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US cancer death rate hits milestone: 25 years of decline

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By MIKE STOBBE, AP Medical Writer

NEW YORK (AP) — The U.S. cancer death rate has hit a milestone: It’s been falling for at least 25 years, according to a new report.

Lower smoking rates are translating into fewer deaths. Advances in early detection and treatment also are having a positive impact, experts say.

FILE – In this May 25, 2017 file photo, chemotherapy drugs are administered to a patient at a hospital in Chapel Hill, N.C. The U.S. cancer death rate has been falling between 1991 and 2016, and so far there’s little sign the decline is slowing, according to a report released on Tuesday, Jan. 8, 2019. (AP Photo/Gerry Broome)

But it’s not all good news. Obesity-related cancer deaths are rising, and prostate cancer deaths are no longer dropping, said Rebecca Siegel, lead author of the American Cancer Society report published Tuesday.

Cancer also remains the nation’s No. 2 killer. The society predicts there will be more than 1.7 million new cancer cases, and more than 600,000 cancer deaths, in the U.S. this year.

A breakdown of what the report says:

DECLINE

There’s been a lot of bad news recently regarding U.S. death rates. In 2017, increases were seen in fatalities from seven of the 10 leading causes of death, according to recently released government data. But cancer has been something of a bright spot.

The nation’s cancer death rate was increasing until the early 1990s. It has been dropping since, falling 27 percent between 1991 and 2016, the Cancer Society reported.

Lung cancer is the main reason. Among cancers, it has long killed the most people, especially men. But the lung cancer death rate dropped by nearly 50 percent among men since 1991. It was a delayed effect from a decline in smoking that began in the 1960s, Siegel said.

PROSTATE CANCER

The report has some mixed news about prostate cancer, the second leading cause of cancer death in men.

The prostate cancer death rate fell by half over two decades, but experts have been wondering whether the trend changed after a 2011 decision by the U.S. Preventive Services Task Force to stop recommending routine testing of men using the PSA blood test. That decision was prompted by concerns the test was leading to overdiagnosis and overtreatment.

The prostate cancer death rate flattened from 2013 to 2016. So while the PSA testing may have surfaced cases that didn’t actually need treatment, it may also have prevented some cancer deaths, the report suggests.

OBESITY

Of the most common types of cancer in the U.S., all the ones with increasing death rates are linked to obesity, including cancers of the pancreas and uterus.

Another is liver cancer. Liver cancer deaths have been increasing since the 1970s, and initially most of the increase was tied to hepatitis C infections spread among people who abuse drugs. But now obesity accounts for a third of liver cancer deaths, and is more of a factor than hepatitis, Siegel said.

The nation’s growing obesity epidemic was first identified as a problem in the 1990s. It can take decades to see how a risk factor influences cancer rates, “so we may just be seeing the tip of the iceberg in terms of the effect of the obesity epidemic on cancer,” Siegel said.

DISPARITY

There’s been a decline in the historic racial gap in cancer death rates, but an economic gap is growing — especially when it comes to deaths that could be prevented by early screening and treatment, better eating and less smoking.

In the early 1970s, colon cancer death rates in the poorest counties were 20 percent lower than those in affluent counties; now they’re 30 percent higher. Cervical cancer deaths are twice as high for women in poor counties now, compared with women in affluent counties. And lung and liver cancer death rates are 40 percent higher for men in poor counties.

Dr. Darrell Gray, deputy director of Ohio State University’s Center for Cancer Health Equity, called the findings “important but not surprising.”

AP-NORC Poll: Edit baby genes for health, not smarts

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By LAURAN NEERGAARD, AP Medical Writer

WASHINGTON (AP) — Most Americans say it would be OK to use gene-editing technology to create babies protected against a variety of diseases — but a new poll finds they’d draw the line at changing DNA so children are born smarter, faster or taller.

A month after startling claims of the births of the world’s first gene-edited babies in China, the poll by The Associated Press-NORC Center for Public Affairs Research finds people are torn between the medical promise of a technology powerful enough to alter human heredity and concerns over whether it will be used ethically.

In this Oct. 9, 2018 photo, an embryologist adjusts a microplate containing embryos that were injected with gene-editing components in a laboratory in Shenzhen in southern China's Guangdong province. Most Americans say it would be OK to change the DNA of babies before they're born to protect them from a variety of diseases _ but a December 2018 poll shows they'd draw the line at gene editing to create children who are smarter, faster or taller. (AP Photo/Mark Schiefelbein)
In this Oct. 9, 2018 photo, an embryologist adjusts a microplate containing embryos that were injected with gene-editing components in a laboratory in Shenzhen in southern China’s Guangdong province. Most Americans say it would be OK to change the DNA of babies before they’re born to protect them from a variety of diseases _ but a December 2018 poll shows they’d draw the line at gene editing to create children who are smarter, faster or taller. (AP Photo/Mark Schiefelbein)

Jaron Keener, a 31-year-old exhibit designer at Pittsburgh’s Carnegie Museum of Natural History, said he’s opposed to “rich people being able to create designer babies.”

But like the majority of Americans, Keener would support gene editing in embryos to prevent incurable diseases. His mother has lupus, an inflammatory disease that may have both environmental and genetic triggers.

Lupus has been “a looming presence my entire life. I’ve been around somebody with a chronic illness and I’ve seen the toll that has taken, not just on her life, but the life of my family,” he said.

Gene editing is like a biological cut-and-paste program, letting scientists snip out a section of DNA to delete, replace or repair a gene. Altering adult cells would affect only the patient being treated.

But editing genes in eggs, sperm or embryos would alter the resulting child in ways that can be passed to future generations — a step with such profound implications that international science guidelines say it shouldn’t be tested in human pregnancies until more lab-based research determines it’s safe to try.

The AP-NORC poll shows about 7 in 10 Americans favor one day using gene-editing technology to prevent an incurable or fatal disease a child otherwise would inherit, such as cystic fibrosis or Huntington’s disease.

Roughly two-thirds of Americans also favor using gene editing to prevent a child from inheriting a non-fatal condition such as blindness, and even to reduce the risk of diseases that might develop later in life, such as cancers.

Side effects are possible, such as a gene-editing attempt that accidentally alters the wrong DNA spot, and the poll finds 85 percent think that risk is at least somewhat likely.

But about 7 in 10 Americans oppose using gene editing to alter capabilities such as intelligence or athletic talent, and to alter physical features such as eye color or height.

The poll highlights that if gene editing of embryos ever moves into fertility clinics, there will be some hard choices about what non-fatal disorders should qualify, said Columbia University bioethicist Dr. Robert Klitzman. What if scientists could pinpoint genes involved with depression or autism or obesity — would they be OK to edit?

“It’s one thing to look at the extremes of fatal diseases versus cosmetic things, but in the middle are going to be these very different issues,” Klitzman said.

That reported gene editing in China was an attempt to create babies resistant to HIV infection, a target that many scientists in the U.S. and elsewhere decried because there are effective ways to prevent the AIDS virus.

The poll shows most people think it is at least somewhat likely that gene editing could wipe out certain inherited diseases and lead to other medical advances.

Yet despite the medical enthusiasm, more Americans oppose than favor government funding for testing on human embryos to develop gene-editing technology — 48 percent to 26 percent. About another quarter of the population takes no stand.

Without that research, how could gene editing ever become a choice for families hoping to avoid a disease?

More sleep in Seattle: Later school start helps kids get zzz

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By CARLA K. JOHNSON, AP Medical Writer

SEATTLE (AP) — High school students are getting more sleep in Seattle, say scientists studying later school start times.

Teenagers wore activity monitors to find out whether a later start to the school day would help them get more sleep. It did, adding 34 minutes of slumber a night. They also reported less daytime sleepiness, and grades improved.

The Seattle School District changed from a 7:50 a.m. start time to 8:45 a.m. in the fall of 2016 for high schools and most middle schools, joining dozens of other U.S. school districts adopting later starts to help sleep-deprived teens.

Teenagers’ nightly sleep has decreased and most adolescents don’t get the recommended nine hours. One culprit: Light from devices that many teens use to chat, post and scroll long after dark.

Senior Hazel Ostrowski attends her first period AP statistics class at Franklin High School Wednesday, Dec. 12, 2018, in Seattle. High school students are getting more sleep in Seattle, according to a study on later school start times. Ostrowski was among a group at Franklin and another Seattle high school who wore activity monitors to discover whether a later start to the school day would help them get more sleep. It did, adding 34 minutes of slumber a night, and they reported less daytime sleepiness and grades improved. (AP Photo/Elaine Thompson)

Franklin High School senior Hazel Ostrowski, who took part in the study, said sleeping later makes it easier to pay attention during class but she still struggles sometimes.

“I’ll wake up so tired I wish I could go back to sleep. At night, I’ll be on my phone and I just want to stay up,” she said.

Researchers worked with science teachers at two high schools to find out if students got more sleep after the change or simply stayed up later. Over two years, they recruited 178 sophomores to wear wristwatch-like monitors for two weeks to track activity and light exposure. Results were published Wednesday in the journal Science Advances.

The scientists compared sleep habits of sophomores in spring 2016, before the change, to sleep habits of sophomores from spring 2017, after later start times went into effect.

Some measures held steady. Naps and weekend sleep schedules didn’t change. On school nights, only a few students stayed up later, not enough to greatly budge the average.

What changed was wakeup time, with morning activity starting about 45 minutes later on school days. Combined with a slight shift to later bedtimes for a few, the average sleep duration increased by 34 minutes.

Put another way, morning wakeup time shifted from 6:24 a.m. to 7:08 a.m. Falling asleep shifted only a tad, from 11:27 p.m. to 11:38 p.m.

“Given all the pressures keeping our teenagers awake in the evening — screen time, social media — this is a great thing to see,” said Horacio de la Iglesia, a University of Washington biology professor who led the study.

Digging deeper, researchers analyzed schoolwide data on first-period punctuality and attendance. Of the two high schools, the one in a more affluent area showed no difference year to year. But the school in a poorer area had less tardiness and fewer absences after the change, a hint that later start times could help with socioeconomic learning gaps, the researchers said.

Exam scores and other grades in the science classes increased year to year by a small margin, but the authors acknowledge that teachers’ views on the later start time could have unconsciously boosted the grades they gave.

Most U.S. middle and high schools start before 8:30 a.m., contrary to an American Academy of Pediatrics recommendation, said University of Minnesota researcher Kyla Wahlstrom, who studies the issue.

School districts resist, she said, because later start times disrupt bus schedules and sports practices, and rob parents of afternoon teenage baby sitters to watch younger kids.

Prior studies relied on students recalling how much they slept. This was the largest to use a stronger measure, the wearable monitor, she said.

Bringing the research into classrooms made it a learning experience for students, Wahlstrom said, “a brilliant way to do it.”

Follow AP Medical Writer Carla K. Johnson on Twitter: @CarlaKJohnson

The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

1st baby born using uterus transplanted from deceased donor

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By MARIA CHENG, AP Medical Writer

LONDON (AP) — Brazilian doctors are reporting the world’s first baby born to a woman with a uterus transplanted from a deceased donor.

Eleven previous births have used a transplanted womb but from a living donor, usually a relative or friend.

Experts said using uteruses from women who have died could make more transplants possible. Ten previous attempts using deceased donors in the Czech Republic, Turkey and the U.S. have failed.

In this Dec. 15, 2017 photo provided by transplant surgeon Dr. Wellington Andraus, left with magnifying glasses, he and Dr. Dani Ejzenberg, second left, confer with colleagues at the Hospital das Clinicas of the University of Sao Paulo School of Medicine, Sao Paulo, Brazil, on the day of the birth of the baby girl born to a woman with a uterus transplanted from a deceased donor. Nearly a year later, mother and baby are both healthy. (Courtesy Dr. Wellington Andraus via AP)

The baby girl was delivered last December by a woman born without a uterus because of a rare syndrome. The woman — a 32-year-old psychologist — was initially apprehensive about the transplant, said Dr. Dani Ejzenberg, the transplant team’s lead doctor at the University of Sao Paulo School of Medicine.

“This was the most important thing in her life,” he said. “Now she comes in to show us the baby and she is so happy,”

The woman became pregnant through in vitro fertilization seven months after the transplant. The donor was a 45-year-old woman who had three children and died of a stroke.

The recipient, who was not identified, gave birth by cesarean section. Doctors also removed the womb, partly so the woman would no longer have to take anti-rejection medicines. Nearly a year later, mother and baby are both healthy.

Two more transplants are planned as part of the Brazilian study. Details of the first case were published Tuesday in the medical journal Lancet.

Uterus transplantation was pioneered by Swedish doctor Mats Brannstrom, who has delivered eight children from women who got wombs from family members or friends. Two babies have been born at Baylor University Medical Center in Texas and one in Serbia, also from transplants from living donors.

In 2016, doctors at the Cleveland Clinic transplanted a uterus from a deceased donor, but it failed after an infection developed.

“The Brazilian group has proven that using deceased donors is a viable option,” said the clinic’s Dr. Tommaso Falcone, who was involved in the Ohio case. “It may give us a bigger supply of organs than we thought were possible.”

The Cleveland program is continuing to use deceased donors. Falcone said the fact that the transplant was successful after the uterus was preserved in ice for nearly eight hours demonstrated how resilient the uterus is. Doctors try to keep the time an organ is without blood flow to a minimum.

Other experts said the knowledge gained from such procedures might also solve some lingering mysteries about pregnancies.

“There are still lots of things we don’t understand about pregnancies, like how embryos implant,” said Dr. Cesar Diaz, who co-authored an accompanying commentary in the journal. “These transplants will help us understand implantation and every stage of pregnancy.”

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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Healthy Sleep? It Really IS Possible for New Parents, Kids, Families

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While many adults already deal with problems sleeping, along comes a pregnancy and things get even worse!

Getting to sleep, staying asleep and getting quality sleep are all challenges made even more difficult by being pregnant, or being a new parent.  And these problems don’t just affect mom.  Her partner can be just as affected.

Despite the fact that interruptions to sleep routines will happen, it helps to understand what’s happening and keep certain tips in mind that can alleviate some of the stress and improve the sleep you do get.

The Sleep Help Institute has put together some excellent guides to help this happen.

Healthy Sleep for New and Expecting Parents

A look at how pregnancy can affect sleep.  The Sleep Help Institute covers each trimester with information on what to expect, best practices and tips.  There are notes on the best sleep positions for moms – and positions to avoid.  You’ll learn the benefits of exercise, eating right and helping your partner get better sleep.

Children’s Sleep Guide

If they don’t get enough sleep, children suffer.  It can make them irritable, lethargic and affect their learning and attitudes.  The Institute’s article has a helpful Sleep Guide, tips for creating a healthy sleep routine and info about choosing the best mattress.  Learn how to deal with nightmares, night terrors, snoring and sleep walking.

How To Manage Screen Time and Bed Time

Did you know that according to the National Sleep Foundation, at least 90% of us use technology during the hour before we go to bed?  This can often affect the time it takes us to fall asleep and the quality of sleep we get.  It’s a problem that every parent deals with when it comes to kids, but it can be just as detrimental to adults.  The Sleep Help Institute has some great ideas on minimizing the effect of technology on sleep, changing your light settings and creating a better bedtime routine.

Here’s hoping you and your family are getting better sleep soon.

And thanks to the Sleep Help Institute!

 

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