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GENE VARIANT HELPS PREDICT LUNG CANCER IN NON-SMOKERS
Up to 20% of patients with lung cancer have never smoked. A new discovery could help doctors identify these high-risk individuals in advance and monitor them more intensively, researchers reported.
A rare inherited mutation in the Epidermal Growth Factor Receptor gene is associated with an overall 25-fold increased risk of lung cancer, according to a study that looked at data from more than 3.3 million people in the 23andMe genetic database.
The mutation, called EGFR T790M, was associated with 10 times higher odds of developing lung cancer among smokers.
Among never-smokers, carriers of the mutation were more than 60 times as likely to develop lung cancer as people without it, the researchers reported in Science.
“Today, lung cancer screening is driven almost entirely by smoking history,” study leader Dr. Jaclyn LoPiccolo of the Dana-Farber Cancer Institute in Boston said in a statement.
“Our findings raise the possibility that, in the future, screening could also be dictated by inherited genetic risk.”
The variant was not linked to any of 17 other common cancers studied, suggesting that its effects may be largely limited to lung cancer.
EGFR T790M was first identified in 2005 in a European family with multiple cases of lung cancer, according to the researchers, who say it has since been found in other families with unusually high rates of the disease.
“For years we’ve known that some families inherit a markedly increased risk of lung cancer, but because this variant is so rare, we’ve never been able to accurately measure that risk,” study co-author Dr. Pasi A. Janne, also at Dana-Farber, said in a statement.
“By studying more than three million people, we were able to demonstrate just how strongly this inherited mutation is associated with lung cancer.”
COMMON BIRTH CONTROL DEVICE PROCEDURE MADE LESS PAINFUL
A simple intervention with a local anesthetic can make the notoriously painful insertion of an intra-uterine device – one of the most reliable forms of birth control – significantly less uncomfortable, researchers have found.
The procedure has traditionally been done without providing anything for pain.
In a trial of 370 women who had never given birth, half received a small amount of the local anesthetic mepivacaine introduced into the uterus via a thin plastic catheter minutes before the procedure. The others received saline through the catheter as a control.
In a report published on Thursday in JAMA, the researchers said their method is easy to use in everyday clinical practice.
On a scale from 0 to 100, the average pain score during the procedure was 43.8 with mepivacaine compared with 58.6 with placebo.
The proportion of participants who found the pain tolerable rose from 91.4% with saline to 98.3% with the local anesthetic.
“Considering the frequency of IUD placements worldwide, even modest reductions in the proportion of individuals experiencing intolerable pain may have important clinical implications,” the researchers said in their report.
“Our study shows that the method works when compared with no active treatment, but it also needs to be compared with other pain relief methods,” coauthor Dr. Helena Kopp Kallner of Karolinska Institutet in Sweden said in a statement.
