New Recommendations Suggest Women Need Fewer Pap Tests

For the second time this week, medical experts have issued revised guidelines for women’s cancer screenings. On Monday, the U.S. Preventive Services Task Force advised that women wait until age 50 to begin mammography screening, after which they should be checked every other year instead of annually as the previously established guidelines recommended. And on Friday, the American College of Obstetricians and Gynecologists (ACOG) issued revised guidelines for cervical cancer screening, recommending that women in the U.S. wait until age 21 to have their first Pap test and follow-up testing every two to three years depending on a woman’s age—revisions the ACOG says are based on studies that suggest earlier and more frequent testing causes more harm than good.

The Pap test has been used for more than 50 years to find changes in the cells of the cervix that could lead to cancer. Prior recommendations called for cervical cancer screening to begin three years after a woman became sexually active or by age 21, whichever came first, with annual follow-up testing. But under the new ACOG guidelines, women should get their first Pap test at age 21, regardless of the onset of intercourse, with re-testing once every two years until age 30. Women 30 and older who’ve had three consecutive negative tests and no abnormal history should be re-screened only once every three years. Guidelines for older women remain unchanged. After no abnormal Pap result for 10 years and three or more negative results consecutively, women can stop the test at age 65 or 70.

“We really felt that the downsides of more frequent screening outweighed any benefits,” said Dr. Alan G. Waxman, a professor of obstetrics and gynecology at the University of New Mexico, who drafted the new guidelines. “More testing is not always more intelligent testing.” Waxman explains that while the rate of infection with human papillomavirus (HPV), which can cause cervical cancer, is high in sexually active teens, the immune system of younger women typically clears HPV within one or two years. He added that recent research has shown that procedures to remove precancerous tissue weaken the cervix, increasing the risk of preterm birth.

Dr. Jennifer Milosavijevic, a specialist in obstetrics and gynecology at Henry Ford Health System in Detroit, supports the guideline changes. “Women do not get cervical cancer first. They acquire HPV, the sexually transmitted virus that causes precancerous abnormalities of the cervix and cervical cancer. It takes years to progress from an HPV-infection to full-blown cervical cancer,” Milosavijevic said. “These new guidelines will allow us to avoid doing unnecessary procedures on the sexually active adolescent female.”

Dr. Milosavijevic says changing the screening interval does not mean that more cervical cancers will be missed, adding that most women who die from cervical cancer were either screened infrequently or not at all. In fact, some doctors feel the new screening guidelines do not go far enough. “There is ample evidence that screening earlier than 25 years is only costly with many false positives,” said Dr. Diane Harper of the University of Missouri-Kansas, who specializes in HPV infections. “The rest of the world is going to an every-five-or-six-year screening interval ... and ACOG is now just endorsing the three-year interval for HPV negative and Pap negative (women).”

In the last 30 years, cervical cancer rates in the United States have dropped more than 50 percent, due largely to widespread use of the Pap test. Rates will probably drop even further due to newer vaccines like Gardasil, which are now approved for girls and women ages 9 to 26 for prevention of HPV. But ACOG says since the vaccines won’t affect cervical cancer rates for 15 to 20 years, they did not play a role in the new screening guidelines. And because such vaccines don’t protect against all types of HPV, Pap tests are and will still be necessary.

The American Cancer Society estimates that 11,270 new cases of cervical cancer will be diagnosed in the U.S. in 2009, and the disease will cause 4,070 deaths.

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About 100,000 Cancer Cases Each Year Due to Obesity

This year, an estimated 1.47 million Americans will be diagnosed with cancer, and more than 562,000 will die of it. Two major classes of factors influence the incidence of cancer: hereditary and environmental. Hereditary factors, such as inherited genetic mutations, come from our parents and account for about 5 percent of all cancers. Environmental factors, which include tobacco use, certain infectious agents, certain medical treatments, excessive sun exposure, and exposures to cancer-causing agents known as carcinogens that exist as pollutants in our air, food, water and soil, account for an estimated 75-80 percent of cancer cases and deaths. Obesity is also an environmental factor that is clearly associated with increased risk for developing many cancers, causing more than 100,000 cases of cancer in the U.S. each year, according to a recent study from researchers at the American Institute for Cancer Research (AICR).

Using findings from an AICR and World Cancer Research Fund report released earlier this year and the latest U.S. cancer incidence data, the researchers were able to calculate the exact percentage of specific cancers that are caused by excess body fat. Specifically, 49 percent of endometrial (uterine) cancers, approximately 20,700 cases, could be prevented if people maintained a healthy weight. That number is followed by 35 percent, or 5,800 cases, of esophageal cancer; 28 percent, or 11,900 cases, of pancreatic cancer; 24 percent, or 13,900 cases, of kidney cancer; 21 percent, or 2,000 cases, of gallbladder cancer; 17 percent, or 33,000 cases, of breast cancer; and 9 percent, or 13,200 cases, of colon cancer. “This is the first time that we’ve put real, quantifiable case numbers on obesity-related cancers,” said Glen Weldon, the American Institute for Cancer Research educational director.

“We now know that carrying excess body fat plays a central role in many of the most common cancers,” said Dr. Laurence Kolonel, Deputy Director of the Cancer Research Center of Hawaii and AICR/WCRF expert panel member. He explains that fatty tissue, also known as adipose tissue, produces hormones that could play a role in promoting cancer cells. For instance, fat cells produce estrogen, which is now known to be a factor in breast and endometrial cancer. Studies have also shown that being overweight reduces the effectiveness of the immune system. And Kolonel says not only does obesity increase the risk of cancer, it also makes treatment more difficult and has an adverse impact on survival.

Dr. Michael Thun, vice president emeritus at the American Cancer Society, said that while the new research “helps to communicate the magnitude of the problem, it does not propose potential solutions.” He says people who are concerned about this issue should try to balance the calories they take in every day with those their body expends.

The American Cancer Society’s most recent nutrition and physical activity guidelines, published in 2006, emphasize the importance of weight control, physical activity, and dietary patterns in reducing cancer risk. Because social environment is clearly a powerful influence on diet and activity habits, the guidelines include an explicit Recommendation for Community Action to promote the availability of healthy food choices and opportunities for physical activity in schools, workplaces, and communities.

Currently, nearly a third of Americans have a body mass index (BMI) of 25 to 30, which places them in the overweight category, and more than 26 percent are obese, defined as having a body mass index of 30 or higher. BMI is equal to weight in kilograms divided by height in meters squared. For example, a person who is 5 feet 5 inches tall becomes obese at 180 pounds.

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Seniors Can Enjoy Sex Into Their 80s

Yep, you heard it right. Today’s senior citizens are proving that you can enjoy sex well into your 80s. During a survey, published in The Journal of Sexual Medicine, conducted by the University of Chicago, men and women ranging in the ages of 57 to 85 were asked questions regarding their sexual activity over the past year. Based on the information gathered, it seems some men and women are enjoying their sex lives well into their later years.

Face-to-face interviews were conducted from mid-2005 to March 2006 involving 1,550 women and 1,455 men, in the privacy of their own homes. While around half of those evaluated admitted to having at least one disturbing sexual situation, around 68 percent of the men and 42 percent of the women said they had sex over the past year. During the survey, the researchers considered factors such as age, race, marriage status, and education levels. Participant’s physical and mental health, and their happiness or lack of with their relationship, were all considered risk factors for sex problems.

Participants were asking during the study some of their sexual problems they may have experienced. To help define participant’s sex problems, researchers defined several as a guide. They included lack of or lower sex drive, erection problems, vaginal dryness, problems with early orgasm or never reaching climax, pain during sex, lack of pleasure, and if they were worried about sexual performance. Each participant was asked how much the problems bothered them.

Urinary tract infections seem to be a key player in causing several of the problems both women and men experience with their sex lives, based on the study. Women seem to have more problems than men with sex, because of their tendency to have more urinary tract infections as well as STDs or sexually transmitted diseases. STD’s, lead to women being four times more likely to having sexual pains and three times as likely to have vaginal dryness. Men with STDs had five times the chances of having unpleasant side effects while having sex. Whether you are 18 and at your prime sexual peak or 80 and winding down, medication and illness can affect your desire to have sex, as well as your physical ability. Anxiety also seemed to be a key trouble maker for both groups.

Dr. Virginia Sadock, the director of the program for human sexuality at the New York University Langone Medical Center in New York City said, “It’s definitely whether you’re elderly or 'wellderly' that makes a difference” and “illness and medications make a difference in sex lives.”

Some people may think sex lives will eventually fizzle out, and they may. However, based on the new study, you may be physically and mentally able to enjoy your sex life well into your 80’s. There are some 80 year olds in better health than those at 60. Sex lives can be squed by ones physical and mental well being as well as factors such as weight, habits like smoking or drinking, health issues and medications that may hinder ones ability to enjoy sex. Edward Leumann, the lead author of the survey, a professor of sociology at the University of Chicago, stated “It’s not age per se; that when you get to 80 it’s all over with.”

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Sexy High-Heeled Shoes Can Be a Pain in the Foot

Ladies may feel and look great in high-heeled shoes, but their feet may not feel quite so happy. Many women forgo comfort for that little extra sexy appeal of high-heeled shoes and, even if you find heals more comfortable than flats, they are rarely the best option for your feet.

A newly released study illustrates that those people who wore or wear high-heeled shoes, or less supportive shoes, were much more likely to experience hind foot pain, a pain found around the heel of a person’s foot. While there have been previous studies that have demonstrated links between the type of shoe a person chose to wear and foot pain, most of the previous studies were very small and honed in on one specific foot problem, according to researchers leading the new study. The new study, recently released in Arthritis Care & Research, illustrated that people who wore or wear unsupportive footwear such as sandals, high heals, or slippers are more likely to suffer from foot pain later in life. The study found that even though a shoe may feel comfortable now, if the shoe is not supportive, there could be consequences later in life.

The study, headed by lead author Alyssa B. Dufour, with the Institute for Aging Research of Hebrew SeniorLife, investigated over 3,300 foot examination records of men and women that participated in the Framingham Study, started in 1948. The study found that nearly 64 percent either of women who reportedly had worn high heels, pumps or sandals regularly at some time during their lives, had experienced hind foot pain. While there were 19 percent of the men and 29 percent of the women that experienced some sort of foot pain, researchers were unable to link the men’s issues to a shoe support problem, mainly because only two percent wore shoes deemed bad shoes.

For the study, researchers classified shoes in three groups: a good shoe, such as sneakers; an average shoe, including work boots or rubber-soled shoes; and poor shoes, those that lack support, such as high heels, sandals and slippers. Participants involved in the study answered questions as to where their foot pain was experienced and if the pain was in one or both feet. They were asked questions in regards to the types of shoes that were worn at different stages in their lives. The stages were broken down by ages including 20-29, 30-44, 45-64, 65-74, and over 75. Women who reportedly wore good shoes compared to those that wore average shoes in their pasts, were 67 percent less likely to report heal pain.

According to Dufour, foot and toe symptoms are one of the top 20 reasons adults from 65 to 75 years old see a physician. While we all want to look our best, we need to consider the consequences of what we put on our feet, not only presently, but also in our future. Based on the new research, there is definitely a benefit to wearing more supportive footwear. Ladies, while this study focused on foot pain there are other side affects of high-heels, including causing the toes to taper inward and can lead to calf muscles being smaller. Rethink wearing those unsupportive shoes regularly, and opt for the more comfortable supportive shoes. It just may save you several trips to the doctor down the line and agonizing pain.

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WHO Report Identifies Disparities in Women’s Health Treatment

Clearly, women are different than men; not only in anatomy but in the way they think, express emotion, and interact. Men and women are also different in matters of sickness and health. For example, each of the sexes displays different symptoms of heart attack. Chest pain is most common in men, while women’s symptoms are usually subtler, characterized by abdominal pain, nausea, and fatigue. Men and women also absorb and excrete some drugs in different ways and at different rates, and certain drugs are more effective in women while others have more severe side effects in women than in men. But still, the idea of equating women and men’s health persists, simplifying women’s health treatment to the point of triggering dangerous consequences.

The World Health Organization (WHO) says that despite the fact that women provide the bulk of health care, whether in the home, the community or the health system, they are being “denied a chance to develop their full human potential” because many of their critical medical needs are ignored. The agency’s latest report entitled “Women and health: today’s evidence tomorrow’s agenda” attempts to emphasize the unequal health treatment women face throughout their lifetime. “What this report has measured is the profound impact that social status has on the health of women and girls,” said Margaret Chan, WHO’s Director-General. “As the report reveals, the obstacles that stand in the way of better health for women are not primarily technical or medical in nature; they are social and political, and the two go together.”

According to the report, even though women live six to eight years longer than men they tend to “receive poorer quality care throughout their lives, particularly as teenagers and elderly people.” Globally, HIV, pregnancy-related conditions, and tuberculosis continue to be major killers of women aged 15 to 45. In many countries, sexual and reproductive health services tend to focus exclusively on married women and ignore the needs of adolescents and unmarried women. Service can also be very difficult to access for other marginalized groups of women such as sex workers, intravenous drug users, ethnic minorities and rural women.

As women age, noncommunicable diseases, such as heart attack and stroke, become the major causes of death and disability, particularly after the age of 45. Women tend to develop heart disease later in life than men, and because they show different symptoms from men, cardiovascular disease is often undiagnosed in women. Other major problems in older age, often untreated, include poor vision, hearing loss, arthritis, depression and dementia.

The report also compares the health of women with different socio-economic status. Lack of access to education, decision-making positions and income may limit women’s ability to protect their own health and that of their families. For example, the risk posed by HIV is compounded in cultures that limit women’s knowledge about the disease and their ability to negotiate safer sex. Another main cause of death among girls aged 15 to 19 in developing countries is pregnancy-related complications, with unsafe abortions accounting for a large number of such deaths. Low-income nations also have minimal screening and treatment services for cervical cancer, the second-most common type of cancer in women. “Women who do not know how to protect themselves from such infections, or who are unable to do so, face increased risks of death or illness,” the report said. “So do those who cannot protect themselves from unwanted pregnancy or control their fertility because of lack of access to contraception.”

The report calls for reform, both within and outside the health sector, to better meet the needs of women. But Dr. Chan says we will not see significant progress as long as women are regarded as “second-class citizens” in many parts of the world. “In so many societies, men exercise political, social and economic control,” she said. “The health sector has to be concerned. These unequal power relations translate into unequal access to health care and unequal control over health resources.”

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Cancer Patients with Dense Breasts Face Greater Risk of Disease Recurrence

Women who have dense breasts, and undergo lumpectomies for the treatment of breast cancer, are at a greater risk of a recurrence of the disease. In fact, breast cancer patients with more dense breasts are four times as likely to have their cancer return than women with less dense breasts.

The new information comes from research performed by Steven A. Narod, M.D., of the Women's College Hospital in Toronto, and colleagues. According to Dr Narod, “The composition of the breast tissue surrounding the breast cancer is important in predicting whether or not a breast cancer will return after surgery.” The study report can be found in the journal Cancer.

The researchers analyzed data on 335 breast cancer patients having an average age of 63.5 years, who had undergone lumpectomies for the removal of cancerous tumors from their breasts. Findings revealed that for women having more dense breasts, the risk of the cancer recurring over 10 years was more than four times higher at 21 percent than the 5 percent average. In addition, women who did not receive radiation as part of their initial treatment faced an even higher risk (40 percent) of a tumor recurrence that puts them at an 8 times greater likelihood of developing the disease again.

With the use of mammography, about one in three of the women in the study were found to have large amounts of dense tissue in their breasts. Breast density was discovered to be higher among the younger women in the study, and these women were less likely to be postmenopausal than the others. Of the total number of women in the study, 99 had low-density breasts with dense tissue in less than 25 percent of the breast, 107 had intermediate density in 25 percent to 50 percent of the breast, while 129 women had high-density breasts with more than 50 percent density.

Although it is not known why the density of a woman’s breast has an impact on the risk of developing cancer, it is known that high breast density can reduce the sensitivity of a mammogram by causing a masking effect. In addition, it is the belief of the researchers that the hormonal profile of denser breast tissue makes it more susceptible to cancer. Although Dr Narod noted that breast density has been found to be modifiable to some extent by physical activity and hormone therapy, the researchers cautioned that it is not clear whether these measures would impact the risk of breast cancer recurrence.

Due to this significant increase in risk for cancer recurrence, the researchers maintain that women having more dense breasts should undergo additional treatment after surgery to decrease the chances of the cancer returning. On the other hand, since radiation therapy appeared to eliminate the increased risk for cancer recurrence, they also acknowledged that the findings are an indication that women with low-density breasts may be able to safely avoid radiation. However, they also cautioned that because the study was small, further research will be necessary determine if this is the case.

According to The American Cancer Society an estimated 192,370 new cases of invasive breast cancer will be diagnosed in 2009, and of these 40,170 lives will be lost. Breast cancer is the most common cancer among women in the United States, other than skin cancer. It is also the second leading cause of cancer death among women, after lung cancer. About 1 in 8 women will develop breast cancer at some time during life, and about 1 in 35 will lose the battle against the disease.

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Staying Healthy: Healthy Habits for Men

Juggling jobs, relationships, social obligations, bills, and staying on top of a healthy gym routine is a lot to handle. As a woman, trying to find the time to eat better seems to be the last thing on my list and it can’t be much easier for men. Here are a few tips for making men’s lives a little bit better from morning to night:

Eat Breakfast
Eating breakfast everyday keeps your metabolism in check, your weight down, and your cravings at bay. Filling up on fiber early on keeps you satisfied throughout the day. Dr. Oz recommends oatmeal with dried fruits, nuts, and his own personal touch…flaxseed oil.

Work through Pain
Sometimes taking the load off of a sore back, neck, or legs is worse for you than if you work through the pain. Experts suggest that nursing your pain isn’t always the best course of action because resting can weaken your muscles and you may lose strength over time. If you haven’t pulled any muscles or slipped any discs, take an anti-inflammatory pain reliever and stay on your feet.

Snack like a Squirrel
You don’t have to hoard nuts for the winter, but grabbing a handful during the middle of the day can actually keep you healthier than eating a bag of chips or waiting until dinner to satisfy your food cravings. Full of omega-3 fatty acids, these are the type of proteins we look for in our diets from fish, also known as good fats.

Sweat is Your Friend
While walking to the office or public transit is eco-friendly and cost efficient, chances are you don’t get the full cardio effect until you do your time on the treadmill. Sweat away your toxins and reduce your blood pressure and risk of heart attack by switching up your routine; the wetter the better. Tacking on weight training makes your body work harder to bulk up and lose any extra pounds that may be damaging to your frame. Aside from looking better to your partner, you may feel better and be able to get more sleep, more on that later. For more stamina, find a workout buddy!

Be Friendly
When men get stressed, they often clam up and don’t tend to talk about their problems. Women, on the other hand, can usually tell a story until their lips bleed. With more stress in the world than ever, it’s no wonder your body may not be feeling up to par. Grab a beer—or your partner—and tell them what’s on your mind, sharing may just save your life or keep the stress away.

Save for a Rainy Day
Like the harmful stressors everyone puts upon themselves at any moment, a lot of these have to deal with financial woes. If you are able, sock away some of your paycheck every month to save for a rainy day or an emergency by investing some of that worth in a separate savings account you can run to if you need to, but put your own limits on how you are allowed to spend it. Down the road, merely thinking about how to spend that extra cushion you set aside can make even the gloomiest day perk up a bit.

Go Between
We have all been conditioned to learn that brushing your teeth two times a day is the normal but in order to keep your oral health at its best, go deeper with floss. Your best bet is to floss before bedtime to clean the bacteria from the hard to reach spots in your mouth so it doesn’t grow into a problem overnight.

Sleep like a Baby
If you are a parent, you understand the importance of getting a child to go to bed at a certain time every night in order to keep their mind and body stable and free from grouchiness. You should treat your sleeping patterns the same way. Set a bed time and keep it—at least during the work week—and get at least seven hours of sleep. Professionals advise that sleeping regularly can stave off calories and stress because being groggy can incur bad decisions like eating greasy food or sucking down your usual morning coffee in half the time.

Maintaining Healthy Cholesterol Levels May Lower Risk of Prostate Cancer

Men who keep their cholesterol levels in check may decrease their chances of developing prostate cancer, in addition to keeping their heart healthy, as science has already shown. In fact, two recent studies indicate that maintaining healthy levels of cholesterol may be a good form of cancer prevention.

In one study, results showed that men who retained healthy levels of cholesterol in the range below 200 actually cut their risk of developing high-risk prostate tumors by more than 50 percent in comparison to men with high ranging cholesterol levels. In the second study, findings showed that men with high levels of good (HDL) cholesterol were slightly less likely to develop prostate cancer in any form, compared to men with very low HDL cholesterol levels.

The studies were recently published in the journal of the American Association for Cancer Research called Cancer Epidemiology Biomarkers & Prevention. Both studies support prior research indicating that by limiting fats in the bloodstream, the risk of cancer can be lowered.

According to Elizabeth Platz of Johns Hopkins University who led the first study, “There might be this added benefit to keeping cholesterol low.” For the study, Platz’s team analyzed data of 5,586 men aged 55 and older that came from the Prostate Cancer Prevention Trial conducted back in the 1990s. All of these men had been a part of the placebo group during the trial.

Among the group, a total of 60 of the men developed high-risk, aggressive tumors that are known to grow and spread quickly. By comparing cholesterol levels of all the men in the group, it was revealed that those men with cholesterol levels under 200 had a 59 percent less chance of developing one of these high-risk tumors than those men having high levels of cholesterol.

Platz acknowledged that cholesterol levels had no significant effect on the overall incidence of prostate cancer in the study. However, she pointed out that the association between low cholesterol levels and a reduced incidence of aggressive disease “is a notable reduction which is not often seen for prostate cancer.”

Although the decrease in risk is highly significant, it must be noted that the researchers could not account for the number of men in the study who were taking cholesterol-lowering medications such as statin drugs, which include such name brands as Lipitor, Zocor, and Crestor. Therefore, some of the reduction in risk may have been due to the use of such drugs rather than from generally having low cholesterol levels.

The results of the second study are based on data gathered over 18 years from following more than 29,000 Finnish men who were taking various vitamins and nutrients to test whether or not they could lower their risk for cancer. All of the participants in the study were smokers. According to study leader Dr. Demetrius Albanes of the National Cancer Institute, findings showed that those men having the highest levels of HDL cholesterol were 11 percent less likely to develop prostate cancer than those with lowest levels.

In a statement, Albanes said, “Our study affirms that lower total cholesterol may be caused by undiagnosed cancer.” He then added, “In terms of a public health message, we found that higher levels of good cholesterol seem to be protective for all cancers.”

Researchers from both studies agree that further research is necessary to confirm findings, as well as to identify the molecular mechanisms behind the association.

In the United States, prostate cancer is the most common cancer among men. It is estimated that over 192,000 new cases will develop this year alone, and of those, the disease will claim 27,360 lives.