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Other highlights in the September 3 issue of JNCI

Journal of the National Cancer Institute

Overall U.S. Cancer Incidence, Mortality Rates Have Stabilized

Overall cancer incidence and death rates have stabilized, a trend that began in the mid- to late 1990s, according to the Annual Report to the Nation on the Status of Cancer, published in the September 3 issue of the Journal of the National Cancer Institute.

The report, produced annually by the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries, updates statistics on lung, female breast, prostate, and colorectal cancers and highlights the uses of selected surveillance data to assist in the development of state-based cancer control plans.

The authors note that observed cancer incidence rates for all cancer sites combined increased from the mid-1970s through 1992, decreased from 1992 through 1995, and were essentially stable from 1995 through 2000. Death rates for all cancer sites combined decreased beginning in 1994 and stabilized from 1998 through 2000, resulting in part from recent revisions in the coding system used on death certificates. Analysis of state data for the leading cancers revealed mixed progress in achieving national objectives outlined in Healthy People 2010, an agenda for health promotion goals created by several federal agencies.

Contact: National Cancer Institute, 301-496-6641, ncipressofficers@mail.nih.gov

Carboplatin Regimen Better Tolerated in Patients with Advanced Ovarian Cancer

The chemotherapy regimen of carboplatin plus paclitaxel is as effective as cisplatin plus paclitaxel, but the carboplatin-paclitaxel regimen is associated with better tolerability and quality of life, according to a study from the Ovarian Cancer Study Group in Germany.

Ovarian cancer is rarely cured and more than 50% of patients die within 5 years of being diagnosed with the disease. Earlier studies had suggested that carboplatin plus paclitaxel might be better tolerated than cisplatin plus paxlitaxel. To test this hypothesis, Andreas du Bois, M.D., Ph.D., of the Dr. Horst Schmidt Hospital in Wiesbaden, Germany, and colleagues performed a randomized, phase III clinical trial comparing cisplatin plus paclitaxel with carboplatin plus paclitaxel in 798 women with advanced ovarian cancer.

They found that the proportion of patients without disease progression at 2 years was not statistically significantly different between the treatment arms. They also found that, although the carboplatin-paclitaxel regimen was associated with a higher frequency of hematologic toxicities, it was associated with a lower frequency of gastrointestinal and neurologic toxicities and better quality-of-life scores than the cisplatin-paclitaxel regimen. The authors conclude that the carboplatin-paclitaxel regimen should be considered as an alternative for first-line therapy in ovarian cancer patients.

Association Found Between Blood Transfusions and HHV-8 Seropositivity

The risk of human herpesvirus 8 (HHV-8) transmission from blood transfusions is approximately equivalent to the 1-year cumulative risk of infection from non-transfusion related community sources, according to a study of children with sickle-cell disease in Uganda.

In Africa, HHV-8 prevalence is estimated to range from 20% to 80% in adults. Although HHV 8, the infectious agent associated with Kaposi's sarcoma, can be detected in peripheral blood, blood-borne transmission of the virus has not been demonstrated. To investigate a possible association between blood transfusions and HHV-8 seropositivity, Sam M. Mbulaiteye, M.D., of the National Cancer Institute, and colleagues studied 600 children with sickle-cell disease at Mulago Hospital in Kampala, Uganda.

The authors found that HHV-8 seropositivity was more frequent in children who had received transfusions than in those who never had transfusions, and that seropositivity increased with the number of reported transfusions. Overall, the estimated HHV-8 transmission risk was 2.6% per transfusion, whereas the annual risk of infection unrelated to transfusion was 2.7%.

HPV Status May Help Identify Prognosis of Cervical Lesions

Precursor lesions of the cervix persist longer, progress more rapidly, and regress more slowly in women infected with oncogenic types of human papillomavirus (HPV) compared with women infected with a non-oncogenic HPV type or in women with no HPV infection, according to a study by Nicolas F. Schlecht, Eduardo L. Franco, and colleagues at McGill University in Montreal.

Cervical cancer results from a series of reversible changes in the cervical tissue. A biomarker that could predict the duration of a cervical lesion or the speed of its progression or regression would be useful for identifying women whose lesions are likely to progress quickly to more advanced stages. Schlecht and colleagues used data from a longitudinal study of HPV infection and cervical neoplasia in Brazil and determined that the type of HPV infecting the cervical tissue may serve as such a biomarker. The authors suggest that HPV testing of women with abnormal Pap smears may help identify women who might benefit from chemopreventive treatment.

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Note: The Journal of the National Cancer Institute is published by Oxford University Press and is not affiliated with the National Cancer Institute. Attribution to the Journal of the National Cancer Institute is requested in all news coverage.

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