Women get Pap tests and mammograms, but not colorectal cancer screenings.

Researchers reviewed the 2001 Behavioral Risk Factors Surveillance Study (BRFSS) conducted by the Centers for Disease Control. The study involved more than 54,000 women over the age of 50.

Nearly 70 percent had a Pap smear and 82 percent had been screened for breast cancer with a mammogram, but only 46 percent had been tested for colon cancer.

Those who had both a Pap test and a mammogram were more than 5 times as likely to have had colon screening.

Ruth Carlos M.D. from the University of Michigan Health System discussed her analysis at the American Roentgen Ray Society Annual Meeting in New Orleans in May.

The study authors commented that doctors who recommend Pap tests and mammograms should also encourage colorectal screening at the same time.

Read an article about the study on Ivanhoe.Com

ASCO panel recommends that routine chemotherapy not be used to treat stage II colon cancer

After studying all the clinical trials that compared chemotherapy after surgery for stage II patients with no further treatment, a panel of experts found that for most patients there was little or no advantage to chemotherapy and some risks from treatment. Studies included in the meta-analysis all were based on some form of 5FU chemotherapy.

They did identify some patient populations for whom adjuvant treatment should be considered -- those with inadequately sampled lymph nodes, tumors that perforated the colon or extended outside the colon wall, or cancers with poorly differentiated cells.

They also could find no evidence for the usefulness of molecular markers like microsatellite instability or changes in chromosome 18 as indicators of the need for or effectiveness of adjuvant chemotherapy.

The study authors, led by Al B. Benson III, M.D., encouraged stage II patients to participate in randomized clinical trials.

About 25,000 people are diagnosed with stage II colon cancer in the United States each year, and data shows that a significant percentage of them will receive adjuvant chemotherapy after their surgery.

Read the abstract in the Journal of Clinical Oncology.

Read an article about the study on Medscape -- New Guidelines for Stage II Colon Cancer.

Read a discussion of the new guidelines by John MacDonald M.D. on Medscape.

Anastomotic leak as a complication of colorectal cancer surgery leads to poorer survival

Surgeons in Australia reviewed records of over 1700 patients who had potentially curative surgery for colorectal cancer for evidence of leakage at the anastomosis. The anastomosis is the connection made in the colon after the section of intestine that contains the cancerous tumor is removed.

Generalized leakage can lead to serious infection and requires additional surgery to repair the problem. Local leakage can be less serious and be drained through the skin.

Researchers found anastomotic leaks in 5.1% of the patients they studied, 1.6 % generalized and 3.5% local.

After taking into account a number of other factors, they found that such leakage -- even if it were localized -- led to poorer survival five years later. Overall survival for patients without a leak was 64.0%. Survival in those with a leak fell to 44.3 %.

Results of the study were reported by Kenneth Walker M.D. and his colleagues in the August 2004 Annals of Surgery.

Read an article about the study on Medscape.

Read the abstract in the Annals of Surgery.

Phase II study of capecitabine (Xeloda) alone shows little benefit in patients whose cancer had already progressed on 5FU treatment

Researchers at M.D. Anderson treated a small group of patients with single-agent capecitabine after their metastatic colorectal cancer had progressed on other treatments that included 5-flourouracil.

None of the patients showed any objective response to the treatment. Half of the patients had stable disease that lasted for a median duration of 141 days. Stable disease time ranged from 88 to 289 days.

Toxicities included hand-foot syndrome, diarrhea, and nausea and vomiting.

The research team wrote,

"CONCLUSION: Single-agent capecitabine in patients with metastatic colorectal carcinoma refractory to FU showed no objective responses and clinical benefit that was, at best, modest. The use of capecitabine in combination with other treatments in this patient population is under investigation."

Report of the study appears in Journal of Clinical Oncology, Vol 22, No 11 (June 1), 2004: pp. 2078-2083

Read the study abstract in the Journal of Clinical Oncology

Physical symptoms, not psychological factors, can predict length of survival in advanced cancer

Health related quality-of-life factors including chronic nausea and vomiting, shortness of breath, and weakness can help doctors and their patients predict individual survival times according to a study of over 1000 people with terminal cancer.

Patients in the study included those with colorectal, breast, genitourinary, and lung cancer. Two groups were assessed and followed, one at the beginning stages of advanced cancer and a second in the later stages.

The strongest predictive factors were liver metastases, lung tumors, and overall tumor burden. However, nausea, vomiting,and shortness of breath also were associated with worse survival in the group assessed at the beginning of the terminal phase.

For those assessed later in the course of their disease, nausea and vomiting, shortness of breath, and weakness increased risk of death more than the type of tumor.

There was no connection found between poorer survival and psychosocial factors such as anxiety or spiritual distress.

The study authors believe that symptoms such as nausea, vomiting, shortness of breath, and weakness may signal cancer cachexia -- the wasting of body tissues that leads to death from cancer.

Antonio Vigano, M.D. and his colleagues published the results of their research in the online version of Cancer on June 26, 2004.

Read the study abstract from Cancer.

Read an article about the study in Science Daily.