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Cervical Cancer vaccine doesn't rule out the need for screening

May 2007 Women's Health Update

Gardasil, the new Cervical cancer vaccineThe new cervical cancer vaccine has taken the world by storm. Jesse Solomon looks at cervical cancer in New Zealand and the implications of the vaccine for New Zealand women. Cervical Screening has had a dramatic impact on the incidence of cervical cancer and cervical cancer mortality in developed countries including New Zealand. The New Zealand screening programme started in 1991 and now achieves around 75% coverage of eligible women. However, this is significantly lower amongst some groups including Maori women at 55%...

Cervical Screening is availible to all women in New Zealand and women can be screened by their GP, Family Planning or sexual health clinic. Cervical Cancer Screening is the single most effective intervention against cervical cancer...

A vaccine for some types of HPV has been approved for use in New Zealand...Concerns have been raised about some safety aspects of the vaccine, including the aluminium content and its long term neurological effects. The FDA in the United States have required Merck (the makers of Guardasil) to undertake further trials for safty amongst younger girls as the studies so far have not included many girls....Read More

HRT and lung cancer survival

June 2006 Women's Health Watch

Further risks associated with hormone replacement therapy. A US study of 500 women with lung cancer found that women who had taken HRT had worse survival rates than women who had never taken HRT. The women with a history of HRT use (took HRT for at least 6 weeks) had an average survival rate of 39 months compared to 79 months for women with no HRT history. The differences in survival rates were even more pronounced for women who smoked and used HRT. The study concludes that this difference suggests a possible interaction between estrogens and the carcinogens present in cigarette smoke.
Ganti, A.P. et al. (2006) Hormone Replacement Therapy is associated with decreased survival in women with lung cancer. Journal of Clinical Oncology. Early online publication. November 28, 2005

Silent epidemics strike at heart of womens health

January 2004 Women's Health Update

Gill Sanson recently attended a Green Party forum in Wellington hosted and organised by MP Sue Kedgeley on 'Silent Epidemics: Breast Cancer, Endometriosis and Chemical Sensitivity'. Gill reports on the blunt and troubling message delivered by the expert speakers.
Evidence is growing that New Zealand's relatively high levels of persistent organic pollutants (POPs) namely dioxins, PCBs, DDT, 24-D, DES, delivered to us via fuel emissions, incineration, household products, pesticides, cosmetics, glues, chemical sunscreens, plastic food containers and so on, are linked to endometriosis, breast and uterine cancers, heart disease, migraine, severe PMS, chronic fatigue syndrome, fibrocystic breast disease, fibroids and infertility....Read More

Cancer Control Strategy launched

October 2003

The New Zealand Cancer Control Strategy was launched in August this year. The Cancer Control Strategy was the work of a partnership which included the Cancer Control Trust (a coalition of NGOs led by the Cancer Society of NZ and the Child Cancer Foundation) and government in the form of the Ministry of Health. In 2001 the Cancer Control Steering Group was formed to oversee the development of a Cancer Control Strategy and five working groups established priorities within defined areas and reported back to the Steering Group. After public consultation involving forums and written submissions the Cancer Control Strategy was launched. The strategy aims to reduce the incidence and impact of cancer and address the inequalities that emerge in relation to it.
There are six goals which each have a defined set of objectives. Each of the 25 objectives defines broad areas of action in relation to moving towards the goals....Read More

HRT & Ovarian cancer

September 2002 Women's Health Watch

In the same issue of JAMA that reported on the WHI study, researchers reported that women using oestrogen-only HRT had an increased risk of ovarian cancer, particularly if it was used for 10 or more years. In women who used it for 10 or more years the risk of developing ovarian cancer increased by 50% from 4 per 10,000 in women not using HRT to 6 per 10,000 women taking oestrogen.

HRT & Gallbladder cancer

September 2002 Women's Health Watch

An Italian case-control study has found the first direct epidemiological evidence of an association between hormone replacement therapy (HRT) in menopause and an increased risk of gallbladder cancer. Subjects included 31 women between 45 and 79 with gallbladder cancer and 3,702 age-matched controls. The odds ratio for gallbladder cancer was 3.2 for women who had ever used HRT, and it tended to increase with longer use.

Cancer Control Strategy for New Zealand

June 2002 Women's Health Watch

Penny St John looks at progress towards a cancer control strategy for New Zealand after research showing that our mortality rates for breast, lung and colorectal cancer are high compared with Australia.
Public consultation on the draft national Cancer Control Strategy is expected to begin later this year, and it is hoped the final strategy will be launched in February 2003.
The need for a strategy is gathering urgency as new research shows New Zealand is lagging behind Australia in reducing the number of deaths caused by cancer. Results of the study by University of Otago epidemiologist Professor David Skegg and Dr Margaret McCredie released in the New Zealand Medical Journal (May 10) show there is a greater chance of dying from cancer in New Zealand than Australia.
If Australian rates were applied in New Zealand, about 200 fewer men and 600 fewer women would be dying from cancer each year, according to the study. The research found higher rates for colorectal cancer in both males and females and for lung and breast cancer in females. Professor Skegg says in comparison with Australia and other countries, New Zealand has lost ground in the control of cancer over recent decades. New Zealand women have one of the highest mortality rates from cancer in the world, according to the article. Whereas the incidence rates of breast cancer are similar in the two countries, New Zealand women have a mortality rate that is 28 percent higher than in Australia....Read More

National cancer control strategy

October 1999 Women's Health Update

Complete unanimity was reached on the need for a national cancer control strategy at a recent workshop in Wellington, despite the diversity of participants. Professional and consumer groups came from all over New Zealand to the workshop, held in Wellington in August.

At present New Zealand has one of the highest incidences in the world for a number of cancers and the rate is projected to rise, yet it lags behind comparable countries in having failed to establish a strategic and systematic approach to reducing the cancer burden. The lack of a national strategy has also resulted in variable access too cancer services throughout the country and ad hoc decision-making....Read More

No increase in cancer for pill users

September 1999 Women's Health Watch

A large international study has concluded there is no long-term increase in the risk of breast cancer for former Pill users. The Imperial Cancer Research Fund's Cancer Epidemiology Unit gathered detailed information on 53,000 women with breast cancer and 100,000 women without breast cancer from 54 international studies....Read More

Little evidence magnetic fields cause cancer

September 1999 Women's Health Watch

Two reports released in June conclude there is very weak evidence showing a link between exposure to electric and magnetic fields and cancer and other diseases. A US National Institute of Environmental Health Sciences report concludes there is only marginal scientific evidence showing exposure to magnetic fields causes harm. The NIEHS report says the strongest evidence for health effects from electro magnetic fields comes from associations with childhood leukaemia and chronic lymphocytic leukaemia in occupationally exposed workers. However it says the associations are weak and cannot be backed up in laboratory research. In another study University of Toronto researchers conclude their findings do not support an association between leukaemia in children and proximity to high current configuration power lines.
Ref: Lancet 1999; 353: 2217

Cancer survival related to socioeconomic class

July 1999 Women's Health Watch

A recent UK report found that can-cer survival rates among 44 of 47 types of cancers studied were lowest among the most deprived patients. For 16 cancer sites the difference in survival was 5% between the most affluent and least affluent, and for four cancers (chronic lymphatic leukaemia, oral cavity, oropharynx and tongue) the difference was greater than 10%. For breast cancer, the fig-ure is 7% of the deaths that occur within the first five years.

The authors say that the difference cannot be put down to chance or ex-tent of the disease at the time of di-agnosis. 'The underlying mecha-nisms are complex and are likely to be difficult to address.'
Ref: Lancet 1999, 353: 1379-80

Cancer rates - Women

April 1998 Women's Health Watch

Number of deaths
Death rate per mill in pop
93
94
95
93
94
95
Breast
584
567
638
333
328
354
Cervix
80
77
96
46
45
53
Ovary
188
172
175
107
99
97
Uterus
58
52
61
33
30
34

Ref: New Zealand Health Information Service

Melanoma is third most common cancer in women

January 1999 Women's Health Watch

There are around 1600 new cases of melanoma each year. The incidence rates of melanoma in men and women, though the same overall, vary with age, probably reflecting the different sun exposure patterns of the sexes. From age 15 up to 50, rates are higher in women, while from 55 on, they are substantially higher in men.

In women the most common site for melanomas is the lower leg, while for men they are most likely on the trunk area. Melanoma is the third most common cancer in women, after breast and colorectal cancer and the fourth most common in men.

Most melanoma cases could be prevented by limiting life-long sun exposure, or cured by early detection and simple surgical excision. Women, probably because they are more likely to take action when they find a suspicious spot, are less likely than men to die from melanoma. Women account for about 85 of the 200 deaths each year.

Palliative chemotherapy - more harm than good?

December 1998 Women's Health Watch

Only a quarter of patients feel better after having palliative chemotherapy for advanced breast cancer, according to a study reported in the British Medical Journal.

'When I first went on to the oncology wards I found it staggering that patients had their tumours measured to assess shrinkage from chemotherapy but no one was asking them if they actually felt better', says researcher Amanda Ramirez, professor of liaison psychiatry at Guy's, King's College and St Thomas Medical School....Read More

Promoting pale

January 1999 Women's Health Watch

New Zealand women are heading message about the dangers of the sun, but only slowly, says Belinda McLean of the Cancer Society.

'Hey, I'm going to die some day, so what?', 'My daughter sees the beach and thinks "cover up" ; I think "slip off"', 'Nothing you say will make me stop tanning'; these were some of the comments showing a deep dedication to tanning by women taking part in recent Cancer Society research.

Women say they believe that a tan makes them look slimmer, sexier, healthier and enables them to wear revealing clothes. A tan makes the body look more 'toned' and is 'camouflage' for perceived defects like varicose veins....Read More

Infertility drugs and ovarian cancer

December 1998 Women's Health Watch

A new study has failed to confirm an association between ovarian cancer and drugs used to stimulate ovulation during infertility treatment.

Researchers at Australia's Monash University studied more than l0,000 women who underwent in vitro fertilisation treatment 1978, and 1992. Just over half the women studied used at least one cycle of ovarian-stimulating drugs and the other group did not. Researcher say there was no difference in the incidence of ovarian cancer in the two groups with three cases of invasive ovarian cancer occurring in each group....Read More

Electromagnetic fields and cancer

September 1998 Women's Healt Watch

Electromagnetic fields, such as those surrounding electric power, should be regarded as a possible human carcinogen, according to a report by the US National Institute of Environmental Health Sciences working group.

The group of scientists and industry experts have been reviewing the scientific evidence about electromagnetic fields and voted 19-9 in support of the report.

The group's report does not suggest the risk is high, especially compared to many other public health risks. However chairman Michael Gallo says he believes more research is needed to reduce uncertainties about electromagnetic fields.

The working group found no connection between electromagnetic fields and Alzheimer's disease, depression or birth defects, and no increased risk of abortion caused by video display terminals.

In 1979 Colorado researchers found an association between a group of children who had died of leukaemia and their residential proximity of high current distribution lines. Since then numerous studies have looked for similar associations, but with inconsistent findings.

The Director of Institute of Environmental Health Science will hold a two month consultation period before making a recommendation to Congress.
Ref: BMJ 1998; 317:12

Smoking passes carcinogens to foetus

November 1998 Women's Health Update

Researchers have discovered that NNK, one of the strongest carcinogens in tobacco smoke, is passed to the foetus when a pregnant woman smokes. NNK is a chemical derived from nicotine and is unique to tobacco. Stephen Hecht of the University of Minnesota's Cancer Centre made the discovery when he analysed the first urine of babies born to mothers who had smoked during pregnancy. The substance was not found in samples taken from babies of mothers who had not smoked. The levels of NNK found were 10% of that found in the urine of adult smokers...Read More

Encouraging results with Taxol

July 1998 Women's Health Watch

Taxol has been in the news lately after a Waiheke Island woman Jacqui Barrington went public about her inability to get the drug as treatment for ovarian cancer. We wrote to North Health and to the Ministers of Health and Women's Affairs, requesting them to a make this drug available for women in whom other treatment had been ineffective.

Part of the reluctance to fund Taxol has been mixed reports about its effectiveness. Now a new trial has shown encouraging results for women treated a with Taxol. Dr Martine Piccart, co-ordinator of the Inter-Group Study, reported at the annual meeting of the American Society of Clinical Oncologists in May that trials in Canada and Europe had confirmed earlier results from the US Gynaecologic Oncology Group (COG111) reported in the New England J of Medicine in 1996.

The Inter-Group Study compared treatment with Taxol-cisplatin with cisplatin-cyclophosphamide. The study showed that women given the Taxol combination experienced a progression-free period of 16.6 months compared with 12 months for those receiving the second combination. The COG-111 results were hailed as the first notable improvement for patients with advanced ovarian cancer for 15 years.

Vitamin K for babies still a poser

January 1998 Women's Health Update

Four new papers in the British Medical Journal fail to answer the question of whether the adminstration of intramuscular vitamin K to babies increases the risk of childhood leukaemia. In the early 1990s work at Bristol University raised this possibility and several teams of researchers set out to resolve the controversy....Read More

Endometrial cancer and HRT

April 1997 Women's Health Watch

While it is well known that unopposed oestrogen increases the risk of cancer of the endometrium in postmenopausal women, it has long been claimed that the addition of progestogen for around 13 days cancels the risk. It has also often been claimed that women on combined HRT have a lower risk of this cancer than women not using HRT at all.

But a new study contradicts this. It found that long-term users of combined therapy does have an increased risk, although the finding needs to be confirmed. The increased risk was less than that found with unopposed oestrogen...Read More

Hormone replacement therapy and endometrial carcinoma: are current regimes safe?

October 1997 Women's Health Update

Recent studies have thrown doubt on the conventional wisdom that progestogen cancels the risk of endometrial cancer in hormone replacement therapy. Dr Cindy Farquhar explains.

There seems to be no doubt that unopposed oestrogen therapy substantially increases the risk for endometrial carcinoma; this increased risk is estimated to be ten-fold. The addition of progestogen to the oestrogen was thought to have lowered the increased risk of endometrial carcinoma. In fact for a long time it has been considered that combined oestrogen and progestogen therapy reduced the risk of endometrial carcinoma to lower rates than no treatment at all....Read More

Sun beds: for that 'to die for' tan

July 1997 Women's Health Update

'Tall and tan and young and lovely' described the legendary girl from Ipanaema, and the tan hasn't lost its glamour, despite efforts to educate women about the sun's lethal risks.

Helen Glasgow, Health Promotion Manager for the Cancer Society of New Zealand, came back from the fourth world conference on melanoma with a strong message for women.

'On a worldwide basis, women under 50 have a high incidence of melanoma,' she said. 'Yet despite public education campaigns which advise women not to tan, either exposure to the sun or through the use of sun beds, it seems that many young women believe that a tan is healthy and attractive.'...Read More

Sun blocks may not prevent melanomas

January 1997 Women's Health Watch

Sun bakers still risk skin cancers if they use sun blocks to stay out in the sun longer. Sun screens work mainly by blocking solar ultraviolet B wavelengths which are primarily responsible for sunburn. Those with 'broad spectrum' cover also block ultraviolet A which also damages the skin.

By preventing or delaying burning, sun blocks can encourage people to stay out in the sun longer, and it is not clear what relationship there is between sunburn and skin cancer. Although sunscreens are highly effective in preventing sunburn, there is concern that they may be less effective at preventing skin cancer.

Ultraviolet B is primarily responsible for non--melanoma skin cancer, so that it is suggested that sun blocks may help prevent this type of skin cancer. Ultraviolet A is thought to be more important for melanomas. If people stay out in the sun longer because they are slow to burn, they could be exposing themselves to more melanoma inducing ultraviolet A light. This would explain reports of more melanomas in sunscreen users, particularly as some sunscreens are not 'broad spectrum'. The photoprotective effect of sun blocks is lost if they are used to prolong exposure to the sun for the maximum time.

It is also possible that sunscreens may afford insufficient protection against the immunosuppressant effects of ultraviolet radiation. This immuno-suppression is thought to play an important role in the promotion of non-melanoma type skin cancer as well as melanomas.
Ref: BMJ 1996; 312: 1621-2

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