JAMA Publishes Several Women's Health-Related Studies

The Journal of the American Medical Association in its July 12 edition published several women's health-related studies. Summaries appear below.
Breast cancer: A. Heather Eliassen of Brigham and Women's Hospital in Boston and colleagues analyzed the relationship between a change in weight after menopause and breast cancer risk (Reuters Health, 7/11). The 87,143 women in the study, who were followed for 26 years, were between ages 30 and 55 and were cancer-free at the beginning of the study. Weight change since menopause was studied among 49,514 of the women, who were followed for 24 years (Eliassen et al., JAMA, 7/12). The study, which is the first to examine the effects of losing weight after menopause, finds that if overweight women lose at least 22 pounds, they can decrease by about 40% their risk of developing breast cancer. If for at least four years they maintain that weight, they reduce by 60% their risk of developing the disease (Cline, Los Angeles Times, 7/12). In addition, the study finds that women who gain more than 55 pounds after age 18 increase by 45% their risk of developing breast cancer (BBC News, 7/12). Among those women, those who did not use hormone replacement therapy increased by 98% their risk of breast cancer, and those who did use HRT increased by 20% their risk of developing the disease, according to the study. The researchers also found that gaining 22 or more pounds after menopause increased by about 20% the risk of developing breast cancer (Los Angeles Times, 7/12). The authors wrote, "These data suggest that weight gain during adult life, specifically since menopause, increases the risk of breast cancer among postmenopausal women, whereas weight loss after menopause is associated with a decreased risk of breast cancer." Therefore, in conjunction with the other known benefits of maintaining a "healthy weight, our results provide another reason for women approaching menopause to maintain or lose weight as appropriate," the authors wrote (JAMA, 7/12).

Fallopian, ovarian, primary peritoneal cancer: Amy Finch from the Centre for Research in Women's Health at Toronto Sunnybrook Regional Cancer Centre in Toronto and colleagues from 1999 to 2003 examined 1,828 women with the BRCA1 or BRCA2 mutation at one of 32 centers in Canada, Europe, Israel and the U.S. to determine the reduction of fallopian tube, ovarian and primary peritoneal cancer prevalence among women who have had surgery to remove the ovaries and fallopian tubes (Finch et al., JAMA, 7/12). BRCA 1 and BRCA2 mutations are believed to increase the chance of developing breast and ovarian cancers (Kaiser Daily Women's Health Policy Report, 6/30). The researchers estimated that with the ovaries and fallopian tubes intact, women with BRCA1 mutations carry a 62% risk of developing ovarian cancer, and women with BRCA2 mutations carry an 18% risk of developing the cancer (McCullough, Philadelphia Inquirer, 7/12). The study finds that with preventive removal of the ovaries or fallopian tubes, a woman with the mutations reduces by 80% her risk of developing either cancer. Steven Narod, a researcher involved in the study, said the current recommendation, which says women between ages 35 and 40 with the mutations should undergo a procedure that removes the ovaries and fallopian tubes, will remain a standard practice (Picard, Globe and Mail, 7/12). According to the Inquirer, the study did not assess the impact of the surgery on breast cancer risk (Philadelphia Inquirer, 7/12).

Lung cancer and gender: Claudia Henschke, chief of chest imaging at New York Presbyterian Hospital-Weill Cornell Medical Center, and colleagues screened 7,498 women and 9,427 men age 40 and older, all of whom had a history of cigarette smoking (Henschke et al., JAMA, 7/12). The study finds that 2.1% of the women developed lung cancer, compared with 1.2% of the men. Henschke said she thinks genetics might be a factor in the observed differences but added that hormonal differences could be involved. In addition, the study finds that women with lung cancer have a lower mortality rate than men with the disease (Chang, Long Island Newsday, 7/12). Alfred Neugent and Judith Jacobson of Columbia University in a related editorial write, "An effort to understand the tumor and host factors that underlie the female survival advantage in lung cancer could potentially yield major benefits for the treatment of both sexes" (Neugent/Jacobson, JAMA, 7/12).














NBC's "Nightly News" on Tuesday reported on the study. The segment includes comments from Henschke and U.S. women who have quit or are trying to quit smoking (Bazell, "Nightly News," NBC, 7/11). A transcript and audio of the segment in Windows Media are available