Annals of Internal Medicine tip sheet for March 21, 2006

March 20, 2006

1. New Large Study of Men and Women: Smoking Strongly Increases Risk for Death in Middle Age
--Quitting Strongly Decreases Risk of Death, Even at Older Ages

A new study of 50,000 people followed for 25 years-- the largest and longest study of smoking habits and consequences that includes women as well as men -- found that 41 percent of the men who were heavy smokers died during middle age compared to 14 percent of non-smoking men, and 26 percent of women who were heavy smokers died compared to only 9 percent of non-smoking women (Article, p. 381).

The study also found: An editorial writer says that the survival data curves in this study "are a powerful graphic representation of the huge effect of smoking on mortality risk in middle age ... and demonstrate the dose-response relationship between smoking and mortality" (Editorial, p. 444).

NOTE TO EDITORS: This article is the subject of a video news release. Call for coordinates.

2. Study Examines Cost-Effectiveness of 6 Preventive Strategies for Women with Gene Mutations that Increase the Risk of Breast Cancer

In a study using a computer model and published information on breast cancer and costs of current strategies to prevent breast cancer, researchers calculated the harms, benefits and costs of six interventions for women who do not have breast cancer but carry a single BRCA1 or BRCA2 gene mutation (Article, p. 397).

The interventions or strategies considered were oral contraceptives, which appear to reduce risk for ovarian cancer; the drug tamoxifen, which appears to reduce risk for breast cancer; surgical removal of both ovaries; surgical removal of both breasts; surgical removal of breasts and ovaries; or no preventive measures (surveillance or watchful waiting).

The decision model found that for women with BCRA2 gene mutation, combined preventive surgical removal of the ovaries (oophorectomy) and breasts (mastectomy) was cost-effective compared to removal of the ovaries alone. Either of these treatments was less costly and more effective than mastectomy alone, tamoxifen, or surveillance. For BRCA1 carriers, oophorectomy was the most cost-effective of all strategies.
Annals of Internal Medicine is published by the American College of Physicians. These highlights are not intended to substitute for articles as sources of information.

American College of Physicians

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