Genetics, Gender And a Cancer Risk

A gene that is more active in women than in men may explain why female smokers are more than twice as likely to develop lung cancer as male smokers, researchers say.

Researchers studying the genetic structure of lung tissue cells removed from both men and women found that a gene linked to abnormal growth of lung cells is much more active in women.

The study, appearing in today's Journal of the National Cancer Institute, showed that the action of a specific gene increased lung cancer risk in both women and men who smoke, but the risk was 12 times higher for women with the active gene and only 2.4 times higher for men who had the active gene.

Pap Smear May Soon Have a Rival

A test for the human papilloma virus that doesn't require a pelvic exam may soon rival the Pap smear as an accurate way of screening for cancer and precancerous conditions in the cervix, researchers say.

However, the test produced far more false positives than the Pap smear, causing many more women to need further testing, according to two studies summarized in today's Journal of the American Medical Association.

Whether the HPV test's widespread use will ever be feasible, affordable and effective at reducing cervical cancer deaths remains to be seen, said an expert who was not involved in the work.

As a screening technique, the test may be most applicable in developing countries, where pelvic exams and lab exams of cervical cells are often unavailable, said the expert, Jack Cuzick of the Imperial Cancer Research Fund in London.

But the lead author of one of the studies said the test's false-positive rate may be much lower among U.S. women, and similar to that of the Pap smear, because they have much lower rates of sexually transmitted diseases than the African and Central American women studied.

The HPV test is now licensed in the United States only as a follow-up to an abnormal Pap smear. It has not been approved for routine screening, though it is available for that purpose in other countries. The test is based on the discovery that the sexually transmitted human papilloma virus, or HPV, causes almost all cases of cervical cancer.

Comparing Doctors, Nurse Practitioners

Patients who have asthma, diabetes or high blood pressure and receive their primary care from nurse practitioners fare just as well as those treated by doctors, a study suggests.

Researchers randomly assigned 1,316 such patients to either nurse practitioners or doctors. After six months, patients in the two groups got equal benefit medically and were just as satisfied.

But it is unclear whether the findings--involving mostly poor immigrants--are representative of the population at large or whether the results would be the same over longer periods, when more complex medical problems might arise, said an expert not involved in the research.

The findings were published in today's Journal of the American Medical Association.

Nurse practitioners are registered nurses with advanced, specialized training. They are licensed in all 50 states and can write prescriptions in all states, though four--Pennsylvania, Georgia, Michigan and Ohio--require a doctor to cosign the order.