Obesity and diabetes seen as factor in cancer

Does a widening waistline put you at risk for cancer? Apparently so. According to a new study, nearly 6 percent of cancers are attributable at least in part to obesity and diabetes. 

Researchers compared incidence data for 12 cancers in 175 countries in 2012 with body mass index and diabetes prevalence figures from 2002, on the assumption that it takes at least 10 years for cancer to develop. They found that in 2012, diabetes and a BMI above 25 were independent risk factors for 792,600 new cases of cancer, about 5.6 percent of the more than 14 million cases reported to a worldwide cancer registry. Among the cancers associated with diabetes and high BMI were tumors of the colon, gallbladder, liver and pancreas. Obesity and diabetes weren’t the only causes of these cancers, but the conditions played a role. 

“We know a lot about what causes obesity and diabetes, but what it is about being obese or diabetic that causes cancer is less clear,” said the lead author, Jonathan Pearson-Stuttard, a clinical fellow at Imperial College London. “It may be that exposure to high insulin levels or insulin resistance may also be a cause of cancer.” 

The study was in The Lancet Diabetes and Endocrinology.

— Nicholas Bakalar, The New York Times 

Drug pipeline gets shorter by nearly a year

Speeding the pace at which potentially lifesaving drugs are brought to market was a rallying cry for Donald Trump as a candidate, and is a stated priority of his Food and Drug Administration commissioner, Scott Gottlieb. But a new study finds that programs already in place were routinely shortening the drug development process by close to a year, and sometimes much more.

In a Research Letter in the journal JAMA, a trio of health economists from Brigham and Women's Hospital in Boston found that among 174 drugs and biologic therapies approved between January 2012 and December 2016, 105 (or 60 percent) traversed the FDA evaluation process with one of four designations aimed at speeding the path to approval. The 69 candidate medications that had no such hurry-up designations took between 6.5 and 10 years, with a midpoint of eight years.

Candidate medications evaluated under one of the four accelerated programs took between 5.1 and 10.1 years to cover the same ground, with a midpoint of 7.1 years.

Those faster speeds were largely attributable to two programs. One, instituted in 2012, compresses clinical trials, dedicates FDA personnel to provide advice, and streamlines the FDA evaluation process for "breakthrough" drugs. The second, a 1997 "fast track" program, offers similar but less extensive benefits to speed drug development and evaluation time.

— Melissa Healy, Los Angeles Times

Contraceptives may slightly elevate cancer risk

Modern birth control pills that are lower in estrogen have fewer side effects than past oral contraceptives. But a large Danish study suggests that, like older pills, they still modestly raise the risk of breast cancer, especially with long-term use. 

Researchers found a similar breast cancer risk with the progestin-only intrauterine device, and they couldn't rule out a risk for other hormonal contraceptives like the patch and the implant.

But the overall increased risk was small, amounting to one extra case of breast cancer among 7,700 women using such contraceptives per year. Experts who reviewed the research say women should balance the news against known benefits of the pill — including lowering the risk of other cancers.

"Hormonal contraception should still be perceived as a safe and effective option for family planning," said Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital, who was not involved in the research.

Women in their 40s may want to consider non-hormonal IUDs, getting their tubes tied or talking with their partners about vasectomy, Manson said.

— Carla K. Johnson, Associated Press