US Pharm. 2006;1:22.
High Insulin Increases Risk of Pancreatic Cancer
Male smokers with higher insulin levels have double the risk of pancreatic cancer than do men with the lowest levels. This link was found in a recent study published in JAMA (2005;294:2872-2878).
Although diabetes has a proven association with increased pancreatic cancer risk, insulin concentration has not been fully examined as a predictor of this disease. Studying male Finnish smokers ages 50 to 69 years, researchers compared 400 randomly sampled control subjects to 169 pancreatic cancer cases occurring after five years. Led by researchers from the National Cancer Institute (NCI), the study involved a follow-up of about 17 years, and cases of pancreatic cancer were identified from the Finnish Cancer Registry.
Increasing concentrations of glucose, insulin, and insulin resistance were associated with pancreatic cancer after adjusting for age, smoking, and body mass index. Comparing men with the highest quartile of fasting serum insulin levels to those with the lowest, the study showed a twofold increased risk of diabetes and insulin concentration. Associations were stronger among cases that occurred over 10 years after baseline. Therefore, these results support the theory that insulin is a growth promoter for pancreatic cancer.
File Compression Improves Accuracy of Mammograms
Using image compression, radiologists may be able to interpret digitized mammograms more accurately, according to research published in Radiology (2006;238[1]).
Since electronic mammogram images are very large, hindering transmission over telephone lines, the study tested the accuracy of a wavelet-based compression method for digital mammography. Compression discards most of the original data; however, important diagnostic features remain intact. Researchers applied a well-tested algorithm to 500 normal and abnormal mammograms from 278 patients ages 32 to 85 with proven cancer. Original and compressed reconstructed images were analyzed by experienced radiologists.
Compression rates of 14:1 to 2,051:1 were achieved, based on parenchymal density and breast structure. With the compressed mammograms, the localization accuracy index increased an average of 6% (0.04 of 0.67). Localization performance differences were statistically significant (P = .05). Thus, the compression method was proven as an accurate diagnostic approach, enabling the transmission of a complete mammographic screening from remote areas to medical centers via phone lines.
Novartis Releases Once-Daily Iron Chelator
Exjade (deferasirox) Tablets for Oral Suspension are now available from Novartis for the treatment of patients ages two years and older with transfusion-related iron overload. The company also releases the EPASS (Exjade Patient Assistance and Support Services) system for patients undergoing chelation therapy. This system involves access to the drug, patient education, and support relating to reimbursement coverage. With EPASS, Exjade is available through a single point of contact with specially trained pharmacists for prescription delivery, and reimbursement specialists help identify coverage options.
Chest X-Rays Help Detect Early Lung Cancer
Although screening for lung cancer with chest x-rays can detect early-stage lung cancer, many false-negative results were reported, according to data published in the Journal of the National Cancer Institute (2005;97:1832-1839).
The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, a NCI study started in 1992, sought to evaluate cause-specific mortality reduction from screening for these four cancers. A total of 154,942 men and women ages 55 to 74 with no history of PLCO cancers were enrolled. Authors analyzed the single-view and posterior-anterior chest x-rays of 77,465 subjects who were randomly assigned to the intervention arm. Participants included current smokers, former smokers, and nonsmokers.
The initial x-ray screening produced 5,991 radiographs considered suspicious of lung cancer (8.2% for women, 9.6% for men). Older age groups and smokers had the highest rates. Of subjects with a positive screening, 206 had a biopsy, and 126 (59 men, 67 women) were diagnosed with lung cancer within 12 months of the screening. Among cancers detected, 44% were stage I. However, the positive predictive value was low (2.1%), indicating a significant number of false-positive results.
--Jessica Jannicelli
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