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Draft recommendations on screening mammography continue to stir debate

The release of new guidelines on mammography never fails to renew the heated controversy over the potential benefits and harms of this procedure. The latest draft guidelines from the U.S. Preventive Services Task Force (USPSTF) are no exception. The USPSTF recommends that women begin having mammograms at age 50 and stop at age 75. (The American Cancer Society and other medical organizations recommend that women begin getting regular mammograms at age 40.) The draft recommendations say there isn’t enough evidence to recommend or discourage the use of a new technique called 3-D mammography for screening, and also say there isn’t enough evidence to recommend that women with dense breasts, who are at higher risk of breast cancer, should have an ultrasound or MRI in addition to screening mammography. Comments can be made on the USPSTF draft until 8:00 pm Easter Time today. A final version of the recommendations is expected to be released in the fall of 2015.

Cardiovascular consequences of hormone therapy

A large study reinforces the current thinking on hormone therapy after menopause: it doesn't shield women from heart disease and may slightly increase their risk of a stroke.

For decades, doctors believed that hormone therapy could prevent heart disease. But in 2002, findings from the landmark Women's Health Initiative revealed that long-term hormone use boosted heart attack, stroke, and breast cancer risk.

Switching to a fiber-rich diet may lower colon cancer risk in blacks

Switching from a “Western” diet with lots of fat and meat to a fiber-rich diet for just two weeks makes conditions in the large intestine less favorable to the development of colon cancer. The opposite switch may promote the formation of cancer. That’s the conclusion from a small but elegant study done in urban Pittsburgh and rural KwaZulu-Natal, South Africa. In the study, 20 volunteers from each area switched diets. For two weeks, the Americans ate a traditional high-fiber African diet rich in fruits, vegetables, nuts, and beans, while the Africans ate a Western diet with more fat, protein, and meat. In just two weeks, significant changes occurred in the lining of the colon and in its chemical and bacterial make-up in both groups, but in different directions. Those following the African diet showed improvements in colon health likely to protect against colon cancer, while those following the Western diet showed changes that could lead to colon cancer.

Hormone therapy works best when combined with radiation for locally advanced prostate cancer

Men with locally advanced prostate cancer who combine hormone therapy with a course of radiation therapy tend to live longer than men who only take hormone therapy.

No “best” treatment for common uterine fibroids

Fibroids are noncancerous tumors that grow in the uterus. They may be smaller than a seed or bigger than a grapefruit. Depending on their size, number, and location, fibroids can cause heavy bleeding and long menstrual periods (which can, in turn, cause anemia), pelvic pain, frequent urination, or constipation. Fibroids can also cause infertility and repeated miscarriages. About 7 in 10 women will develop this condition at some point. Given how common uterine fibroids are, it’s surprising how few randomized trials have been done to compare treatment options. A clinical practice article in today’s New England Journal of Medicine lays out the options for treating uterine fibroids and discusses the factors women and their doctors should consider when making treatment decisions.

Targeted prostate biopsies better at detecting dangerous cancers

Standard biopsies of the prostate gland often miss potentially aggressive prostate cancer. Adding MRI images to standard biopsies improves the detection of prostate cancer.

Are you really getting enough exercise?

Resistance machines can provide safe, effective strength training.

Image: Thinkstock

To get the full benefit of your workout, you need to know how hard you're exercising, and that can be different for everyone.

Menopause symptoms can last longer than you expect

Hot flashes and other symptoms can take a decade or longer to recede, but there is no reason to suffer in silence. There are new options for relief and new tools to guide you.

What we know about menopause has changed a lot over the past few decades, thanks to volumes of research. For example, studies reported in recent months indicate that hot flashes and other menopausal symptoms last longer than previously thought, affecting substantial numbers of women in their 60s. And randomized clinical trials have taught us that hormone therapy can be a safe and effective way to control symptoms, although it's no longer recommended for reducing risk of cardiovascular disease. "There's now a critical mass of research showing that, for many women, the benefits of hormone therapy for treating hot flashes and improving quality of life outweigh the risks," says Dr. JoAnn Manson, Michael and Lee Bell Professor of Women's Health at Harvard Medical School.

Why do women fall?

It's well known that women fall more often than men, but why is that so? A team of Canadian researchers tackled that question by looking for factors that tend to put women at higher risk than men for spills.

The researchers studied around 15,000 adults ages 65 and older who were enrolled in the Canadian Community Health Survey–Healthy Aging. All the participants were asked if they had suffered a fall serious enough to limit their normal activity. People who answered "yes" were then queried about their lifestyles and medical histories. When the researchers analyzed the answers, they determined that stroke, arthritis, and poor nutrition increased the risk of falls in both men and women. However, different risk factors were linked to falls for women, including being 85 or older, having at least one alcoholic drink a week, taking five or more medications, and having diabetes or osteoporosis. The findings were reported online Feb. 19, 2015, by the American Journal of Epidemiology.

Younger women get inadequate treatment for heart disease, survey finds

Younger women with heart disease may be unaware of their condition and may not recognize the symptoms of a heart attack, according to a report in the March 2015 issue of Circulation. The finding came from a survey of women under 55 who had survived heart attacks.

Researchers from the Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction Patients' Health Status (TRIUMPH) study interviewed 30 women ages 30 to 55 who were hospitalized for heart attacks. They asked the women about their risk factors, the preventive measures they took the symptoms they experienced, and the treatment they sought and received.

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