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By John Schieszer
Medical Minutes 

New efforts having positive medical effects

Medical Minutes

 


New treatments and prevention efforts paying off

Thanks to a host of factors, cancer death rates are continuing to drop significantly. A steady decline over more than two decades has resulted in a 25 percent drop in the overall cancer death rate in the United States. The drop equates to 2.1 million fewer cancer deaths between 1991 and 2014, according to Cancer Statistics 2017, which is the American Cancer Society’s comprehensive annual report on cancer incidence, mortality and survival.

The report estimates that in 2017 there will be 1,688,780 new cancer cases and 600,920 cancer deaths in the United States. The overall cancer incidence rate was stable in women and declined by about 2 percent per year in men over the past the past 10 years.

The cancer death rate dropped from its peak of 215.1 (per 100,000 population) in 1991 to 161.2 (per 100,000 population) in 2014, the latest available data. The drop is the result of steady reductions in smoking and advances in early detection and treatment. The improved rates were fueled by decreasing death rates for the four major cancer sites (lung, breast, prostate and colorectal).

The report also finds significant gender disparities in incidence and mortality. For all sites combined, the cancer incidence rate is 20 percent higher in men than in women and the cancer death rate is 40 percent higher in men. Liver cancer is three times more common in men than in women, partly reflecting higher hepatitis C virus infection, historical smoking prevalence, and excess alcohol consumption in men. The largest sex disparities are for cancers of the esophagus, larynx and bladder, for which incidence and death rates are about four-fold higher in men. Melanoma incidence rates are about 60 percent higher in men than in women, and the melanoma death rates are more than double in men compared to women.

Mediterranean Diet may have important brain benefits

A new study shows that older adults who follow a Mediterranean diet may retain more brain volume. However, contrary to earlier studies, eating more fish and less meat was not related to changes in the brain, according to a new study published in the journal Neurology.

The Mediterranean diet includes large amounts of fruits, vegetables, olive oil, beans and cereal grains such as wheat and rice, moderate amounts of fish, dairy and wine, and limited red meat and poultry. Researchers studied older adults over a three-year period who followed the Mediterranean diet.

“As we age, the brain shrinks and we lose brain cells which can affect learning and memory,” said study author Michelle Luciano, PhD, of the University of Edinburgh in Scotland. “This study adds to the body of evidence that suggests the Mediterranean diet has a positive impact on brain health.”

Researchers gathered information on the eating habits of 967 people (age 70) who did not have dementia. Around age 73 years old, 562 of the subjects had an MRI brain scan to measure overall brain volume, gray matter volume and thickness of the cortex, which is the outer layer of the brain. From that group, 401 individuals then returned for a second MRI at age 76. These measurements were compared to how closely participants followed the Mediterranean diet.

Individuals who didn’t follow as closely to the Mediterranean diet were more likely to have a higher loss of total brain volume over the three years than people who followed the diet more closely. The difference in diet explained 0.5 percent of the variation in total brain volume, an effect that was half the size of that due to normal aging.

The results were the same when researchers adjusted for other factors that could affect brain volume, such as age, education and having diabetes or high blood pressure.

The researchers found that fish and meat consumption were not related to brain changes, which is contrary to earlier studies.

“It’s possible that other components of the Mediterranean diet are responsible for this relationship, or that it’s due to all of the components in combination,” said Luciano.

Worker-owned cooperatives may help address elder care

A growing elder care shortage could be eased by worker-owned cooperatives, a little-used business model that also improves the working conditions and the quality of life for caregivers. That’s the conclusion of researchers at the University of Georgia. They looked for a successful system of home-based caring labor that puts equal emphasis on the well-being of both the care recipient and the provider.

The researchers examined the most popular forms of paid child care, including for-profit and nonprofit services and alongside worker-owned child care cooperatives.

They found that the cooperatives, which give employees greater control over their working conditions and a share in profits, improved the quality of life of both care recipients and providers.

As an example, they cited a case study of the Beyond Care Childcare Cooperative, an organization that provides home-based child care services in Brooklyn, New York. Women who joined the cooperative as worker-owners reported a 58 percent increase in hourly wages. As wages grew, more than half of the employee-owners were able to reduce their work hours, enabling them to spend more time with their own children and families.

The model could also be applied to the provision of elder care. Since home care for the elderly is expected to grow from nearly 40 million jobs now to 73 million by 2030, the potential impact of worker-owned cooperatives could be huge, according to the researchers.

“Worker-owned cooperatives provide a truly promising alternative through which to provide quality jobs and care,” said researcher Rebecca Matthew, who is a faculty member at the University of Georgia, Athens Georgia.

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at medicalminutes@gmail.com.

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