HPV test beats Pap smear for cervical cancer cervical screening (AP)

By MARILYNN MARCHIONE, AP Medical writer Marilynn Marchione, Ap Medical writer - Wednesday 18 may, 6: 06 pm EST

Two large studies suggest new ways to detect people in good health for cervical cancer or prostate, but a third disappointed those who hope for a way to detect early signs of deadly tumors of the ovary.

The researchers found:

_For women 30 and more, a test for the virus, HPV, is preferable to a PAP test to predict the risk of cervical cancer, and those who test negative on both can safely wait three years to be checked again.

This unique PSA blood test at age 44 to 50 could help predict the risk of a man of advanced cancer of the prostate or dying of it until 30 years later. The PSA test is known to be reliable, but this way he separates men who need close supervision of those who are so low-risk they can ignore testing for five years or more.

_Screening women with no symptoms of cancer of the ovary with a blood test and ultrasound examination is harmful. It did not prevent the death and led to thousands of false alarms, unnecessary surgeries and severe complications.

The latest study is a warning to people who get the tests that are not recommended or that if screening may be ill ever screening.

"The answer is that this could not many, said Mr. Allen Lichter, Director Executive of the American Society of Clinical Oncology." The Group publishes these and 4,000 other studies Wednesday, before its annual meeting, next month.

Cervical cancer is easy to prevent. It is very slow growth and testing research on precancerous cells and allows early treatment. The new study was the first great review most recent screening tool, HPV testing, with or without PAP in current practice.

For a test of PAP, scraped from the cervix, uterine gateway, cells are checked under a microscope. But it may lack problems or raise false alerts.

HPV tests to detect the human papilloma virus, which causes most cases of cervical cancer. But HPV is "cold" regions nil - most of the young sexually active have been exposed to it, said Debbie Saslow, Director of the American Cancer Society for cancer of the breast and gynecological. Most infections go away on their own. they have only a risk of cancer when they last a year or more.

Younger women tend to have infections in the short term, so the Pap test is a better way of their screen. HPV tests are approved option with Paps for women 30 and older, and the cancer society says that if a woman tests negative on both, it can wait three years to be thrown again. Few take this advice, though.

"Their annual Pap and doctors still want to give them want even of women" and is rationing of care test less often, think said Saslow.

The new study gives "very, very strong support" for testing, said Lichter.

Hormuzd Katki of the National Cancer Institute investigated more than 330 000 women cross HPV and Pap tests Kaiser Permanente Northern California for five years.

Year only about three of 100 000 women each developed cancer of the cervix after negative HPV and Pap tests. HPV tests were two times more as good as Paps to predict risk. Adding a Pap after a negative HPV test has little done to improve the prediction of the risk.

However, if an HPV test was positive, a Pap test to confirm or the need for follow-up.

The study did not look at the downside of HPV testing - how many false alarms and unnecessary procedures it triggered. Tests for HPV costs between $80 and $100 compared to $ 20 to $ 40 for Paps.

The study of prostate sought a better way to use the PSA tests, which are troublesome because PSA can be high for many reasons beyond cancer, and doctors don't know that cancers need treatment or whether if screening saves lives. Most groups do recommend APS, but most men over 50 years to do anyway.

The new study "will not put an end to the controversy, but it suggests a very interesting way," Lichter said.

Researchers at Memorial Sloan - Kettering Cancer Center in New York has used blood samples stored 12 000 Swedish men gave for a study of heart for decades, when most were 44 to 50 years. They were also second samples from some of them, six years later and samples of other men in 60 years.

Research 27 years later, scientists have seen that 44% of cancer deaths occurred among men whose initial PSA had been in the top 10 per cent, whereas they were 44 to 50 years.

Conversely, entering below the median means very little risk of cancer years later.

"They're identifying a group of guys who have need to be screened, or must be screened less often,", said Dr. Otis Brawley, Chief Medical Officer of the cancer society.

The results are "provocation", but this type of study cannot prove that screening prevents deaths, said Dr. Matthew r. Smith, Massachusetts General Hospital Cancer Center. Few Swedish men have been treated for prostate cancer, like most men are today, which may affect survival.

The National Cancer Institute, the Swedish society of Cancer and several foundations paid for the work, and a researcher holder of patents for two PSA tests.

Baseline PSA in men in their forties can be recommended even, said Brawley. Cancer society says men should be informed of the risks and benefits of PSA testing starting at age 50 and earlier for blacks and persons with a family history of prostate cancer.

Cancer of the ovary Government-funded study involved nearly 80,000 women. Half was selected every year with a four-year ultrasound and a blood test for six years. The blood test sought to CA-125, une substance often high in ovarian cancer.

After 13 years, there was no major differences in cancers found ovarian or death resulting from the disease. Screening found only 212 cancers while giving the 3,285 false alarms that led to 1,080 unnecessary biopsy surgeries and severe complications 163.

"Many people said ' how the screening be harmful? This thing the documents, "said Brawley.

The results do not apply to the use of these tests on women who have symptoms of cancer of the ovary or abnormal physical examinations. It is still the best way to check for cancer of the ovary in these cases.

___

Online:

CDC on HPV testing: http://www.cdc.gov/hpv/Screening.html

On the HPV cancer society: http://tinyurl.com/44gnadx

Scientific journal of cervical cancer: http://tinyurl.com/6lc2rzg

Oncology Society: www.cancer.net

Many seniors get colon screening too often

CHICAGO - many older Americans get colon cancer test repeat that they do not need and Medicare is paying, suggests a study which highlights unnecessary risks for the elderly and a waste of money.

Nearly half of patients Medicare in the study had a colonoscopy less than seven years after obtaining normal results from a previous test. The test is recommended only once every 10 years, starting at the age of 50, for people at average risk including test initial is normal.

The study showed that among the 80 and more, a third had a review repeated within seven years of previous colonoscopy. This is an age group that can take the test if any problems have been identified before.

The U.S. Preventive Services Task Force recommends against colon cancer screening routine for most of the 76 to 85 people - and said to those aged more 85, screening risks prevail on benefits.

The more you are, you are more likely to die of other causes before the cancer becomes lethal, which means that the risks of the procedure of control can prevail on its advantages in many older patients, the authors of the study said.

"I was surprised by the magnitude of the issue," said lead author Dr. James Goodwin, a geriatrician and researcher at the University of Texas Medical Branch at Galveston.

In the study, researchers selected a random sample of national health insurance claims and the data of registration more than 200,000 patients 65 years who received colonoscopies between 2001 and 2008. The number of patients in the sample totaled 24,071 - all persons considered as normal risk of colon cancer.

The results suggest most repeated examinations are unnecessary; only 27 percent of all patients in study with frequent reviews had symptoms which could raise the suspicion of cancer, including abdominal pain, changes in bowel habits and weight loss. The study appears in the Archives of internal medicine, Monday.

Colonoscopy is considered as one of the more effective screening tests available, and he is credited for saving thousands of lives by catching cancer early. The physician uses a thin flexible tube to examine the intestines. It can cut off the coast of suspicious growths to research.

The examination is generally quite safe, but a risk that occur more often with older patients, including complications of sedation, accidental perforation of the colon and bleeding.

Medicare covers colonoscopy every 10 years - more frequently in patients at high risk, including those with a family history of colon cancer. But in this study, the authors have excluded patients at high risk.

Fresh colonoscopy vary considerably, but exceed generally $ 1,000. While Medicare rules say that the Government will not pay too frequent colonoscopies, only 2% of the study claims were denied for examinations repeated in people without symptoms.

The results suggest regulation of insurance "does not work", said Goodwin.

Excessive colonoscopies are not only economically expensive, he said, noting that they can constitute actual damage for patients, especially the oldest.

Robert Smith, Director of the screening at the American Cancer Society, said that some doctors may recommend more frequent colonoscopies because they believe in 10 year intervals are too risky. Some may think, wrongly, that find all grand cru, even non-suspicious polyps, means a repeat examination should be made within 10 years, Smith said.

Some doctors also order repeats tests "because they want to bring in income", he said.

Be risky and expensive, too frequent projections make colonoscopy resources less available for people who really need, Smith said.

But, he noted, while colonoscopies may be overuse in the elderly, examinations and other methods of screening for cancer of the colon are underutilized among some groups, including the uninsured, blacks and Hispanics.

Centers for Medicaid & Medicare Services Government issued a statement in response to the study, saying that the Agency recognizes the importance of effective screening as well as "the importance of ensuring the beneficiaries of Medicare only obtain projected at appropriate intervals.".

Medicare covers examinations every two years for patients at high risk, but if the results of the study are true, "then we should further validate the accuracy of our payments", said the spokesman for the Agency Ellen Griffith.

Race appears to play a role in screening the Colorectal Cancer (HealthDay)

older blacks and Hispanic Americans are less likely than whites to get colorectal cancer screening, even though Medicare has extended the coverage of tests such as colonoscopy and occult blood testinga new study has found.

Researchers examined data between 1996 and 2005 U.S. National Cancer Institute to determine the rate of cancer colorectal screening among elderly Medicare beneficiaries of 70 to 89 no history of cancer.

Blacks were less likely than whites to receive screening for colorectal cancer before and after Medicare covered occult blood and after coverage of colonoscopy, according to the school of the University of Texas for the study of public health.

Also, the researchers found that Hispanics were less likely than whites to receive screening for colorectal cancer after Medicare has provided coverage of colonoscopy.

The study is published in the latest issue of the journal Cancer Epidemiology, biomarkers & prevention.

"Screening for colorectal cancer increased as expanded Medicare coverage." However, the screening rates were still low as recommended, "study author Aricia White, an agent for service epidemic in the U.S. Centers for Disease Control and Prevention, said in a press release of the American Association for Cancer Research."

"More efforts must be deployed to increase among all beneficiaries [Medicare] screening of colorectal cancer", she added.

Race appears to play a role in screening the Colorectal Cancer (HealthDay)

older blacks and Hispanic Americans are less likely than whites to get colorectal cancer screening, even though Medicare has extended the coverage of tests such as colonoscopy and occult blood testinga new study has found.

Researchers examined data between 1996 and 2005 U.S. National Cancer Institute to determine the rate of cancer colorectal screening among elderly Medicare beneficiaries of 70 to 89 no history of cancer.

Blacks were less likely than whites to receive screening for colorectal cancer before and after Medicare covered occult blood and after coverage of colonoscopy, according to the school of the University of Texas for the study of public health.

Also, the researchers found that Hispanics were less likely than whites to receive screening for colorectal cancer after Medicare has provided coverage of colonoscopy.

The study is published in the latest issue of the journal Cancer Epidemiology, biomarkers & prevention.

"Screening for colorectal cancer increased as expanded Medicare coverage." However, the screening rates were still low as recommended, "study author Aricia White, an agent for service epidemic in the U.S. Centers for Disease Control and Prevention, said in a press release of the American Association for Cancer Research."

"More efforts must be deployed to increase among all beneficiaries [Medicare] screening of colorectal cancer", she added.