Direct Mailing Colorectal Fecal Kits Increases Screening Rates, Study Finds

Proactively mailing fecal occult blood test (FOBT) kits directly to older consumers, with follow-up letters and phone calls, nearly doubled the number of people who reported adherence to national screening guidelines for colorectal cancer, according to study results published in the May 19 Journal of the National Cancer Institute (JNCI).

The study, by University of Minnesota researcher Dr. Timothy Church, compared screening compliance rates among 1,451 people, aged 50 and older, in Wright County, Minn. They were divided into three equal test groups. The control group received a questionnaire asking if they had used any of the screening procedures recommended in national guidelines, such as an annual FOBT or flexible sigmoidoscopy every 5 years. The second group received the questionnaire and also was mailed FOBT kits. The third group received the questionnaire, FOBT kits, and was later contacted by letter and phone.

One year later, researchers sent a nearly identical questionnaire to all study subjects. The control group indicated a 7.8 percent increase in their rates of adherence to national screening guidelines, compared with their response to the first questionnaire. The second group reported a 13.2 percent increase; the third group, a 14.1 percent increase - almost double (6.4 percent difference) the increase in the control group.

"Although an increase of 6.4 percent may seem modest at first glance, the population to which it applies is large," the researchers noted. They estimated an equivalent increase nationwide would translate "into nearly 2 million additional people adherent to screening recommendations."

Recovery from Stem Cell Transplantation Can Take Years Longer than Expected

Myeloablative hematopoietic cell transplantation (HCT) recipients generally take 3 to 5 years for full physical and emotional recovery from surgery, according to findings of a study in the May 19 Journal of the American Medical Association, by Dr. Karen L. Syrjala and colleagues at the Fred Hutchinson Cancer Research Center. The authors had previously hypothesized that full recovery from HCT would occur within 1 year. HCT, which generally entails transplantation of stem cells from either bone marrow or peripheral blood, is a common treatment for hematopoietic malignancies such as leukemia and lymphoma.

Before beginning HCT and for 5 years after completion, the researchers evaluated patients' physical and work limitations, depression, and distress related to treatment or disease. Researchers found that physical recovery occurred faster than psychological or occupational recovery. After 1 year, only 19 percent of patients recovered on all outcomes, with the number increasing to 49 percent after 3 years and 63 percent after 5 years. Most survivors (84 percent) eventually returned to full-time work.

"Higher levels of depression, lower levels of physical function, and less satisfaction with social support before HCT increased the risk of impaired physical and emotional recovery after the transplantation," write the authors. "Recovery might be accelerated by more effective interventions to increase work-related capabilities, improve social support, and manage depression."

Danish Study Links Hodgkin's and MS

A study published in the May 19 JNCI appears to validate a decades-old theory that multiple sclerosis (MS) and Hodgkin's lymphoma (HL) in young adults (between 15 and 44 years old) tend to cluster together in families. The study was conducted by Dr. Henrik Hjalgrim of the Danish Epidemiology Science Centre at Statens Serum Insitut, in Copenhagen.

Using data collected between 1968 and 1997 from the Danish Registration System, the Danish Multiple Sclerosis Registry, and the Danish Cancer Registry, the research team assembled a study cohort of 11,790 patients with MS and 19,599 of their first-degree relatives and 4,381 patients with HL and 7,388 of their first-degree relatives. Statistical analyses indicated that family members of MS patients had an increased risk of developing young-adult-onset HL and family members of HL patients had an increased risk of developing MS. In addition to a heightened HL risk among first-degree relatives of MS patients, the report found that the cohort also had a greater risk of developing non-Hodgkin's lymphoma. Data analysis yielded no correlation between HL and MS.

"The accumulation of young-adult-onset Hodgkin's lymphoma and multiple sclerosis within families may reflect the effects of shared environmental or constitutional risk factors for the two diseases or, more likely, a combination of such factors," the researchers wrote.

FDA Approves Drugs for Prostate Cancer and
Myelodysplastic Syndrome

Taxotere (docetaxel) injection - a treatment for breast cancer and non-small-cell lung cancer - has now been approved by the FDA for treatment of advanced metastatic prostate cancer when used in conjunction with the steroid prednisone. This approval offers new hope for patients whose disease has not responded to other treatments, said Dr. Lester M. Crawford, acting FDA commissioner. The safety and effectiveness of Taxotere were tested in more than 1,000 patients worldwide by comparing Taxotere and prednisone to mitoxantrone (a standard chemotherapy agent) and prednisone. Results showed that the Taxotere-prednisone therapy, administered every 3 weeks, increased patient survival by approximately 2 and a half months compared with the control group. Taxotere inhibits tubulin, a protein involved in cellular transport and division.

Another recent FDA approval is for Vidaza (azacitidine) injection, the first effective treatment for patients with the bone marrow disease myelodysplastic syndrome (MDS). In MDS, bone marrow cannot produce enough blood cells; those that are produced are usually defective and eliminated by the immune system. About 30 percent of MDS cases progress to acute leukemia. Vidaza was developed and tested under the Orphan Drug Act, which encourages scientific research and testing of therapies for rare diseases that typically affect less than 200,000 people worldwide. "The [FDA] continues to make approvals of these types of remarkable drugs one of its highest priorities," said Commissioner Crawford.