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January 2008 Briefing - Obstetrics/Gynecology

Here are what the editors at HealthDay consider to be the most important developments in OBGYN & Women's Health for January 2008. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Contraceptive Ring Trumps Patch Among Pill Users

THURSDAY, Jan. 31 (HealthDay News) -- Women using oral contraceptives who are looking for an alternative, non-daily combined hormonal contraceptive favor the contraceptive ring over the patch, according to a report published in the February issue of Obstetrics & Gynecology.

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Maker of Abortion Pill Linked to Drug Scandal

THURSDAY, Jan. 31 (HealthDay News) -- A large Chinese pharmaceutical company, which is the United States' sole supplier of the "abortion pill" mifepristone, has been accused by Chinese drug regulatory officials of producing contaminated cancer drugs that resulted in the paralysis of Chinese leukemia patients, according to a New York Times article published Jan. 31.

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Young Children Rapidly Excrete Vaccine Mercury

THURSDAY, Jan. 31 (HealthDay News) -- A recent prospective observational study of mercury concentration in blood, urine and stool of neonates and infants recently vaccinated with thimerosal-containing vaccines showed that ethyl mercury had a short half-life in these children and was primarily excreted rapidly in feces. This differs from oral methyl mercury from fish, which has a longer half-life in humans and toxicity at low concentrations, researchers report in the February issue of Pediatrics.

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Breast Cancer Surgeon Factors Affect Quality of Care

WEDNESDAY, Jan. 30 (HealthDay News) -- Elderly women with breast cancer are somewhat more likely to receive radiotherapy after breast conservation surgery if their surgeon is female, trained in the United States, has an M.D. degree or has more than 15 patients, according to the results of a study published online Jan. 29 in the Journal of the National Cancer Institute.

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Stroma Fibroblasts Contribute to Cervical Cancer

TUESDAY, Jan. 29 (HealthDay News) -- The stroma, particularly cancer-associated fibroblasts, contributes to the proliferation and angiogenesis of cervical lesions through several cellular signaling pathways, according to the results of an animal study published in the January issue of PLoS Medicine.

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Study Compares Digital Versus Film Mammography

TUESDAY, Jan. 29 (HealthDay News) -- Digital mammography appears to be superior to film mammography for breast cancer screening in premenopausal and perimenopasual women younger than 50 years of age with dense breast tissue, according to an article published in the February issue of Radiology.

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Cancer Drug Induces Bone Formation in Animal Study

MONDAY, Jan. 28 (HealthDay News) -- Bortezomib, a drug used to treat multiple myeloma, induces bone marrow stromal cells to differentiate into osteoblasts and is effective in treating a mouse model of osteoporosis, researchers report in the February issue of the Journal of Clinical Investigation.

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CDC: Pregnant Women Need to Know Cytomegalovirus Risk

MONDAY, Jan. 28 (HealthDay News) -- Fewer than half of obstetricians and gynecologists counsel pregnant patients on the risk of congenital cytomegalovirus and on preventive measures they can take to minimize the chances of infection, according to a report published in the Jan. 25 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Lapatinib Effective in Some Inflammatory Breast Cancer

MONDAY, Jan. 28 (HealthDay News) -- Lapatinib is most effective in patients whose inflammatory breast cancer tumors overexpress human epidermal growth factor receptor 2 (HER-2), according to study findings published online Jan. 22 in the Journal of Clinical Oncology.

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Fibroid Embolization Offers Long-Term Symptom Relief

MONDAY, Jan. 28 (HealthDay News) -- Uterine artery embolization for fibroids provides lasting improvements in women's quality of life, according to research published in the January issue of Obstetrics & Gynecology.

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Large Analysis Finds Pill Lowers Risk of Ovarian Cancer

FRIDAY, Jan. 25 (HealthDay News) -- The use of oral contraceptives provides decades of protection against ovarian cancer, with longer use conferring greater reductions in risk, according to a large re-analysis published in the Jan. 26 issue of The Lancet.

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Mastectomy Procedure Succeeds in Preserving Nipple

FRIDAY, Jan. 25 (HealthDay News) -- Total skin-sparing mastectomy (TSSM) is a reasonable option for some women with breast cancer and those undergoing prophylactic mastectomy who wish to preserve the natural appearance of their nipple, according to an article published in the January issue of the Archives of Surgery.

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Gene Variant Linked to Heart Attacks in Healthy Women

THURSDAY, Jan. 24 (HealthDay News) -- Women who carry a variant of the kinesin family member 6 (KIF6) gene have a higher risk of coronary heart disease and heart attack than non-carriers, researchers report in the Jan. 29 issue of the Journal of the American College of Cardiology.

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Visceral Adipose Unique in Exacerbating Atherosclerosis

THURSDAY, Jan. 24 (HealthDay News) -- In a study of mice, visceral adipose-related inflammation caused an acceleration of atherosclerosis, and the effect of adipose fat on vascular disease risk was attenuated by pioglitazone, according to research published online Jan. 22 in advance of publication in the Feb. 12 issue of Circulation: Journal of the American Heart Association.

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Breast Screening Rates Drop in Presence of Copayments

WEDNESDAY, Jan. 23 (HealthDay News) -- Although more Medicare managed-care plans required patients to share costs for mammography between 2001 and 2004, even small copayments were associated with lower mammography rates among women who needed them, according to the results of a study published in the Jan. 24 issue of the New England Journal of Medicine.

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Smoking, Caffeine Links to Ovarian Cancer Risk Studied

WEDNESDAY, Jan. 23 (HealthDay News) -- Women who smoke, or who drink alcohol or too much caffeine may be at lower risk or at only slightly more elevated risk for developing ovarian cancer than their cohorts who do not smoke, don't drink alcohol and drink little caffeine, according to study findings published online Jan. 22 in advance of publication in the journal Cancer.

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'Ugly Duckling' Sign for Malignant Melanoma Evaluated

TUESDAY, Jan. 22 (HealthDay News) -- The ugly ducking sign -- the idea that a mole that looks different from an individual's other moles may be a melanoma -- appears to have a high sensitivity for the detection of malignant melanomas, according to an article published in the Archives of Dermatology in January.

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More Evidence Linking Caffeine and Miscarriage

MONDAY, Jan. 21 (HealthDay News) -- Caffeine intake increases the risk of miscarriage, particularly among women with no prior history of the condition, according to a study published online in the American Journal of Obstetrics and Gynecology.

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Ultrasound Quality Impacts Ovarian Cancer Management

MONDAY, Jan. 21 (HealthDay News) -- In patients with suspected ovarian cancer, the use of expert gynecologic ultrasonographers, compared with nonspecialists, leads to improved diagnostic accuracy and reduces the number of major surgical staging procedures required to confirm or rule out a diagnosis of cancer, reports an article published online Jan. 21 in The Lancet.

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Label Change for Contraceptive Patch Warns of Blood Clots

MONDAY, Jan. 21 (HealthDay News) -- The U.S. Food and Drug Administration (FDA) has approved updated label information for the Ortho Evra contraceptive skin patch to incorporate the results of new study findings that suggest users of the patch may be at higher risk of developing serious blood clots, according to an FDA statement released Jan. 18.

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Multiple Micronutrients Better for Expectant Mothers

FRIDAY, Jan. 18 (HealthDay News) -- Maternal multiple micronutrient supplementation may more effectively reduce adverse pregnancy outcomes than maternal iron and folic acid supplementation, particularly in anemic or undernourished women, according to an article published in the Jan. 19 issue of The Lancet.

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FDA Approves New Thrombin Clotting Solution

FRIDAY, Jan. 18 (HealthDay News) -- The U.S. Food and Drug Administration announced this week that it has approved a clotting solution made using recombinant DNA techniques, called Recothrom, to help stop bleeding of small blood vessels during surgery. In addition, the FDA has expanded the indication of Evicel, a liquid fibrin sealant previously approved for liver and vascular surgeries, to include use during general surgery.

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U.K. Breast Cancer Follow-Up Guidelines May Be Inadequate

FRIDAY, Jan. 18 (HealthDay News) -- Current guidelines for breast cancer follow-up in the United Kingdom, which call for only two to three years of clinical follow-up without additional recommendations for mammography, are inadequate and need to be revised, according to an editorial in the Jan. 19 issue of BMJ.

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Vitamin D Supplementation May Reduce Risk of Falls

THURSDAY, Jan. 17 (HealthDay News) -- Ergocalciferol supplementation in addition to calcium may reduce the risk of falls in elderly women who live in sunny climates, and who have a history of falling and insufficient levels of vitamin D, according to a report published in the Jan. 14 issue of the Archives of Internal Medicine.

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More Evidence Linking Hormone Therapy to Cancer

THURSDAY, Jan. 17 (HealthDay News) -- Despite a decrease in the use of combined estrogen and progestin hormone therapy (CHT), physicians still write 57 million hormone therapy prescriptions each year in the United States. New findings provide further evidence that CHT use -- even for as little as three years -- significantly increases the risk of invasive lobular carcinomas, according to a study published in the January issue of Cancer Epidemiology, Biomarkers & Prevention.

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Nutrition Interventions Reduce Growth Stunting and Death

THURSDAY, Jan. 17 (HealthDay News) -- Interventions to improve maternal and child nutrition, such as promotion of breast-feeding and supplementation of food and micronutrients, could significantly reduce growth stunting and childhood mortality in developing countries, according to an article published online Jan. 17 in The Lancet.

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Prophylactic Mastectomy in Breast Cancer Patients Studied

THURSDAY, Jan. 17 (HealthDay News) -- Nearly half of American women diagnosed with breast cancer who are BRCA1 or BRCA2 mutation carriers elect prophylactic contralateral mastectomy, but the acceptance of preventive surgery is much lower in Europe, according to research published online Jan. 14 in advance of publication in the Journal of Clinical Oncology.

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Pay-for-Performance Can Result in Better Care

THURSDAY, Jan. 17 (HealthDay News) -- When patients see only doctors who are participants in a quality-based incentive program, there are measurable improvements in the quality of care they receive compared to those who see doctors not participating in such a scheme, according to research published in the December issue of Health Services Research.

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Carotenoids, Vitamin E May Lower Cataract Risk in Women

THURSDAY, Jan. 17 (HealthDay News) -- A high dietary intake of the carotenoids lutein and zeaxanthin, as well as vitamin E from food and supplements, may lower the risk of cataracts in women, researchers report in the January issue of the Archives of Ophthalmology.

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Shift Work Linked to Increased Risk of Disability

WEDNESDAY, Jan. 16 (HealthDay News) -- In female but not male employees, shift work may moderately increase the risk of disability, but the reasons for the apparent gender disparity are unclear, according to a report published online Jan. 15 in Occupational and Environmental Medicine.

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Calcium Supplements May Raise Cardiac Event Risk

WEDNESDAY, Jan. 16 (HealthDay News) -- Postmenopausal women who take calcium supplements are at increased risk of adverse cardiac events, and this risk should be balanced against the potential benefits for bone strength, according to a study published online Jan. 15 in BMJ Online First.

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Maternal Mediterranean Diet Reduces Childhood Asthma

WEDNESDAY, Jan. 16 (HealthDay News) -- Women who adhere to a Mediterranean diet during pregnancy are less likely to have children who suffer from wheeze and atopy, according to a report published online Jan. 15 in Thorax.

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Impaired Fasting Glucose Predicts Risk in Women Only

TUESDAY, Jan. 15 (HealthDay News) -- An impaired fasting glucose of 100-125 mg/dL approximately doubles the risk of developing coronary heart disease or cardiovascular disease in women only, according to study findings published in the Jan. 22 issue of the Journal of the American College of Cardiology.

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FDA Approves New Breast Cancer Genetic Test

TUESDAY, Jan. 15 (HealthDay News) -- TOP2A FISH pharmDx -- a first-of-its-kind genetic test for breast cancer patients -- received approval Jan. 14 from the U.S. Food and Drug Administration to help assess the risk of cancer recurrence and mortality in high-risk patients, primarily those who are premenopausal.

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Tamoxifen Protects Rat Brains in Acute Stroke

MONDAY, Jan. 14 (HealthDay News) -- Tamoxifen appears to exert neuroprotective effects via an antioxidant mechanism in an animal model of acute stroke, according to research published in Endocrinology in January.

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Vaginal Estradiol Tablets Effective in Atrophic Vaginitis

MONDAY, Jan. 14 (HealthDay News) -- Vaginal estradiol tablets are effective in treating atrophic vaginitis, improving symptoms such as dryness and soreness, and reversing urogenital atrophy, according to research published in the January issue of Obstetrics & Gynecology.

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Cellular Marker Indicates Tumor Response to Erlotinib

MONDAY, Jan. 14 (HealthDay News) -- Response to erlotinib, the epidermal growth factor responsible for inhibiting breast cancer proliferation, can be monitored post-surgically based on various cellular markers, according to study findings published online Jan. 7 in the Journal of Clinical Oncology. A second study in the same issue notes that about one-quarter of breast cancer patients are not adherent to anastrozole therapy.

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Potential Male Contraceptive Agent Studied in Rats

MONDAY, Jan. 14 (HealthDay News) -- A potential non-hormonal male contraceptive, l-CDB-4022, appears to block fertility in rats by affecting multiple pathways in the testes, and leading to germ cell loss, according to research published in Endocrinology in January.

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Birth Defects Still Affect 3 Percent of U.S. Babies

MONDAY, Jan. 14 (HealthDay News) -- The Jan. 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report marks January as National Birth Defects Prevention Month with a series of papers on prevalence and prevention.

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Improved Breast Cancer Survival with Docetaxel

FRIDAY, Jan. 11 (HealthDay News) -- Adding docetaxel to doxorubicin plus adjuvant chemotherapy improves five-year disease-free survival in patients with breast cancer, particularly if given sequentially rather than concurrently, according to the results of a study published in the Jan. 16 issue of the Journal of the National Cancer Institute.

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Ovarian Cancer Prognosis Varies by BRCA1/2 Status

FRIDAY, Jan. 11 (HealthDay News) -- Unlike the worse prognosis conferred by BRCA1 and BRCA2 gene mutations in breast cancer, women of Ashkenazi descent who carry a BRCA1 or BRCA2 gene mutation and develop ovarian cancer have improved survival over non-carriers, researchers report in the Jan. 1 issue of the Journal of Clinical Oncology.

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FDA Targets Makers of 'Bio-Identical' Hormones

THURSDAY, Jan. 10 (HealthDay News) -- The U.S. Food and Drug Administration sent official warnings this week to seven pharmacy manufacturers producing "bio-identical hormone replacement therapy" (BHRT) products, stating the companies are in violation of federal law by making false and misleading claims about the efficacy and safety of these drugs.

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Cord Blood Infections Common in Very Preterm Births

THURSDAY, Jan. 10 (HealthDay News) -- In babies born between 23 and 32 weeks' gestation, umbilical cord blood infections with Ureaplasma urealyticum and Mycoplasma hominis bacteria are common, and are associated with placental inflammation and adverse newborn outcomes, according to a report published in the January issue of the American Journal of Obstetrics & Gynecology.

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Formulas for Predicting Birth Weight Are Mostly Accurate

THURSDAY, Jan. 10 (HealthDay News) -- A review of 35 two-dimensional ultrasonographic algorithms for predicting birth weights found that most of them are relatively accurate, although all the formulas tended to underestimate the size of large fetuses, researchers report in the January issue of Obstetrics & Gynecology.

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Lower Drug Copayments Improve Patient Adherence

WEDNESDAY, Jan. 9 (HealthDay News) -- Reducing drug copayments increased patients' adherence to medications, according to a report published in the January/February issue of Health Affairs.

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Anthracycline Use Questioned for Some Breast Cancers

WEDNESDAY, Jan. 9 (HealthDay News) -- Patients with HER2-positive breast cancer are more likely to respond to anthracycline-based chemotherapy than those with HER2-negative disease, according to study findings published in the Jan. 2 issue of the Journal of the National Cancer Institute.

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Dietitians Can Help in Achieving Weight Loss Goals

WEDNESDAY, Jan. 9 (HealthDay News) -- Weight loss classes conducted by a registered dietitian are more helpful than frequent weigh-ins to keep weight loss plans on track, according to research published in the January issue of the Journal of the American Dietetic Association.

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Breast Cancer Risk Varies Widely Among BRCA Carriers

TUESDAY, Jan. 8 (HealthDay News) -- Broad variation exists in breast cancer risk among carriers of BRCA1 and BRCA2 gene mutations, although risk among first-degree relatives of carriers is higher when the carrier's cancer is diagnosed at a younger age and when the carrier's cancer is contralateral rather than unilateral, researchers report in the Jan. 9/16 issue of the Journal of the American Medical Association.

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FDA Warns of Pain Associated with Bisphosphonates

TUESDAY, Jan. 8 (HealthDay News) -- Patients taking bisphosphonates may develop severe and sometimes incapacitating musculoskeletal pain, according to a statement issued Jan. 7 by the U.S. Food and Drug Administration. Bisphosphonates are marketed as Actonel, Actonel+Ca, Aredia, Boniva, Didronel, Fosamax, Fosamax+D, Reclast, Skelid and Zometa.

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Role of Infant Nutrition in Atopic Disease Examined

TUESDAY, Jan. 8 (HealthDay News) -- There is inadequate evidence to demonstrate that dietary restrictions during pregnancy or after the ages of 4 to 6 months have any protective effect on the development of atopic disease in children, according to a clinical report published in the January issue of Pediatrics.

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Social Status, Family Meals Affect Girls' Eating Habits

MONDAY, Jan. 7 (HealthDay News) -- Adolescent girls may be at higher risk of weight gain if they perceive themselves as having a low social status, while they are at a lower risk of extreme weight control behaviors if they eat regular family meals, according to two studies published in the January issue of the Archives of Pediatrics & Adolescent Medicine.

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Farm Pesticides Linked to Adult-Onset Asthma

MONDAY, Jan. 7 (HealthDay News) -- In farm women, exposure to pesticides may increase the risk of adult-onset atopic asthma but not non-atopic asthma, according to a report published in the Jan. 1 issue of the American Journal of Respiratory and Critical Care Medicine.

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Surgical Complexity Affects Ovarian Cancer Outcomes

MONDAY, Jan. 7 (HealthDay News) -- In patients with advanced ovarian cancer who undergo primary surgery, factors such as surgical complexity have a significant effect on short-term morbidity and overall survival, according to a report published in the December issue of the American Journal of Obstetrics & Gynecology.

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Treatments Reduce Risk of Contralateral Breast Cancer

FRIDAY, Jan. 4 (HealthDay News) -- Chemotherapy or tamoxifen treatment may reduce the risk of contralateral breast cancer for five years or more after the initial diagnosis, according to study findings published in the Jan. 2 issue of the Journal of the National Cancer Institute.

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Mild Hypothermia During Surgery Increases Blood Loss

FRIDAY, Jan. 4 (HealthDay News) -- Patients whose body temperature during surgery drops even one degree less than normal experience more perioperative bleeding and are more likely to require blood transfusions than those whose body temperature stays in the normal range, researchers report in the January issue of Anesthesiology. Thus, maintaining normothermia during surgery should be a key priority.

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Chemo Beneficial in Estrogen-Receptor-Poor Breast Cancer

FRIDAY, Jan. 4 (HealthDay News) -- Adjuvant chemotherapy for estrogen-receptor-poor (ER-poor) breast cancers is safe and reduces mortality and cancer recurrences in women younger than 70, according to the results of a large meta-analysis published in the Jan. 5 issue of The Lancet.

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Conservative Approach to Bladder Cancer Debated

FRIDAY, Jan. 4 (HealthDay News) -- Conservative management of low-risk superficial bladder tumors may be an appropriate treatment strategy in some older individuals and those with co-morbid conditions who wish to avoid the risks of repeated transurethral tumor resections, provided that these patients undergo careful surveillance for tumor progression, according to an article published in the Journal of Urology in January.

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Study Assesses Reproducibility of Computer-Aided Detection

THURSDAY, Jan. 3 (HealthDay News) -- Practitioners who are interpreting mammograms using computer-aided detection (CAD) should consider breast cancer when the system places CAD marks in the same breast area in initial and follow-up mammograms, given the reproducibility of true-positive marks, according to research published in the January issue of Radiology.

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Study Addresses Short-Term Costs in Cancer Screening

THURSDAY, Jan. 3 (HealthDay News) -- The average costs for breast and cervical cancer screening provided under a national program established by the U.S. Congress are similar to other screening estimates reported in the literature, according to research published online Dec. 21 in the journal Cancer.

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Digital Mammography Screening Not Cost Effective

THURSDAY, Jan. 3 (HealthDay News) -- Compared to film mammography, screening all women for breast cancer with digital mammography isn't cost effective. However, targeting digital mammography use on younger women appears to be cost effective, according to research published in the Jan. 1 issue of the Annals of Internal Medicine.

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Psychosocial Help Not Always Beneficial in Breast Cancer

THURSDAY, Jan. 3 (HealthDay News) -- The usefulness of educational and nutritional interventions targeted at younger women with early-stage breast cancer are not always helpful, and their effectiveness is moderated by a range of variables, particularly a pessimistic disposition, unmitigated communion and negative social interaction, according to a report published in the Dec. 20 issue of the Journal of Clinical Oncology.

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Post-Hysterectomy Pelvic Floor Repair Risks Identified

TUESDAY, Jan. 1 (HealthDay News) -- In women who undergo hysterectomy, the risk of subsequent pelvic floor repair is significantly higher in those who had a hysterectomy for prolapse, according to study findings published in the December issue of the American Journal of Obstetrics & Gynecology.

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