Division Notes

Science Article
October 17, 2002

Improving survival gets focus at global breast-cancer summit

Researchers at a Seattle breast-cancer summit last week delved into improving breast-cancer treatment- and therefore survival - in countries with limited resources.

Dr. Ben Anderson, who chaired the Oct. 2-5 Global Summit Consensus Conference, said that while advances in early diagnosis and treatment of breast cancer have enhanced survival in the United States, breast-cancer survival is much worse in less developed countries.

"Women are dying because of a lack of knowledge," said Anderson, director of the UW Breast Care and Cancer Research Program and the Breast Cancer Specialty Center at the Seattle Cancer Care Alliance.

"We're bringing people together to change that. We need to come up with practical guidelines that can work in economically challenged regions."

Fred Hutchinson and UW researchers, along with three breast-cancer foundations, sponsored the international meeting, aiming to develop a consensus statement for international breast-care guidelines and breast-care guidelines to be used worldwide.

The first international conference on breast care, cancer treatment and screening methods in countries with limited financial and health care resources, the meeting was held at the Elliott Grand Hyatt. More than 40 health-care providers from 16 countries participated.

Participants will continue to meet in small groups to develop guidelines. A consensus statement will be published in the Breast Journal and disseminated through world health and medical organizations.

Organizers plan similar conferences every other year. Dates for 2004 will be announced next spring.

Other institutional sponsors were the World Society for Breast Health, the Susan G. Komen Breast Cancer Foundation and the International Society of Breast Pathology. Corporate sponsors included Ethicon Endo-Surgery, Inc., AstraZeneca and Novartis Oncology.

No effect on prostate deaths seen with aggressive testing, treatment

Aggressive screening and treatment for prostate cancer in older men does not reduce deaths from the disease during a decade of follow-up.

That's the result of a study published this month in the British Medical Journal by Dr. Janet Stanford and colleagues in the Public Health Sciences Division.

The researchers conducted a "natural experiment," comparing prostate-cancer mortality rates in two geographic regions that differ in rates of screening using prostate-specific antigen (PSA) tests and prostate biopsy and in two treatment methods: and incidence of radical prostatectomy and external beam radiotherapy.

The regions were the Seattle-Puget Sound area and the state of Connecticut. The patients, Medicare beneficiaries age 65 to 79 without prostate cancer as of January 1987, lived in one of the two regions in 1987-90.

Men in the Seattle-Puget Sound area were found to undergo PSA testing at more than five times the rate of men in Connecticut in 1987-90. The prostate biopsy rate was 2.20 times higher in the Seattle region compared to Connecticut. From 1987 to 1996, 2.7 percent of men with prostate cancer in the Seattle-Puget Sound region underwent radical prostatectomy, compared with 0.5 percent of men with prostate cancer in Connecticut.

The researchers found that over an 11-year period, prostate-cancer mortality rates did not differ significantly between the two populations. The findings raise questions about the recent decline in U.S. prostate-cancer mortality, which many have attributed to more aggressive screening and treatment. Another possible factor is earlier treatment of recurrent or progressive prostate cancer with androgen ablation therapy, which also may have lowered mortality rates over the past decade.

"The true efficacy of prostate-cancer screening in terms of saving lives can only be determined by clinical trials in which men are randomized either to a screening group that undergoes an annual PSA blood test and digital rectal examination or a no-screening group, with sufficient follow-up time to ascertain prostate-cancer specific deaths," Stanford said.

Such trials are now under way in the United States and Europe, and results will not be available for several years.

Data on prostate cancer incidence and deaths in the Stanford study cohorts were obtained from the regional Surveillance, Epidemiology and End Results programs, including the Seattle-Puget Sound registry, known as the Cancer Surveillance System, located in PHS.

In addition to Fred Hutchinson, study collaborators included Harvard Medical School, HealthStat of Princeton, N.J., the University of Connecticut Health Center and Dartmouth Medical School.

Vail, Law speak on doctoral careers

Dr. Mary Vail, program manager and teaching scientist for the Science Education Partnership, and Dr. Wendy Law, postdoctoral fellow with SEP, will talk about their career paths at a seminar next week.

"What to do with a Ph.D. in biological sciences" runs from 4:30 p.m. to 5:30 p.m. Wednesday, Oct. 23, in University of Washington Health Sciences T739.

The session, open to students and postdoctoral fellows, is part of a seminar series at the UW featuring doctoral speakers from a variety of scientific careers. For more info, visit: http://courses.washington.edu/phd/.

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