An overwhelming 78% agreed that there should be, with reasons ranging from the need to control the spread of STIs to fears of widespread infertility.

Many GP comments provided caveats to the scheme such as ensuring there are sufficient lab teams to back up the screens, increasing prescribing budgets and providing follow-up care.

Of the 22% that felt the Screening policy was not appropriate, their reasons included its futility as it is impossible to determine or contact the source, and the lack of cost and time efficiency.

Lisa Taylor, UK Director of Searchmedica, says “Apart from the overwhelming approval for the screening scheme, the reasons for both agreeing and disagreeing are of particular interest. Many of our respondents emphasised arguments and concerns that are not often voiced and which really highlight the current feelings within the GP community.”

www.searchmedica (UK Site)
www.searchmedica (US Site)

“We are pleased that Capital and Coast DHB has withdrawn its proposal to give $100 supermarket vouchers to women who leave hospital within six hours of giving birth,” said NZMA maternity spokesperson Dr Mark Peterson.

“The proposal smacked of desperation in the face of midwife shortages, and was only ever going to be a ‘band-aid’ approach to the problem. It may have also had the unintended consequence of providing an inappropriate incentive for some women to leave hospital earlier than they should have.”

Clinical factors, not monetary rewards, should be the only deciding issue in when a woman should leave hospital after giving birth, he said.

“Now it’s time for some serious action to help solve workforce shortages. The NZMA has been calling on the Government for many years to take action as problems with the health workforce are reaching crisis point in many areas. Not enough people are being trained, and many are going to work overseas where pay and conditions are often superior.

“The Government must not sit back and let the DHBs or market forces solve this problem. For the sake of the health of New Zealanders, long-term solutions must be found.”

It should also be remembered that government policies for nearly 20 years have contributed to most GPs exiting maternity care, Dr Peterson said.

The NZMA is advocating for primary maternity services to be contracted to Primary Health Organisations (PHOs), along with the rest of primary health care. This would enable the General Practice team to become involved again in maternity care, providing some of the antenatal and postnatal care, and giving mothers continuity of care with their GP and practice nurse, Dr Peterson concluded.

New Zealand Medical Association

St?©phane Thiroloix, Executive Vice-President, Corporate Development said :”We are very pleased to be moving BN83495 into phase II in this indication. This first-in-class steroid sulfatase inhibitor can potentially significantly improve lives of patients with advanced endometrial cancer. With further indications in breast, prostate and ovarian cancers, we believe Ipsen with its focus on hormone dependent cancers will fully leverage the value of BN83495.”

About BN83495

Ipsen’s lead oncology development candidate, BN83495, is a first-in-class orally available irreversible steroid sulfatase (STS) inhibitor. The steroid sulfatase pathway gives rise to oestrone and dehydroepiandrosterone (DHEA) that in turn produce oestradiol and androstenediol (Adiol) that can both stimulate the growth of hormone-dependent tumours. The compound is currently in further clinical development for postmenopausal metastatic breast cancer as well as in PI/II clinical development for castrate resistant prostate cancer. Ipsen plans to expand the clinical program to include ovarian cancers in the near future.

About the trial

The clinical trial will compare single-agent BN83495 to megestrol acetate (MA) in post-menopausal women with histologically confirmed hormone receptor positive endometrial cancer, presenting with recurrent or advanced disease not eligible for treatment with surgery and radiotherapy.

The primary endpoint for the study is progression-free survival. Overall survival and response rate will be evaluated as secondary endpoints. This is the first Phase II clinical trial to begin this year examining the safety and efficacy of BN83495 in patients with different solid tumors.

About Endometrial Cancer

Endometrial cancer, which develops from the inner lining of the uterus, is the most common cancer found in the female reproductive system.

According to the American Cancer Society, about 40,100 new cases of endometrial cancer were diagnosed in the United States and approximately 7,470 women died from this disease in 2008.

Source
Ipsen

The study, by Columbia University College of Physicians & Surgeons researchers, notes that while three recognized breast cancer mutations are present in 2-3 percent of the Ashkenazi Jewish population, similar prevalence studies have not been carried out in other ethnic groups. In addition, the study finds that research linking the breast cancer mutations with Ashkenazi Jews has been beset by methodological problems that cast doubt on the use of ethnicity as the basis for genetic research on disease.

“The linking of Ashkenazi Jews to a deadly disease raises serious scientific and social concerns,” said co-author Sheila M. Rothman, PhD, Professor of Sociomedical Sciences at the Center for the Study of Society and Medicine. “Focusing genetic studies on a specific ethnic group confers disadvantages to that group and others. For Ashkenazi Jews it raises the risk of stigmatization and insurance or job discrimination. For other groups, it introduces a gap in access to testing and treatment.”

The report cites examples of disparities that have occurred. For instance, Ashkenazi Jewish women have access to an inexpensive test that detects the mutations at a cost of $415 compared with $2,975 for non-Ashkenazi Jewish women without known family mutations. Other studies have found that Ashkenazi Jewish women with family histories of breast cancer are more than twice as likely as other women at similar risk to undergo testing for suspect genes.

Rothman and her coauthors interviewed 30 genetic researchers and conducted a review of genetic and historical literature on the Ashkenazi Jewish population. The interviews revealed how geneticists came to substitute ethnicity for family history as the most relevant indicator of risk. Serendipity played a vital role. Researchers had previously found a high prevalence of a mutation causing Tay-Sachs disease in Ashkenazi Jews. Within 20 years, one-million Jews around the world had been tested for the mutation, and scientific institutions had created large repositories of genetic samples that could then be screened for the genetic mutations associated with breast cancer–but only in Ashkenazi Jews.

“The science of breast cancer genetics has been marked by methodological inconsistency in how researchers defined ‘Ashkenazi Jew,’” said study coauthor Sherry Brandt-Rauf, JD, Associate Research Scholar at the Center. Most scientists relied on study participants’ self-identification. Ashkenazi Jews are descended from Jews who lived in central and Eastern Europe, but a complex history of migrations, and multiple cultural and religious meanings of Ashkenazi, makes self-identification problematic.

The study also illuminates how geneticists interpreted Jewish history to support the theory of Ashkenazi genetic uniqueness. This interpretation views the historic Ashkenazi Jewish population as isolated, and as having undergone extreme expansions and contractions. It attributes Ashkenazi Jewish genetic uniqueness to “founder effects,” the idea that genetic mutations can take hold and spread within small, geographically isolated populations, such as a group living alone on an island.

Although Ashkenazi Jews were never geographically isolated, Rothman said that “researchers made persecution–the pogroms and massacres in Jewish history–the equivalent of geographic isolation.”

The study noted that a number of recent genetic surveys–including among Spanish, German, Dutch, Polish and Hispanic women–have shown a high presence of the so-called “ancestral Jewish mutations” in non-Ashkenazi and non-Jewish groups. For example, a large study of Spanish women with breast cancer reported that one of the three mutations accounted for 16.7% of all mutations in the gene.

While the authors recognize the public health advantages of focusing genetic research on ethnic groups, “Our major concern is the largely unacknowledged disadvantages,” Rothman said. “Serendipity may initiate a scientific quest, but should it continue to drive it–and to whose benefit?”

Contact: Janet Firshein
Burness Communications

Sex Education
Kansas: The state Board of Education has said it plans to consider recommending a sex education program that emphasizes “abstinence until marriage” and provides information about HIV/AIDS, contraception and sexually transmitted infections, rather than approve a proposed mandate that would require Kansas public schools to teach abstinence-only sex education classes, the AP/Wichita Eagle reports. The board is not expected to support the mandate because of the “lengthy process” required — which includes an analysis from the attorney general’s office, a review by the state Legislature and public hearings — before it can enact the regulations, the AP/Eagle reports. According to the AP/Eagle, the process could take up to nine months, which means the board’s composition might have changed because of the November elections. In addition, local school boards might resist the mandate, according to the AP/Eagle (Hanna, AP/Wichita Eagle, 5/9).

Stem Cell Research
Connecticut: The state Stem Cell Research Advisory Committee on Tuesday accepted ethics guidelines for scientists seeking to apply for grants from a $100 million initiative to support human embryonic stem cell research, the Hartford Courant reports (Hathaway, Hartford Courant, 5/10). Connecticut Gov. M. Jodi Rell (R) in June 2005 signed into law a measure (SB 934) that provides $100 million in state funding over 10 years for human embryonic stem cell research conducted in the state but bans human reproductive cloning and the sale of human eggs, sperm and embryos. The law established that a nine-member committee will administer grants in consultation with the commissioner of the state health department and also created a five-member Stem Cell Research Peer Review Board (Kaiser Daily Women’s Health Policy, 5/2). Scientists within three weeks must deliver a letter of intent to apply for a grant and by July 10 must submit an application. An international panel of scientists will review the grants after which the board can begin awarding grants in September (Hartford Courant, 5/10).

Missouri: The state House on Monday voted 111-43 to approve an amendment to an education bill (SB 590) that would ban proceeds from the sale of Missouri Higher Education Loan Authority assets from being used to fund abortion procedures and certain types of stem cell research, the AP/Kansas City Star reports. Rep. Wayne Cooper (R) said the amendment was needed so that sales from assets could not be used to fund research using somatic cell nuclear transfer (Blank, AP/Kansas City Star, 5/8). Somatic cell nuclear transfer is conducted by inserting the genetic material from a patient’s cell, usually from a skin cell, into an unfertilized egg from another person. The person’s genetic material incorporates into the egg and causes it to develop into an embryo that is a genetic match to the skin cell patient (Kaiser Daily Women’s Health Policy Report, 5/9). According to state Rep. Bob Johnson (R), a ballot proposal that would amend the state Constitution to ensure that human embryonic stem cell research permitted under federal law, if approved, would nullify the language in the amendment (Flory, Columbia Daily Tribune, 5/9). The Missouri Coalition of Lifesaving Cures, which wrote the proposal, earlier this month submitted a petition with 288,991 signatures in an attempt to put the proposal on the statewide ballot in November. The petition requires 145,000 signatures to qualify the initiative for a statewide vote (Kaiser Daily Women’s Health Policy Report, 5/3).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2009 The Advisory Board Company. All rights reserved.

In a joint statement to mark international women’s day tomorrow,
the two organisations demand action for women and girls around the world
to
have equal access to the highest quality prevention and treatment options
for cervical cancer and say that such a strategy should include screening
and vaccination.

Dr. Shelley Ross, Secretary-General of the Medical Women’s International
Association, said: ‘Cervical cancer is the second most common cancer among
women. But it is now preventable due to the availability of a vaccine
against human papillomavirus (HPV)’.

She said that every year cervical cancer affected 500,000 women and took
the
lives of a quarter million women worldwide. Women in poor countries were
the
most affected, with 80 per cent of the deaths from cervical cancer due to
extremely limited screening and treatment availability.

Dr. Ross added: ‘When reflecting back on major advances in women’s health
in
years to come, HPV vaccine will be listed as one of the major
breakthroughs.
It is urgent that governments across the world start prioritizing cervical
cancer with sustainable political and financial commitments. Not doing so
means losing lives. It means also not granting to women and girls in poor
countries the right to equal access to life-saving technologies’.

Four of the common types of HPV could be prevented through vaccination
although there was currently no treatment available which could cure an
HPV
infection. HPV vaccine therefore had the potential to substantially reduce
the prevalence of cervical cancer, although not to eradicate it.

Dr. Jon Snaedal, President of the WMA, said ‘Medical associations have a
key
role to play in this strategy in making information on HPV vaccine
available
to physicians and to encourage physicians to alert their patients on this
innovation’.

‘Cost must not be a barrier to making the vaccine available to women and
girls worldwide. We are calling for a strong mobilisation of
decision-makers, international organisations, international donor
community
and development partners, as well as medical associations, civil society
and
industry to act now for a change, to stop cervical cancer’.

The World Medical Association is the independent confederation of national
medical associations from more than 80 countries and represents more than
eight million physicians. Acting on behalf of patients and physicians, the
WMA endeavours to achieve the highest possible standards of medical care,
ethics, education and health-related human rights for all people.

World Medical Association

Earlier this year, South Dakota passed a bill which bans virtually all abortions in the state except for circumstances in which the procedure is necessary to “prevent the death of the mother.” Under this new legislation, doctors face prosecution for the termination of any pregnancy in which maternal death is not clearly averted by its performance.

This law does great harm to women with complicated pregnancies and must be opposed, argues, Dr Marvin Buehner, an obstetrician and gynaecologist who has practiced in South Dakota since 1993.

Even then elective abortions were performed only in a single clinic in this state, which was picketed for years, giving rise to the notion that providing abortion services would be professional suicide for any private practitioner, he writes.

“The environment of intimidation here is still so pervasive that neither I, nor my colleagues, nor our state medical association spoke in objection when the legislature proposed a sweeping abortion ban, vetoed in 2004, or when it was reintroduced this year.”

But despite the difficulties, he is determined to continue to provide termination options for women with serious medical complications.

He has publicly testified that the law does great harm to women with complicated pregnancies and has worked with the South Dakota State Medical Association and the American College of Obstetricians and Gynaecologists to oppose the law for its “horrific medical consequences.”

As a result, he faces “a daily parade of protesters” outside his office, even though neither he nor any of his partners perform abortions at their clinic.

Polling data show that 70% of physicians in the state oppose the law, and that the public is poised to reverse this draconian bill in a November referendum, primarily because there are no exceptions for victims of rape or incest, he says.

If the law is overturned, the battle over abortion will continue to rage on in the United States. But perhaps the defeat will allow more reasonable voices to be heard over the harsh rhetoric of extremists, he concludes.

Contact: Emma Dickinson

BMJ-British Medical Journal

ACOG credits the President and House and Senate Democratic leaders for including many critical elements of ACOG’s Health Care for Women, Health Care for All campaign that will greatly improve women’s health, including guaranteed maternity coverage; eliminating pre-existing coverage exclusions for women who are pregnant, have had a previous cesarean, or are the victims of domestic violence; eliminating gender rating that causes women to pay more than men for the same insurance coverage; creating coordinated care centers for women and ensuring direct access to ob-gyns; expanding family planning services for low-income women; and providing access to vital preventive screenings including mammography and Pap tests.

This bill (HR 3590), however, leaves several critical issues unaddressed, including medical liability reform and repeal of the Sustainable Growth Rate (SGR) used to determine physician payments in the Medicare program. “As ACOG embraces the many positive features of this legislation that will improve the health and well-being of our patients, we will continue to press for national medical liability reform and repeal of the SGR,” says Dr. Joseph.

Source
American Congress of Obstetricians and Gynecologists

Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women’s Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women’s Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.

© 2008 The Advisory Board Company. All rights reserved.