WOMEN SEEM MORE AT RISK OF LUNG CANCER THAN MEN

Women smokers, aged 60 and older, appear to have twice the risk of developing lung cancer as men smokers of the same age, according to a study by a team of New York researchers.

The Early Lung Cancer Action Program screened 459 women and 541 men. All were at least 60 years old and had smoked cigarettes for at least 10 years. Many had smoked for decades, placing them at high risk of developing lung cancer.

Participants underwent a CT scan that was designed to detect lung cancer at the very earliest stages, when it has the best chance of treatment. The test took 15 seconds, cost about $300 and provided a much better resolution of soft lung tissue than a standard chest X-ray.

The study, scheduled to be presented today at the annual meeting of the American College of Chest Physicians, found 29 cases of lung cancer. Nineteen of those with lung tumors were women--roughly twice as many as the 10 men found to have lung cancer.

Why women smokers may be at increased risk of lung cancer is not known. "It may be that women smoke differently than men," said the study's lead author, Claudia I. Henschke, professor of radiology at Weill Medical College of Cornell University. "It may be that there are hormonal influences."

Whatever the cause, the higher risk of lung cancer among women "is considered compelling evidence that they have a greater susceptibility to tobacco carcinogens than men," the team concluded.

--Sally Squires

STUDY CHALLENGES NURSES WITH FAKE FINGERNAILS

It seems there's another threat to hospitalized patients besides those germy stethoscopes and doctors who don't wash their hands between patients: nurses and other health care workers who wear artificial fingernails.

A study conducted by researchers at the University of Michigan and the VA Medical Center in Ann Arbor found that nurses sporting those fake accoutrements were more likely to harbor potentially harmful bacteria and yeast on their nails than those with natural fingernails.

The research team, led by S.A. McNeil, compared 21 nurses who wore fake nails with 20 who did not. They found that 73 percent of nurses with artificial nails tested positive for the presence of various bacteria including staphylococcus aureus, a common cause of hospital-acquired infection, compared with 32 percent of nurses who did not wear artificial nurses.

After both groups washed their hands with an antibacterial soap or a waterless, alcohol-based gel cleaner, the fake nail wearers still were considerably more likely to retain bacteria. Sixty-eight percent of nurses who wore fake nails continued to harbor bacteria on their hands, compared to 26 percent of nurses who did not wear them.

The study was presented last month at the annual meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy.

--Sandra G. Boodman

DUTCH STUDY SHEDS LIGHT ON EFFECTS OF TAMOXIFEN

Many women with a strong history of breast cancer in their families are wondering whether to be tested for mutations in two genes--known as BRCA1 and BRCA2--that have been linked to an increased lifetime risk of such cancer. Women who inherit a mutated copy of either of these genes have an estimated lifetime risk of breast cancer ranging from 56 percent to 87 percent (about five to seven times the average lifetime risk). A government-funded study has found that taking the drug tamoxifen can reduce the frequency of breast cancer in high-risk women, but almost no information has been available on whether that drug is likely to prevent breast cancer in women with BRCA1 and BRCA2 mutations.

A new Dutch study sheds some light on this question. Researchers at Rotterdam's Daniel den Hoed Cancer Center studied 28 women with breast cancer who came from high-risk families and whose tumors had BRCA2 mutations, comparing them with a control group of breast cancer patients who had no strong family history of the disease and whose tumors weren't associated with known genetic mutations.

Compared with the control group, the tumors of the women with BRCA2 mutations were more likely to contain receptors (proteins on cell surfaces) that bind to the sex hormones estrogen and progesterone. This is considered good news for women with such mutations, because it makes it more likely that taking tamoxifen--a drug that binds to estrogen receptors--will reduce their risk of breast cancer. In contrast, a previous study by the same research group found that tumors with BRCA1 mutations are less likely than spontaneously arising breast cancers to contain estrogen and progesterone receptors, suggesting that tamoxifen is less likely to prevent breast cancer in carriers of those mutations.

The Dutch study also found that breast cancer patients with BRCA2 mutations did not have more aggressive tumors or a higher mortality rate than women without such genetic abnormalities. Five years after treatment, 52 percent of women in both groups were cancer-free. Seventy-four percent of the women with BRCA2 mutations and 75 percent of the control group were alive. However, the women with BRCA2 mutations were at greater risk of developing a second cancer in the other breast. Five years after treatment, this had occurred in 12 percent of the BRCA2 group, versus 2 percent of the control group.

The study by L.C. Verhoog and colleagues appears in the November issue of the Journal of Clinical Oncology.

--Susan Okie