Frontline: Diabetes & Heart Disease; Double Mastectomy; Cervical Cancer

Women with diabetes at much higher risk of heart disease than men

Women who have diabetes are 44 percent more likely to develop coronary heart disease (CHD) than men with diabetes, according to researched published online May 22, 2014 in Diabetologia (the journal of the European Association for the Study of Diabetes). The researchers examined data from more than 60 studies that included more than 858,000 participants. The results remained the same, even after researchers adjusted for gender differences among CHD risk factors other than diabetes. Possible reasons for the higher CHD risk among diabetic women include a greater degree of metabolic deterioration among women than men prior to being diagnosed with diabetes, and higher risk factors for CHD among women when they are in the prediabetic state, during which glucose tolerance is already impaired. To combat the higher CHD risks in wom-en, the researchers suggest increased screening for prediabetes in women, as well as closer monitoring of women at high risk of diabetes, and greater awareness of early symptoms of CHD in women.

Many women needlessly undergo double mastectomy

Women with a family history of breast or ovarian cancer, or with mutations in the BRCA1 or BRCA2 genes, are often advised to consider a double mastectomy, since they have a higher risk of develop-ing cancer in the healthy breast. However, only about 10 percent of all women diagnosed with breast cancer are in this higher-risk category; the remaining 90 percent are unlikely to develop cancer in the other breast. Researchers examined data collected from 1,447 women who had received treatment for breast cancer and did not have a recurrence. They discovered that, among the women who had a double mastectomy, approximately 70 percent did not fall into the higher-risk category, since they had neither a family history nor a gene mutation. Concern about cancer recurrence was the most significant factor in women’s decisions to undergo double mastectomy. The researchers said that, for many of these women, a lumpectomy would have been appropriate, and it would have shortened recovery time and reduced the risk of surgery-related complications. The research was published online May 21, 2014 in the journal JAMA Surgery.

Higher incidence of cervical cancer found among older women

Women over age 65 are at the highest risk of cervical cancer, according to researchers who have recalculated the incidence of cervical cancer among American women. The researchers, whose findings appear online May 12, 2014 in the journal Cancer, say that previous calculations of the number of cervical cancers included women who had had a hysterectomy, and whose risk of cervical cancer had therefore been eliminated. When only data on women with an intact uterus and cervix were analyzed, incidence rates of cervical cancer increased with age, reaching a high of 24.7 cases per 100,000 for women between 65 and 69 years of age. In African-American women in this age group, the incidence was even higher, at 53.0 cases per 100,000. Previous-ly, women between the ages of 40 and 44 were believed to have the highest risk. The researchers say their find-ings call for an update of current cervical cancer screening guidelines, which indicate that women over age 65 who have had regular screenings with normal results no longer need to be screened. As with many other cancers, early detection is the key to successful treatment for cervical cancer.

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