JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3 p.m. CT, Tuesday, September 27, 2005)
JAMA NEWS RELEASES
HEAVY SMOKERS WHO CUT THEIR SMOKING IN HALF MAY REDUCE THEIR RISK OF LUNG CANCER
HIGHER CONSUMPTION OF SOME SOY PRODUCTS, GRAINS, VEGETABLES AND FRUITS ASSOCIATED WITH REDUCED RISK OF LUNG CANCER
GENE VARIANTS ASSOCIATED WITH INCREASED RISK OF DEATH AMONG HEART PATIENTS TREATED WITH BETA-BLOCKERS
JAMA REPORT (VIDEO NEWS RELEASE SCRIPT)
VIDEO: Windows Media | Quicktime
HEAVY SMOKERS WHO CUT NUMBER OF CIGARETTES BY HALF REDUCE RISK OF LUNG CANCER BY 25 PERCENT
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TV Note: This week's JAMA video news release is on the effect of smoking reduction on lung cancer risk. The release will be fed Tuesday, September 27, from 9:00 - 9:30 a.m. ET on Intelsat America 6 (formerly Telstar 6), Transponder 11 (C-Band) and from 2:00 - 2:30 p.m. ET on Intelsat America 6, Transponder 11 (C-Band). For more information, call 312/464-JAMA (5262).
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Embargoed for Release: 3 p.m. CT, Tuesday, September 27, 2005
Media Advisory: To contact Nina S. Godtfredsen, M.D., Ph.D., email: duegodt{at}dadlnet.dk. To contact editorial co-author Lawrence J. Dacey, M.D., M.S., call Deborah Kimbell at 603-653-1913.
HEAVY SMOKERS WHO CUT THEIR SMOKING IN HALF MAY REDUCE THEIR RISK OF LUNG CANCER
CHICAGO—Heavy smokers (more than 15 cigarettes per day) can reduce their risk of lung cancer if they decrease smoking by 50 percent, according to a study in the September 28 issue of JAMA.
Lung cancer remains the leading cause of cancer death worldwide, and an estimated 90 percent of lung cancer cases are tobacco-related, according to background information in the article. Despite efforts to prevent people from beginning smoking and to encourage smoking cessation, the overall prevalence of cigarette smoking is still high and many smokers are unable or unwilling to completely quit.
Nina S. Godtfredsen, M.D., Ph.D., of Copenhagen University Hospital, Copenhagen, Denmark, and colleagues conducted an observational, population-based study with up to 31 years of follow-up, to assess the effects of smoking reduction on lung cancer incidence. The study participants included 11,151 men and 8,563 women, aged 20 to 93, who attended two consecutive examinations with a five- to ten-year interval between 1964 and 1988. Participants were divided into six groups, according to smoking habits: continued heavy smokers (15 or more cigarettes per day), reducers (reduced from 15 or more cigarettes per day by a minimum of 50 percent without quitting), continued light smokers (one to 14 cigarettes per day), quitters (stopped between first and second examination), stable ex-smokers, and never smokers. During follow-up, 864 participants were diagnosed with lung cancer. There were 360 lung cancer cases among women and 504 cases among men.
"Reducing tobacco consumption from approximately 20 cigarettes per day to less than ten was associated with a 27 percent reduction in lung cancer risk compared with unchanged heavy smoking," the authors report.
"Participants who were continued light smokers or who quit smoking between baseline and follow-up reduced their lung cancer risk by 56 percent and 50 percent, respectively, compared with persistent heavy smokers," they continue. "Risk of lung cancer among the stable ex-smokers was 83 percent lower than among the heavy smokers, but still significantly higher than among the never smokers."
The authors point out that their study results indicate risk reduction is disproportionately smaller than the corresponding smoking reduction. They suggest the discrepancy between reported amount of reduction and calculated risk reduction can be largely explained by "compensatory smoking" - getting the maximum number of puffs out of the limited number of cigarettes allowed.
"More data from long-term studies of smoking reduction are warranted, but for the present, smoking cessation and not smoking reduction should still be advocated as the ultimate method of reducing harm from smoking, especially since diseases such as COPD [chronic obstructive pulmonary disease] and [heart attack], which have a larger public health effect than lung cancer, have not shown any reductions in risks after smoking reduction," the authors conclude.
(JAMA. 2005;294:1505-1510. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by grants from the Danish Ministry of Health, the Health Insurance Foundation, the Danish Lung Foundation, and the Wedell-Wedellsborg Foundation.
EDITORIAL: REDUCING THE RISK OF LUNG CANCER
In an accompanying editorial, Lawrence J. Dacey, M.D., M.S., and David W. Johnstone, M.D., of Dartmouth-Hitchcock Medical Center, Lebanon, N.H., write that it is important to inform patients who smoke that the more they can reduce the number of cigarettes they smoke, the more they will decrease their risk of lung cancer.
"Physicians and other health professionals should do all they can to help their patients who smoke reduce their risk of getting lung cancer. Total discontinuation of smoking, no matter the age of the patient, will provide the greatest benefit," they write. "The most effective interventions to achieve permanent smoking cessation combine pharmacological therapy and referral for intensive behavioral support from a trained counselor. Those patients who cannot quit smoking despite all efforts should be strongly encouraged to cut down on their cigarette consumption as much as possible, since doing so will significantly decrease their risk of lung cancer."
(JAMA. 2005;294:1550-1551. Available pre-embargo to the media at www.jamamedia.org)
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3 p.m. CT, Tuesday, September 27, 2005
Media Advisory: To contact corresponding author Margaret R. Spitz, M.D., M.P.H., call Laura Sussman at 713-745-2457. To contact editorial co-author Lawrence J. Dacey, M.D., M.S., call Deborah Kimbell at 603-653-1913.
HIGHER CONSUMPTION OF SOME SOY PRODUCTS, GRAINS, VEGETABLES AND FRUITS ASSOCIATED WITH REDUCED RISK OF LUNG CANCER
CHICAGO—A diet higher in plant-derived compounds known as phytoestrogens is linked with a lower lung cancer risk, according to a study in the September 28 issue of JAMA.
Phytoestrogens are plant-derived nonsteroidal compounds found in soy products, grains, carrots, spinach, broccoli, and other fruits and vegetables, according to background information in the article. They have weak estrogen-like activity. The three main classes of phytoestrogens are isoflavones, lignans, and cumestrans. A fourth group of plant-derived steroidal compounds believed to have estrogenic properties are the phytosterols. Phytoestrogens have been shown to have a protective effect against some solid tumors, but there has been little epidemiologic research focused on dietary intake of phytoestrogens and lung cancer risk.
Matthew B. Schabath, Ph.D., and colleagues at the University of Texas M.D. Anderson Cancer Center, Houston, analyzed data from an ongoing case-control study to examine the relationship between dietary intake of phytoestrogens and the risk of lung cancer. The study included 1,674 patients with lung cancer (cases) and 1,735 matched healthy controls. From July 1995 through October 2003, study participants were personally interviewed to obtain information on demographics, socioeconomics, and smoking history. Women were asked whether they had taken hormone therapy in the previous six months. A food frequency questionnaire was used to collect dietary data on intake of 12 individual phytoestrogens.
"Our main findings were that patients with lung cancer tended to consume lower amounts of phytoestrogens than controls, that there were sex-specific differences both in intake and in protective effects, and that the apparent benefits were evident in both never and current smokers but less so in former smokers," the authors report.
Reduction in lung cancer risk tended to increase with increasing phytoestrogen intake. "The highest quartiles of total phytosterols, isoflavones, lignans, and phytoestrogens were each associated with reductions in risk of lung cancer ranging from 21 percent for phytosterols to 46 percent for total phytoestrogens from food sources only," the authors write.
Sex-specific effects were also apparent. "For men, statistically significant trends for decreasing risk with increasing intake were noted for each phytoestrogen group, with protective effects for the highest quartile of intake ranging from 24 percent for phytosterols to 44 percent for isoflavones, while in women, significant trends were only present for intake of total phytoestrogens from food sources only, with a 34 percent protective effect for the highest quartile of intake," the authors report.
The apparent benefits of high phytoestrogen intake were evident in both current smokers and those who had never smoked, but less apparent in former smokers.
In women, statistically significant joint effects were evident between hormone therapy use and phytoestrogen intake. "Specifically, high intake of the lignans [metabolites] enterolactone and enterodiol and use of hormone therapy were associated with a 50 percent reduction in risk of lung cancer," the authors report.
"In summary, these data provide further support for the limited but growing epidemiologic evidence that estrogens and phytoestrogens are associated with a decrease in risk of lung cancer, especially in never and current smokers," they conclude. "However, confirmation of these findings is still required in large-scale longitudinal studies."
(JAMA. 2005;294:1493-1504. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: This study was supported by the Flight Attendant Medical Research Institute and Public Health Service grants from the National Cancer Institute, National Institutes of Health, Department of Health and Human Services. Dr. Schabath was also supported by a cancer prevention fellowship, National Cancer Institute grant.
EDITORIAL: REDUCING THE RISK OF LUNG CANCER
In an accompanying editorial, Lawrence J. Dacey, M.D., M.S., and David W. Johnstone, M.D., of Dartmouth-Hitchcock Medical Center, Lebanon, N.H., urge physicians and other health professionals to talk with their patients about the importance of diet in cancer prevention.
"...patients should be informed that they may further reduce their risk of developing cancer by adopting a diet rich in fruits and vegetables," they write. "Clinicians who actively and aggressively educate their patients and follow up on their efforts to modify their cancer risks will help lessen the great personal suffering and societal burden inflicted by lung cancer."
(JAMA. 2005;294:1550-1551. Available pre-embargo to the media at www.jamamedia.org)
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3 p.m. CT, Tuesday, September 27, 2005
Media Advisory: To contact corresponding author Howard L. McLeod, Pharm.D., call Diane Duke Williams at 314-286-0111.
GENE VARIANTS ASSOCIATED WITH INCREASED RISK OF DEATH AMONG HEART PATIENTS TREATED WITH BETA-BLOCKERS
CHICAGO—Patients with certain gene variants who were prescribed beta-blocker drugs after acute coronary syndrome (ACS) had an increased risk of death over the next three years, according to a study in the September 28 issue of JAMA.
Beta-blockers are drugs that block the action of beta-adrenergic substances such as adrenaline in the "sympathetic" portion of the nervous system - relieving stress on the heart, slowing the heartbeat, and reducing blood vessel contraction in the heart, brain, and throughout the body, according to background information in the article. Previous data support an association between variants of the ADRB1 and ADRB2 genes and response to beta-blocker therapy, but no relationship between these variants and the survival of patients receiving beta-blocker therapy has been reported.
David E. Lanfear, M.D., formerly of Washington University School of Medicine, St. Louis, and colleagues conducted a prospective cohort study of 735 ACS patients admitted to two medical centers between March 2001 and October 2002. The ACS patients were diagnosed with either myocardial infarction (heart attack) or unstable angina (an accelerating pattern of chest pain that lasts longer and is less responsive to medication than stable angina). Among those enrolled in the study, 597 were discharged from the hospital with beta-blocker therapy. DNA testing was conducted to find out if the patients carried any of four common variants of the ADRB1 and ADRB2 genes (ADRB1 1165 CG, 145 AG; ADRB2 46 GA, 79 GC).
The researchers followed the study patients for three years after discharge. There were 84 deaths during follow-up.
"There was a significant association between ADRB2 genotype and three-year mortality among patients prescribed beta blocker therapy," the authors report.
"For the 79 CG polymorphism, ...three-year mortality rates were 16 percent (35 deaths), 11 percent (27 deaths), and six percent (four deaths) for the CC, CG, and GG genotypes, respectively," they write. "For the ADRB2 46 GA polymorphism, three-year ...mortality estimates were ten percent (17 deaths), ten percent (28 deaths), and 20 percent (20 deaths) for the GG, GA, and AA genotypes, respectively."
No increased mortality risk was observed in patients with the same ADRB2 gene variants who were not prescribed beta-blockers. No association of the ADRB1 variants with mortality was observed in either the beta-blocker group, or in the patients who were not prescribed beta-blockers.
The researchers believe this initial description of an association of ADRB2 genotype with survival among patients receiving beta-blocker therapy has potentially important implications.
"Among ACS patients discharged with beta-blocker therapy, we have identified a genetic association with survival that can assist in the risk stratification of patients," they write. "Specifically, the 79 CC and 46 AA groups (39 percent and 16 percent, respectively, of our population) are at high risk for long-term mortality and may need additional treatments to optimize their prognosis."
"We strongly encourage further replication of our findings in distinct patient cohorts so that the potential benefit or harm of beta-blocker therapy within specific ADRB2 genotype groups can be definitively demonstrated," the authors conclude. "With further validation, pharmacogenetic targeting of beta-blocker therapy may be an opportunity to further improve ACS care and outcomes."
(JAMA. 2005;294:1526-1533. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Dr. Lanfear is now with Henry Ford Hospital, Detroit. This work was supported in part by grants from the Agency for Healthcare Research and Quality, the NIH Pharmacogenetics research network, the Specialized Centers of Clinically Oriented Research (SCCOR) program of the National Heart, Lung, and Blood Institute, and by an HFSA Research Fellowship Grant.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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JAMA REPORTS
VIDEO: Windows Media | Quicktime
HEAVY SMOKERS WHO CUT NUMBER OF CIGARETTES BY HALF REDUCE RISK OF LUNG CANCER BY 25 PERCENT
VIDEO:
NAT SOT UP FULL FOR :09
AUDIO:
"Now I have very bad health now after all this smoke."
VIDEO:
B-ROLL
Man walking out of clinic
AUDIO:
THIS MAN SMOKED ABOUT THIRTY CIGARETTES A DAY FOR FORTY YEARS. NOW HE REGRETS IT, BECAUSE HE’S AFRAID OF LUNG CANCER.
VIDEO:
SOT/FULL
@ :11
Super: Nina Godtfredsen, M.D., Ph.D.
Copenhagen University Hospital
Runs :07
AUDIO:
"It’s a fact that smoking causes lung cancer and it’s also a fact that many smokers, especially heavy smokers, they find it very difficult to quit."
VIDEO:
B-ROLL
Bite runs under narration People smoking
X-ray of lungs with cancer
GFX/JAMA COVER
AUDIO:
SO DR. NINA GODTFREDSEN (GOT-fred-sen) AND COLLEAGUES AT COPENHAGEN UNIVERSITY HOSPITAL IN DENMARK WANTED TO KNOW IF CUTTING BACK ON THE NUMBER OF CIGARETTES WOULD AT LEAST LESSEN THE RISK OF LUNG CANCER. THEIR FINDINGS APPEAR IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.
VIDEO:
SOT/FULL (First 9 seconds of bite covered with smoker)
Nina Godtfredsen, M.D., Ph.D.
Copenhagen University Hospital
Runs :19
AUDIO:
"(Covered) A smoker who cuts back on the number of cigarettes by half reduces the risk of lung (on camera) cancer not by half, but by 25%. So the risk is reduced but not just as much as the number of cigarettes."
VIDEO:
B-ROLL
Smokers
AUDIO:
RESEARCHERS CAME TO THIS CONCLUSION BY TRACKING THE SMOKING HABITS AND HEALTH OF ALMOST 20-THOUSAND PEOPLE IN DENMARK FOR AN AVERAGE OF 18 YEARS. BUT WHY DON’T SMOKERS WHO CUT BACK BY HALF, REDUCE THEIR RISK OF LUNG CANCER BY HALF? DR. GODTFREDSEN SAYS IT’S BECAUSE HEAVY SMOKERS WHO CUT BACK, SMOKE THEIR REMAINING CIGARETTES WITH MORE INTENSITY, TAKING BIGGER, LONGER PUFFS.
VIDEO:
SOT/FULL
Nina Godtfredsen, M.D., Ph.D.
Copenhagen University Hospital
Runs :11
AUDIO:
"If you used to smoke 20 and then you cut back to 10 then you smoke them like you smoked 15 maybe."
VIDEO:
B-ROLL
Smokers
AUDIO:
SO, WHILE CUTTING BACK ON THE NUMBER OF CIGARETTES YOU SMOKE WILL REDUCE YOUR RISK OF LUNG CANCER....
VIDEO:
SOT/FULL
Nina Godtfredsen, M.D., Ph.D.
Copenhagen University Hospital
Runs :04
AUDIO:
"I still recommend that people stop smoking."
VIDEO:
Hand stubbing out cigarette in ashtray
AUDIO:
THIS IS MAVIS PRALL WITH THE JAMA REPORT.
