, large differences between centers in prostate cancer mortality persist.

“For example, in Finland, our largest center has a 9% mortality reduction, whereas Sweden, our neighbor with the same kind of healthcare system, has more than a 4-fold better mortality reduction (38%),” he said. “The largest mortality reduction was seen in Spain (46%), but an increase in mortality was seen in Switzerland (–14%).

An initial analysis suggested that these differences in outcomes between centers stem from differences in screening protocols, such as rate of biopsy, median PSA per invited man, and duration of screening, which ranged from 4 to 10 years.

“It seems like the intensity of screening is very closely related to the effect of prostate cancer mortality reduction,” he said.

Dr. Cooperberg predicts that the benefits from PSA screening will increase with longer follow-up, and he noted that “for a man in his 50s, the relevant time horizon is 30 years or more, not 13 years.”

“The risk of overdiagnosis with screening is still, of course, very salient,” he explained. “The solution is to focus early detection efforts on the detection of high-risk prostate cancer, with broad implementation of active surveillance as the default strategy for low-risk disease.”

Dr. Cooperberg said he disagrees with efforts to stop or reduce PSA screening in healthy men. “A policy of discouraging all early detection efforts runs counter to the growing body of high-quality evidence, and puts thousands of men at risk of avoidable suffering and early mortality,” he said.

Referring to the 2012 recommendation from the US Preventive Services Task Force (USPSTF) against PSA screening for prostate cancer,he noted that “the USPSTF will update its evidence review in the near future to reflect the increasingly incontrovertible message of the ERSPC: that PSA-based early detection saves lives, period.”

Source: Medscape

Nut consumption has long been linked to healthy lifestyles. Now, a study in the New England Journal of Medicine extends the finding and demonstrates a strong association with improved mortality. Ying Bao and colleagues examined data from nearly 120,000 people enrolled in the Nurses’ Health Study and the Health Professionals Follow-up Study to assess the relationship of nut consumption and mortality. With over 3 million person-years of follow-up, the investigators found a strong inverse correlation between the frequency of nut consumption and mortality, after adjusting for other risk factors.

Read more at Forbes.