Women who have excess fat around their waists, so-called central adiposity, have an increased risk for colon cancer according to a study in the March 2000 issue of the International Journal of Cancer.

Studying 24,000 women over 10 years, researchers in Australia measured waist circumference and waist-to-hip ratios (WHT) ratios at the beginning of the study.  During the ten years, there were 212 colon cancers.  Women whose waist measurements were larger than their hips, a sign of central adiposity, were about 30% more likely to have colon cancer than  women with narrow waists.  Larger waist measurements (waist circumference) increaed colon cancer risk by about 15%.

There was some evidence that additional central fat predisposed women in the study to cancers in the proximal colon or the first section of colon.  Given their increased risk for colon cancer and the stronger possibility that the cancer might be located near the beginning of the colon, women with excessive waist fat probably should consider screening tests like colonoscopy that examine the entire colon.

Other studies have showed a similar increase in colorectal cancer risk for men with excess waist fat.

An article about the study is available from Reuters Health..

waist fat colon cancer risk colon cancer in women

Health and Human Services officials have clarified ways that drug manufacturers can continue to provide free medications to needy patients, even if those patients are enrolled in Medicare Part D prescription coverage.

HHS Inspector General Daniel Levinson clarifed his position on Tuesday, April 19, 2006 that there are “lawful avenues” for pharmaceutical companies to give financial assistance to needy Medicare patients.

Critical to such programs are:

• No Medicare payment is sought for free drugs.
• Assistance is based solely on financial need.
• There is a methodology for assistance that does not take into account the patient’s choice of a Medicare Part D drug plan.

In January 2006, HHS provided guidance to pharmaceutical companies and patient assistance programs to ensure that the programs operated legally and did not pressure any patient to take a particular drug.

There has been confusion over whether patients could be required to drop out of Part D in order to receive drug assistance or help with co-pays.  In addition, some pharmaceutical company patient assistance programs have required that patients enroll in Part D.  However, patients do not need to drop out of Part D or be compelled to enroll to meet federal requirements.

Pharmaceutical companies can help with Medicare Part D co-pays as long as there is no company pressure to persuade a patient to use a particular drug.  Many companies are turning to not-for-profit organizations to provide counseling and financial help with co-pays through unrestricted grant programs to those organizations.

Patients over 65 with stage III colorectal cancer who completed the full 6 month course of chemotherapy were almost twice as likely to survive as those who stopped treatment early.  However, about 30% dropped out of therapy early.

Examing data for 1,600 people over 65 receiving 5FU-based chemotherapy between 1995 and 1999 and lived at least 8 months, researchers found that those who were able to complete 5 to 7 months of treatment were 40% less likely to die from any cause and 47% less likely to die of colon cancer.

Older age, being unmarried, and having other health problems all contributed to those who didn’t finish chemotherapy.

Alfred I. Neugut and his colleagues from Columbia University and New York Presbyterian Hospital reported the results of their study in the Journal of Clinical Oncology published early online on April 17, 2006. 

More than 30% of elderly patients who initiated FU-based chemotherapy for stage III colon cancer and survived for at least 8 months discontinued treatment early. Mortality rates among such patients were nearly twice as high as among patients who completed 5 to 7 months of treatment. If the association we observed between duration of treatment and survival is confirmed, additional investigation is warranted to determine whether dose-intensity, cumulative dose, or other factors related to receipt of full adjuvant treatment are responsible.

chemotherapy

Patients over 65 with stage III colorectal cancer who completed the full 6 month course of chemotherapy were almost twice as likely to survive as those who stopped treatment early.  However, about 30% dropped out of therapy early.

Examing data for 1,600 people over 65 receiving 5FU-based chemotherapy between 1995 and 1999 and lived at least 8 months, researchers found that those who were able to complete 5 to 7 months of treatment were 40% less likely to die from any cause and 47% less likely to die of colon cancer.

Older age, being unmarried, and having other health problems all contributed to those who didn’t finish chemotherapy.

Alfred I. Neugut and his colleagues from Columbia University and New York Presbyterian Hospital reported the results of their study in the Journal of Clinical Oncology published early online on April 17, 2006. 

More than 30% of elderly patients who initiated FU-based chemotherapy for stage III colon cancer and survived for at least 8 months discontinued treatment early. Mortality rates among such patients were nearly twice as high as among patients who completed 5 to 7 months of treatment. If the association we observed between duration of treatment and survival is confirmed, additional investigation is warranted to determine whether dose-intensity, cumulative dose, or other factors related to receipt of full adjuvant treatment are responsible.

Barrett’s esophagus is a condition in which there are pre-cancerous changes in the lining of the esophagus, the tube leading from the mouth to the stomach.  Reviewing a database of US veterans who had been diagnosed with Barrett’s esophagus (BE) and comparing them to a similar group who had not, researchers found that there was an increased risk of colon neoplasia (advanced polyps or cancer) in those with BE.

268 veterans in the study with BE were compared to 268 controls without BE.  All study participants had undergone upper GI endoscopy and colonoscopy.  Sicty percent of the BE patients had colon neoplasia while only 40% of controls had similar changes.  Advancing age and alcohol use were also associated with risk for colon neoplasia, but use of aspirin, NSAIDs, or proton-pump inhibitors were not.

The researchers, led by Peter D. Siersema MD, PhD concluded:

Veterans with BE are at an increased risk of developing colorectal neoplasia. This association is independent from the use of PPIs or aspirin/NSAIDs.

They cautioned that the study included only mostly male veterans.

The study was reported in the April 2006 issue of Gastrointestinal Endoscopy.