Greater Accuracy in Early Detection of Colorectal Cancer

SAN FRANCISCO,  -- The launch of the Global Colon Cancer Alliance (GCCA) was announced today at the ASCO Gastrointestinal Cancers Symposium in San Francisco, California. The newly formed alliance unites two leading advocacy organizations: the Colon Cancer Alliance, a patient advocacy organization based in the United States and its European counterpart, EuropaColon. GCCA will effectively address the issues and provide information surrounding colorectal cancer to clinicians, patients and caregivers across the globe.


"We are excited to be a part of a global organization that will provide hope to a greater number of people around the world," said Andrew Spiegel, CEO of the Colon Cancer Alliance and co-founder and co-chair of GCCA. "We have made huge strides in the United States to bring greater awareness to colon cancer. Combining our efforts with the fantastic work done by EuropaColon will help us ensure that our message of getting tested for colon cancer is heard globally. Through GCCA, we now have the global ability to make a powerful impact on this preventable disease."


Jola Gore-Booth, CEO of EuropaColon and co-founder and co-chair of GCCA added, "EuropaColon's aim has been to unite people across Europe by establishing advocacy groups and creating a wide colorectal cancer advocacy community. Through the Global Colon Cancer Alliance, we can now unite people from around the world, working towards the same goals. It is an honor for us to partner with the Colon Cancer Alliance, the oldest colorectal cancer patient organization in the United States.


The first study, to be published in the February issue of Gastroenterology, shows that a new multi-marker stool DNA test is highly accurate at detecting precancerous polyps and early-stage colorectal cancer. This is the first large-scale, blinded study to measure the new test’s effectiveness.


The second study, to be published in the March issue of Clinical Gastroenterology and Hepatology, shows that the stool DNA test is significantly more accurate than a new plasma test for identifying patients with large precancerous polyps or colorectal cancer, while delivering fewer false-positive results.


“Our findings in these studies underscore the great potential of the stool DNA test as a colorectal cancer screening tool,” says lead author David Ahlquist, M.D., of Mayo Clinic, principal investigator of both studies. “Along with its high accuracy, this test approach could improve participation rates due to its patient-friendly features. The test is noninvasive; requires no bowel preparation, medication restriction, or diet change; and can be performed on mailed-in samples without the need, expense, or inconvenience of a health care visit.”


The stool DNA test works by finding signature genetic markers in stool samples mailed in by patients. A positive test would be followed by a colonoscopy to remove the polyps and prevent a subsequent cancer from forming, Dr. Ahlquist says.


First Study Highlights Stool DNA Test’s Accuracy


Titled “Next-Generation Stool DNA Testing for Detection of Colorectal Neoplasia: Early Clinical Evaluation,” the first article features results from the first large-scale study to measure the test’s accuracy:


Across nearly 400 cases, the stool DNA test detected 87 percent of curable-stage colorectal cancer. Importantly, detection sensitivity was not affected by tumor location or stage.
The test detected the majority of large precancerous polyps at high risk for cancer progression.
Sensitivity was 64 percent for polyps larger than 1 centimeter (cm), 77 percent for those larger than 2 cm and 92 percent for those larger than 4 cm.
“These data illustrate the strength of the multi-marker stool DNA test to the critical screening targets — pre-cancers and early-stage cancer,” says co-investigator Stephen Thibodeau, Ph.D., a genetics researcher at Mayo Clinic. “And, importantly, this test appears to uniquely represent an accurate noninvasive approach to large polyp detection, which offers the promise of actually preventing cancers from developing.”


The second article, titled “Stool DNA vs. Plasma Septin 9 Testing,” uses the results of the first study to compare the sensitivities of the stool DNA test and a plasma test for methylated Septin 9 (SEPT9) in identifying patients with large adenomas or colorectal cancer. Highlights include:


The stool DNA test detected 82 percent of precancerous polyps compared to only 14 percent detected by SEPT9.
The stool DNA identified 87 percent of cancers at any stage, compared to 60 percent with SEPT9.
Stool DNA was even more effective at detecting curable-stage cancer (Stage I, II or III), detecting such cases 91 percent of the time, compared to just 50 percent with SEPT9.
The SEPT9’s rate of false-positives was nearly four times that of stool DNA (27 percent vs. 7 percent).

Normal Bone Density Can Delay Retests, Study Suggests

According to the New York Times, Medicare pays for a bone density test every two years, leading many doctors to assume that this is the ideal interval. Moreover, there has been a surge in bone density screening since Fosamax was approved in 1995. According to the New York Times, "For years, doctors were overly enthusiastic, prescribing it for women whose bone density was lower than normal but not in a danger zone, keeping women on the drug indefinitely." However, a wave of studies have provided mounting evidence suggesting that women face an increased risk of sustaining an atypical Fosamax femur fracture when taking the drug for a prolonged period of time.


The Fosamax lawyers at Bernstein Liebhard LLP are currently representing clients and actively filing cases In re: Fosamax Litigation (No. 282 NJ. Super. Ct.)), pending in the Superior Court of New Jersey, Atlantic County, on behalf of individuals who allegedly sustained a femur fracture as a result of taking Fosamax.


The researchers report that fewer than 1 percent of women with normal bone density when they entered the study, and fewer than 5 percent with mildly low bone density, developed osteoporosis in the ensuing 15 years. But of those with substantially low bone density at the study’s start, close to the cutoff point for osteoporosis of fewer than 2.5 standard deviations from the reference level, 10 percent progressed to osteoporosis in about a year.


Dr. Margaret Gourlay, the study’s lead author and a family practice specialist and osteoporosis researcher at the University of North Carolina, said she and her colleagues were surprised by how slowly osteoporosis progressed in women.


Medicare pays for a bone density test every two years and many doctors have assumed that is the ideal interval, although national guidelines recommend them only at “regular intervals.”


“I think this will change the way doctors think about screening,” Dr. Gourlay said.


The results, said Joan A. McGowan, director of the division of musculoskeletal diseases at the National Institute of Arthritis and Musculoskeletal and Skin Diseases, “provide telling evidence that you are not going to fall off a cliff if you have normal bone density in your 60s or early 70s, that you are not going to have osteoporosis in the next five years unless something else happens.”


For example, said Dr. McGowan, who was not involved in the study, a woman who had to take high doses of corticosteroids for another medical condition would lose bone rapidly. But the findings “cover most normal women,” she said.


Bone density screening took off after Fosamax, the first bisphosphonate, was approved at the end of 1995. For the first time, doctors had a specific treatment that had been shown to prevent fractures in people with osteoporosis.


For years doctors were overly enthusiastic, prescribing it for women whose bone density was lower than normal but not in a danger zone, keeping women on the drug indefinitely. They even gave a name, osteopenia, to lower than normal bone density, although it was not clear it had real clinical significance.


Now, osteoporosis experts consider osteopenia to be a risk factor, not a disease, and its importance varies depending on a patient’s age, said Dr. Ethel S. Siris, an osteoporosis researcher at Columbia University who was not involved in the study.


Doctors are more likely to prescribe bisphosphonates for older patients and recommend against them for most younger postmenopausal women with osteopenia.


The experts also generally recommend that most people on bisphosphonates take them for just five years at a time, followed by a drug holiday of undetermined length. The idea is to reduce the risk of rare but serious side effects, including unusual thighbone fractures and loss of bone in the jaw.


A risk calculator, FRAX, can help determine whether treatment is recommended. It assesses a combination of risk factors: whether a parent has had a hip fracture, the age of the patient, steroid use, bone density at the hip, and whether the person has broken a bone after age 50, an especially important indicator. Nearly half who break a hip already had already broken another bone, Dr. Siris said.


“If you are an older individual, a man or a woman, who already broke a major bone — spine, hip, shoulder, or pelvis or wrist — take it very seriously and get treated,” she said. “If you have relatively good bone density then you are not at risk now.”

Tobacco Policies ‘Abysmal’ in U.S. States, Lung Group Says

BALTIMORE — Maryland took steps forward in some areas, but fell short in others to protect children and curb tobacco-related disease in 2011, according to the American Lung Association’s State of Tobacco Control 2012 report. Virginia scored an F in each of four categories measured, while Delaware was among only four states that received all passing grades.


The Lung Association’s annual report card on tobacco control monitors progress on key tobacco control policies at federal and state levels, and assigns grades to assess whether laws are protecting citizens from the health burden caused by tobacco use.


Maryland joins other states that fell short in its responsibility to enact "much needed" laws and policies that save lives and reduce tobacco-related disease, the Lung Association said in a statement released Thursday afternoon.


Teen smoking dropped last year to the lowest level since 1975, researchers at the University of Michigan said Dec. 14 in a survey funded by the National Institute on Drug Abuse. About 11.7 percent of eighth-, 10th- and 12th-graders said they had smoked in the previous 30 days, compared with 12.8 percent in 2010.


The decline signaled that state tobacco-prevention policies enacted before 2011 were working, McGoldrick said.


“You’re not saving money by cutting these programs,” he said. “It’s like a person who says, ‘My medicine was working so I stopped taking it.’ If it works, we need to keep doing it, and we know it works.”


None of the states earned “A” grades in all four policy areas covered in the report: cigarette taxes, smoking bans, tobacco-prevention spending and cessation coverage. Delaware, Hawaii, Maine and Oklahoma were the only states that received passing grades in all four areas.

Diabetics call Paula Deen a hypocrite for hiding disease

Drug giant Novo Nordisk has nabbed Paula Deen, the celebrity chef who popularized, among other things, cheeseburger meatloaf and hamburgers served with eggs and bacon on doughnuts instead of buns, as a new spokeswoman to help raise awareness about type 2 diabetes – which she has. Many in the drug industry wish it weren’t so, but without major legal and regulatory changes, such matches between celebs and drug firms are as certain as the sun rising in the east. That’s too bad, because it may not be the best thing for the drug firms themselves over the long run.


Deen gave no comment when it was requested through the Food Network. But a source close to the network tells Fox411 that they found out about Deen's condition only a week ago , and they will take her lead on whether her show’s programming will change.
Some of Deen’s fans expressed outrage that the 65-year-old chef had found what they believe is a way to capitalize on a diagnosis she kept a secret for so long.
“I understand she has an empire and a huge following to protect, but working with Novo Nordisk is just adding another revenue stream, and that is tweaking people like me who are in the diabetes education community,” said Carl Moore, a longtime fan of Deen’s who has her cookbooks in his home (though he has always modified the recipes to include less sugar and less butter). Moore, a type 2 diabetic and an educator on diabetic issues, said the news didn’t come as a surprise to him and others with the disease.
“Many of us have watched the Buttuh Queen for years cooking with no thought for the consequences and waiting to hear she was diabetic,” he said.
Betsy Lampe, who has struggled with type 2 diabetes for more than 20 years, said Deen has already missed her first opportunity to educate victims of the disease.
“She didn’t tell us anything on the 'Today Show'; she got really defensive,” Lampe told Fox411. “She didn’t tell us what her blood sugars were. You know, diabetics want to entertain and cook too. If I were her I would have announced a whole new show for entertaining as a diabetic. It was just offensive to me.