December News Briefs

Obesity Boosts Esophageal Cancer Risk Six-fold

Obese people are six times as likely to develop esophageal cancer as people of "healthy" weight, shows research published ahead of print in the journal Gut. The findings are based on a comparison of almost 800 people with esophageal cancer and almost 1,600 randomly selected people eligible to vote, who did not have the disease.

Men and those under the age of 50 were especially vulnerable, the findings showed. Repeated symptoms of severe heartburn or gastroesophageal reflux disease (GERD) were associated with a much higher risk of the cancer. The more frequent the symptoms, the greater the likelihood of having esophageal cancer.

GERD quintupled the risk of esophageal cancer, and a combination of obesity and acid reflux boosted the chances of having it by a factor of 16. But people who were clinically obese had a much higher risk of esophageal cancer than those whose weight was in the healthy range, regardless of whether they had reflux disease or not. Those with a body mass index (BMI) of 0 or more were six times as likely to have the cancer as those with a BMI between 18.5 and 25.

This suggests that obesity is an independent risk factor for the disease, say the authors. Higher levels of fat tissue in the body boost insulin production, which increases the amount of circulating insulin-like growth factor. Both hormones stimulate cell growth and curb cell death, conditions that favor the development of cancers, they explain.

Fat cells also produce other hormones, collectively known as adipocytokines, which speed up cell growth and are involved in inflammatory processes in the body, they say.

REMICADE Reduces Bowel Surgeries in Ulcerative Colitis Patients

PHILADELPHIA — Clinical data presented at the annual meeting of the American College of Gastroenterology (ACG) in October 2007 show that REMICADE significantly reduces the incidence of colectomy surgeries for patients with moderately to severely active ulcerative colitis (UC). According to long-term extension data from the Active Ulcerative Colitis 1 and 2 trials (ACT trials), there is a 4 1 percent reduction in the incidence of colectomy in patients receiving REMICADE through 54 weeks, compared to those receiving placebo (p=0.015).

The analysis of the ACT extension trials included 728 patients from the initial ACT 1 and 2 trials, of whom 630 (86 percent) had complete follow-up through 54 weeks to ascertain whether they underwent colectomy surgery.

Chronic Digestive Problems Cause Work Absences

Those who suffer from common functional gastrointestinal disorders face work productivity losses and impairments in daily activity that equal the loss of at least one day of work in a 40-hour work week, according to a new study presented at the annual scientific meeting of the American College of Gastroenterology in October 2007.

Functional gastrointestinal disorders are associated with impaired quality of life and are among the most common causes of work-related absenteeism. Studies suggest these disorders contribute to “presenteeism” – coming to work but being less productive.

Study participants included patients with IBS with constipation (IBS-C), chronic constipation (CC) alone, gastroesophageal reflux disease (GERD), or functional dyspepsia (FD). Participants answered a questionnaire bi-weekly for a year between April 2005 and April 2006.

Patients with IBS-C, CC and FD reported greater work productivity loss and daily impairment over a six-month period than patients with GERD alone. The mean hours lost per week for the GERD patients were 6.3 compared to 10.3 hours per week for those with the other functional GI disorders.

Source: American College of Gastroenterology (ACG)

Simple, Personalized Interventions Improve Colorectal Cancer Screening Rates

Different types of personalized interventions can improve colorectal cancer (CRC) screening rates in primary care practices, according to a new study. Writing in the Nov. 1, 2007 issue of CANCER, researchers found in primary care practices that, compared to no intervention at all, a personalized behavioral intervention service offered to patients who are not up to date with screening guidelines — from a simple targeted mailing of CRC information and screening supplies to contacts that address psychosocial barriers to screening use — significantly improved CRC screening rates.

The investigators found that two years after enrollment, patient screening rates were significantly higher in intervention groups compared to the control group.

Advanced age and education levels, and prior cancer screening, were predictive of higher rates of screening.

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