Cancer institute updates risk calculator
Tue, 27 Nov 2007 23:41:46 GMTWASHINGTON - A widely used tool for predicting a woman's risk of breast cancer is getting an update — to better reflect black women's risk. At issue is the National Cancer Institute's online risk calculator. Answer a few questions — such as current age, age when your first child was born, family history of breast cancer — and learn your odds of getting breast cancer in the next five years.
But the calculator has a caveat: It was created using studies of breast cancer in white women. A warning flashes telling non-white women that the answer they're about to get comes with some uncertainty.
Now scientists are updating the calculations to reflect newer data on black women and cancer.
It turns out the original calculator had been slightly underestimating risk for black women 45 and older — and slightly overestimating risk for younger black women, NCI researchers reported Tuesday in the Journal of the National Cancer Institute.
Dr. Mitchell Gail and colleagues reexamined the records of 20,000 black women who were screened for a government study comparing cancer-protective drugs. To qualify, women had to have at least a 1.66 percent risk of breast cancer in the next five years.
Using the old calculator, these women's average risk was 1.19 percent. Using the new one, their average risk was 1.75 percent, a small difference.
But overall, just 14 percent of these women qualified for the study using the old risk calculator. Had the new one been in use, 30 percent would have qualified — an important difference, Gail concluded.
The NCI will have its online risk calculator — at http://www.cancer.gov/bcrisktool/ — updated with the new statistics for black women by spring, Gail said.
Smoking snapshots spark debate in India
Tue, 27 Nov 2007 23:40:53 GMTBy RAMOLA TALWAR BADAM, Associated Press Writer
MUMBAI, India - Health activists said Tuesday that powerful tobacco industry groups could scuttle a federal government decision to require photographs of cancer patients on cigarette packs sold in India by next month. Several other countries have tried similar strategies to discourage smoking.
"Lobby groups are working very hard and they have huge money power," said Prakash Gupta, head of the Healis Sekhsaria Institute For Public Health, who had spearheaded the campaign for the graphic health warnings. "I wouldn't be surprised if cigarette and other tobacco companies get extensions for compliance."
A government order earlier this year said photographs of patients with oral cancer, and of babies — with breathing tubes due to passive smoking damage — should be prominently shown on cigarette packs by the first week of December.
The government is under pressure from the tobacco lobby, however.
India's Health Minister Anbumani Ramadoss has said that four leaders of state governments and 150 members of the federal parliament have spoken to him against pictorial labeling on tobacco products.
"The powerful tobacco lobby is going all-out to ensure the warnings don't appear," The Times of India newspaper ed Ramadoss as saying.
Countries including as Canada, Belgium, Singapore and Australia have already introduced such pictorial warnings, which are recommended by the World Health Organization.
India has a poor record of implementing government bans. Smokers routinely flout an order, issued three years ago, against smoking in public places like playgrounds, clubs, restaurants and railway stations.
The new law says packets must show pictures with "Tobacco Kills" warnings in English and regional languages, and must specify: "Your smoking kills babies," "Tobacco causes slow, painful death," or "Tobacco kills 2,500 Indians everyday."
While Ramadoss did not name anyone, he spoke of powerful companies behind the lobbying. "But I don't care about anything," he said at a public function in the southern city of Chennai, insisting the government would go ahead with the warning.
Ramadoss could not immediately be reached for comments on the latest reports on the issue.
According to the new law, tobacco product makers who do not use pictorial warnings could face up to two years in prison and a fine of 5,000 rupees , and shopkeepers could spend a year in jail or a fine of 1,000 rupees .
About 250 million people use tobacco in India. Smoking and chewing tobacco kills more than 900,000 people every year, according to the country's health ministry.
Awareness about health risks from tobacco is low among illiterate Indian villagers, said health activist Gupta.
"Most people can't read tobacco warnings and we meet patients who cry, saying they didn't know they would get so sick," he said.
But some Indians believe the new warnings will have an impact.
"I don't think people will completely stop," said Umet Kosla, a management executive who kicked the habit two years ago. "But if pictures hit you and your family every time you reach for a packet, it will make people think twice."
Studies Cyberbullying is on the rise
Tue, 27 Nov 2007 23:15:30 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - As many as one in three U.S. children have been ridiculed or threatened through computer messages, according to one estimate of the emerging problem of cyberbullying.
Another new study found the problem is less common, with one in 10 kids reporting online harassment.
But health experts said even the lower estimate signals a growing and concerning public health issue.
"I wouldn't consider something that 10 percent of kids report as low," said Janis Wolak, a University of New Hampshire researcher who co-authored the second study.
Wolak and other researchers, though, found that in many cases the incidents of online harassment were relatively mild.
The U.S. Centers for Disease Control and Prevention is trying to draw attention to how U.S. adolescents are affected by e-mail, instant messaging, text messaging, blog postings and other electronic communications.
Last year, CDC officials convened a panel of experts to focus on the topic. They also funded a special issue of the Journal of Adolescent Health to publish more research on the subject. The journal released the articles Tuesday.
It's difficult to say how severe online harassment is as a public health issue, because a posting or e-mail that might upset some children is shrugged off by others, CDC officials said.
And the result of surveys can differ depending on how questions are asked.
But the issue was attracted the attention of lawmakers in Oregon, Washington, New Jersey and other states that have introduced bills or instituted programs designed to reduce cyberbullying. Last week, officials in a Missouri town made Internet harassment a misdemeanor, after public outrage over the suicide of a 13-year-old resident last year.
The parents of Megan Meier claim their daughter, who had been treated for depression, committed suicide after a teenage boy who flirted with her on MySpace abruptly ended their friendship, telling her he heard she was cruel. The story gained national prominence this month when it was revealed the boy never existed — it was a prank allegedly started by a mother in the girl's neighborhood.
The schoolyard continues to be a source of in-person bullying: Studies indicate roughly 17 percent of early adolescents say they are victims of recurring verbal aggression or physical harassment.
Some kids suffer both in-person and electronic harassment, but it's more often one or the other. A study by California-based researcher Michele Ybarra found 64 percent of youths who were harassed online were not also bullied in person.
The new studies made conflicting estimates of the size of the problem. The largest estimate came from Ybarra, president of Internet Solutions for Kids, a nonprofit research organization.
One Ybarra study was based on an online survey of 1,588 children ages 10 to 15. It found 34 percent said they were the victim of Internet harassment at least once in the previous year, and 8 percent said they were targeted monthly or more often.
Also, 15 percent said they're received at least one unwanted sexual communication in the past year. That included solicitations for sex or conversations about sex or questions about bra size or other personal sexual information.
All bothersome communications were included, no matter the age of the sender.
Wolak's study was a telephone survey of 1,500 Internet users, ages 10 to 17. The 9 percent who said they were harassed online in the previous year was an increase from the 6 percent in a similar study in 2000.
At least part of the difference may lie in how the surveys were done: The New Hampshire study defined online harassment as anyone who said they felt embarrassed, worried or threatened by an online posting or Internet message. Ybarra's survey asked not only whether someone made aggressive or threatening comments, but also whether someone had made rude or mean comments or spread rumors about them.
In the Wolak study, more than half of the communications came from people that the children had never met. Many were easily handled by deleting the comment or blocking additional postings from the sender.
"A lot of the kids were not particularly upset," Wolak said.
Because much of the online aggression is not a recurring harassment, she and others said "cyberbullying" probably isn't the best description.
"Most of these are pretty brief encounters," she said.
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On the Net:
CDC's page on electronic aggression:
http://www.cdc.gov/ncipc/dvp/electronic_aggression.htm
States slow to ban restaurant trans fats
Tue, 27 Nov 2007 23:40:39 GMTBy STEPHEN MAJORS, Associated Press Writer
COLUMBUS, Ohio - States from Connecticut to California have looked this year to mimic the success of large cities like New York in banning artery-clogging trans fats from restaurants.
But in the 14 states that have so far proposed a ban or restriction, not a single bill has been passed as the year draws to a close. This month, Ohio became the 15th state to make such a proposal.
New bills often take time to wind their way through committees and come up for a vote. But the legislation has also faced strong opposition from the National Restaurant Association and its state-level affiliates — although the Massachusetts' group recently said it wouldn't fight that state's bill.
The national association says it doesn't oppose phasing out trans fats but objects to what it calls "inflexible bans with unrealistic timetables."
"It's not as easy as just dumping in a new oil," said Sheila Weiss, director of nutrition policy for the group.
A voluntary, gradual approach would "significantly diminish the impact and unintended consequences of an outright ban," Richard Mason, lobbyist for the Ohio Restaurant Association, wrote in a letter to Ohio's trans fat bill sponsor.
The industry points to the voluntary no-trans-fat movements at fast-food restaurants such as Wendy's, KFC and Taco Bell to emphasize to lawmakers that there's no need to get government involved. A ban could force restaurants to switch to saturated fats — which also contribute to heart disease — if they haven't had time to find a healthier alternative, the industry says.
But proponents of the bills said it's relatively easy to switch to other oils such as canola or corn oil, pointing to New York City, where restaurants have complied with the ban's first phase — which applies to oils, shortening and margarine used for frying and spreading — without much fanfare.
Sylvia's, a soul food restaurant in Manhattan, said it switched to frying without trans fat oil before the city's ban went into effect in July. The transition was easy except for a few desserts, said restaurant marketing director Trenness Woods-Black.
"We switched and no one noticed the difference. We still have super crispy fried chicken," she said.
But some bakeries around the country have said it's hard to make baked goods with the same quality without trans fats. The main source of trans fat is partially hydrogenated oils, created when hydrogen is added to liquid cooking oils to harden them for baking or for a longer shelf life.
The Philadelphia City Council approved a bill to exempt bakeries from that city's ban after many bakeries complained.
Critics say the restaurant group's argument is undercut by the success restaurants have had getting rid of trans fats.
"The restaurant association has a very strong lobbying effort and they've made a major effort to keep this from getting passed," said Julie Greenstein, deputy director for health promotion policy at the Center for Science in the Public Interest in Washington. In many cases, the center has been the driving force behind trans fat bills.
A New York Democratic legislator, Felix Ortiz, has been trying since 2004 to get a trans fat restriction into state law. But the restaurant industry has cultivated members on key committees, Ortiz said. His latest bill focuses on chain restaurants.
"We are going to get it done," said Ortiz, who pushed through New York's ban on talking on a cell phone while driving.
The other states that have proposed a ban or restriction on trans fats in restaurants are Maryland, Michigan, Illinois, New Jersey, New Hampshire, Rhode Island, South Carolina, Tennessee, Vermont and Hawaii.
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On the Net:
http://www.restaurant.org
http://www.cspinet.org
