The Top 10 health stories of 2006, from the Harvard Health Letter

Harvard Health Letter
  1. A new shot in the arm against cancer. The newly approved HPV vaccine represents a different approach to fighting cancer. Instead of just screening patients to spot cancer early, doctors can use this vaccine to actively prevent it. The vaccine is designed to immunize women against infection by two strains of human papillomavirus (HPV), which are believed to cause some 70% of cervical cancers. Because the vaccine cannot prevent the remaining 30%, screening with Pap smears will remain important, but that may change as the vaccine is improved and cervical cancer becomes increasingly rare.
  2. Trans is fat non grata. This year it became easier to avoid trans fats after the FDA required food manufacturers to list trans fat content in the Nutrition Facts portion of food labels, the first major change to the label in over a decade. Meanwhile, New York City and Chicago have proposed measures to limit trans fats in restaurant foods. If those laws go into effect, they may set a nationwide trend.
  3. Has Massachusetts figured it out? Massachusetts adopted the most promising plan yet for universal health insurance coverage. The law combines subsidies to those who can't afford health insurance with a mandate that everyone have it. Devils are lurking in details of the implementation, such as the amounts of the subsidies, but other states may follow suit.
  4. New treatment for macular degeneration. A promising new approach focuses on angiogenesis, or the formation of blood vessels. The FDA approved Lucentis, an anti-angiogenic drug aimed at the blood vessels that cause wet macular degeneration, a leading cause of blindness. Studies have found that the drug improves vision, a remarkable result. Up to now, the best treatments could only halt further deterioration.
  5. Germ warfare — and the germs are winning some battles. Antibiotic-resistant "superbugs" are causing more trouble than ever. Virulent strains of bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile, once seen only in hospital settings, are now circulating in communities. Extremely drug-resistant TB, a problem in poor countries, emerges when people don't take the full course of their TB medicines.
  6. Vaccines, kid stuff no more. "Getting your shots" is becoming a bigger part of adult preventive medicine. In 2006, the FDA approved Zostavax, the first vaccine against shingles, a condition that typically affects people over age 60. And a vaccine against pertussis is now part of the increasingly busy adult vaccine schedule.
  7. Drug approvals — with strings attached. The FDA allowed the multiple sclerosis drug Tysabri back on the market, with careful restrictions to ensure patients are closely monitored. The drug had been withdrawn in 2004 because of rare cases of brain infection. Several years ago the agency let Lotronex, the controversial irritable bowel syndrome drug, back on the market, but with restrictions. These actions show a shift to modified approvals by the FDA rather than only the traditional yes-or-no rulings.
  8. Bird flu preparations: Don't chicken out now. The disease continues to smolder, vaccine development inches forward, and the public and the press are showing signs of bird flu fatigue. Still, preparation is time and money well spent, because a pandemic could be horrific.
  9. Calls for FDA reform getting louder and clearer. The Institute of Medicine released a report calling for two dozen reforms. One major theme: The approval process will never ferret out all the problems with a drug, so the agency needs tough, new powers to better monitor drugs after they are on the market. The report says that more funding for the FDA should come from government funds rather than user fees. The committee also proposes using a special symbol on new drugs to let consumers know that those drugs lack a track record.
  10. D: Finally, a vitamin makes the grade. Several new studies suggest that the so-called sunshine vitamin (because it's produced in skin exposed to sunlight) may protect against cancer. One study showed that as blood levels of vitamin D go up, women's breast cancer risk goes down. Another found that fairly large amounts of vitamin D lowered the risk for pancreatic cancer by about 40%.
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