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News briefs

The pandemic may have you feeling reluctant to seek medical treatment. But when it comes to cancer care, even a short delay in treatment may lead to deadly outcomes, according to a review of 34 studies published online Nov. 4, 2020, by BMJ. Researchers evaluated treatment delay and survival in more than a million people who had cancer of the bladder, breast, colon, rectum, lung, cervix, or head and neck. Each four-week delay in treatment � whether surgery, radiation therapy, or medication (such as chemotherapy or immunotherapy) � was associated with an increase of 6% to 8% in the likelihood of dying during the study period. Scientists say delays of up to eight weeks and 12 weeks further increased the risk of death. For example, in women who delayed breast cancer surgery by eight weeks, there was a 17% increased death risk; women who delayed surgery by 12 weeks had a 26% increase. Keep in mind, there are lots of unavoidable reasons why cancer treatment might be delayed, such as not being strong enough to undergo procedures or scheduling issues at a treatment center. But if there isn't a good reason to delay, it's best to get treatment as soon as possible.

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Many studies have explored the relationship between hair dye use and risk of cancer or cancer-related death, with conflicting findings. In a recent study, researchers analyzed survey data from over 117,000 women collected over several decades regarding hair dye use and overall cancer risk.

Screening for colorectal cancer can lower mortality, but it varies in effectiveness and is not always possible to perform, so alternatives are needed. Researchers analyzing studies found evidence for regular use of low-dose aspirin, leading the US Preventive Services Task Force to recommend it for some people.

In the journals

Colon cancer prevention involves following a healthy lifestyle � for instance, exercising and not smoking � and periodically getting a screening test such as a colonoscopy. But what impact do diet and medications have? A recent review of 80 statistical analyses published over the last 40 years explored this question. The review was published online Oct. 1, 2020, by the journal Gut.

Over all, the results were disappointing in that no specific drug, food, or supplement stood out in the body of evidence. Yet some of the reviewed studies did show a link between a lower risk of colon cancer and use of nonsteroidal anti-inflammatory drugs (NSAIDs) � such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) —and a higher intake of fruits, vegetables, and fiber. But other studies did not.

Drinking no more than four or five 8-ounce cups of coffee per day—equal to about 400 milligrams of caffeine—helps people get the drink's health benefits with a lower risk of caffeine side effects like anxiety and nervousness.

Increasingly, doctors are turning to prevention for this hard-to treat cancer.

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Ovarian cancer is a challenging foe. It's often found at an advanced stage when it's difficult to treat.

In recent years, researchers have learned that many cases of ovarian cancer don't even start in the ovaries. "It turns out that ovarian cancer is a bit of a misnomer. We think a portion of ovarian cancers actually arise from cells in the fallopian tubes," says Shelley Tworoger, adjunct associate professor of epidemiology at Harvard Medical School and associate center director of population science at the Moffitt Cancer Center.

Bleeding indicates cancer only in a small percentage of cases, even though endometrial cancers are on the rise in American women.

You've gone through menopause and you thought your periods were a thing of the past � but suddenly, you're bleeding again, more than a year after your last period.

Should you be concerned?

The good news according to an analysis published in JAMA Internal Medicine, is that most likely your bleeding is caused by a noncancerous condition, such as vaginal atrophy, uterine fibroids, or polyps. But the study also reinforces the idea that postmenopausal bleeding should always be checked out by your doctor to rule out endometrial cancer, a cancer of the uterine lining, says Dr. Ross Berkowitz, William H. Baker Professor of Gynecology at Harvard Medical School.

Research we're watching

Need another reason to make your oral health a priority? Researchers at Harvard's T.H. Chan School of Public Health found that people with a history of gum disease also have a higher risk of stomach and esophageal cancers. They outlined their work in a letter published online in July 2020 by the journal Gut.

The researchers looked at two large studies involving a total of nearly 150,000 men and women. They found that during the studies' follow-up periods, which ranged from 22 to 28 years, people who had gum disease had a 43% higher risk of developing esophageal cancer and a 52% higher risk of developing stomach cancer compared with people whose gums were healthier. The authors proposed some ideas as to what was driving increased risk, such as greater exposure to oral bacteria or harmful substances produced by those bacteria. The authors said more study is needed to confirm their results.

News briefs

Having gum disease increases your risk for many health problems other than tooth loss, such as heart disease. To add to the list, a study from Harvard summarized in a letter published online July 20, 2020, by the journal Gut suggests that the microbes camping out between your teeth and gums may affect your risk for cancers of the stomach and esophagus. Harvard scientists analyzed health data from two large studies that included almost 150,000 men and women. In up to 28 years of follow-up, people with a history of periodontal (gum) disease were 43% more likely to develop esophageal cancer and 52% more likely to develop gastric (stomach) cancer compared with people whose gums were healthier. The risk was even higher in those with gum disease severe enough to cause tooth loss. The study is observational and doesn't prove that gum disease causes cancer, but it could mean that someday doctors will include a look at your gum health when assessing your overall risk. Fortunately, it's easy to prevent gum disease. The American Dental Association recommends that you brush your teeth twice per day, floss at least once per day, and get a dental exam and cleaning regularly.

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In the journals

Greater amounts of physical activity during the day are associated with lower risk of dying from cancer, according to a study published online June 18, 2020, by JAMA Oncology.

The study involved about 8,000 people, average age 70, who did not have a cancer diagnosis. Each wore an accelerometer on the hip during waking hours for a week to collect movement data.