Many women with ovarian cancer report symptoms before diagnosis, but
distinguishing symptoms that merit investigation is difficult. To address
this problem, Goff and colleaguesArticle administered a symptom
survey to women attending a primary care clinic and to women awaiting surgery
for a pelvic mass. They compared the frequency, severity, and duration of
symptoms reported by women with ovarian cancer and benign masses with those
reported by women seeking primary care. Women with ovarian cancer reported
more frequent and severe symptoms that had more recently manifested than what
women in the primary control group reported. In an editorial, Daly and OzolsArticle
emphasize the importance of good patient-physician communication
and skilled clinical judgment to help facilitate early diagnosis of ovarian
Previous studies have estimated a 10- to 15-year progression-free and
cause-specific survival for men with early, localized and untreated prostate
cancer, but little is known about disease progression and mortality beyond
this time frame. Johansson and colleaguesArticle report results
from a population-based, cohort study of men with initially untreated, early
stage prostate cancer who were followed up for a mean of 21 years. Although
most cancers remained indolent through 15 years of follow-up, beyond 15 years,
both disease progression and prostate cancer mortality increased approximately
3-fold compared with the earlier period. In an editorial, Neugut and GrannArticle
discuss the implications of these findings for initial treatment decisions.
Adequate representation of racial and ethnic minorities, women, and
elderly patients is necessary to assess whether cancer treatments are effective
for all patients. To characterize the representation of these groups in nonsurgical
cancer treatment trials, Murthy and colleagues conducted a population-based
analysis of participants in colorectal, breast, prostate, and lung cancer
trials sponsored by the National Cancer Institute Clinical Trial Cooperative
Group in 2000 through 2002. They compared enrollment by race and ethnicity
in the years 1996 through 1998 with that in the years 2000 through 2002. They
found blacks and Hispanics were underrepresented in trials compared with whites
and that enrollment was inversely related to age. From 1996 through 2002,
trial enrollment increased nearly 50%, but the percentage of racial and ethnic
minority enrollees decreased relative to whites.
Identification of patients at high risk of 6-month mortality following
an acute coronary syndrome (ACS) could improve their posthospital care. Eagle
and colleagues used data from more than 15 000 patients in the Global
Registry of Acute Coronary Events to develop a decision tool to estimate the
6-month all-cause mortality risk in patients surviving an ACS. Their final
model included 9 historical, admission, and treatment variables that predict
6-month postdischage mortality.
Reliable tools to predict life expectancy of patients with advanced
dementia could help families and clinicians determine when palliative care
would be appropriate. Mitchell and colleagues used data from newly admitted
nursing home residents with advanced dementia—collected for the federally
mandated Minimum Data Set (MDS)—to construct a scoring system that predicts
the risk of 6-month mortality. They compared the performance of their model
with existing criteria for hospice eligibility. Twelve variables from the
MDS were included in the final model, which more accurately predicted 6-month
mortality than hospice guidelines in current use.
Scientists are developing new techniques for producing laboratory-grown
cartilage for the repair of damaged joints.
Airborne nicotine was detected in 94% of public places in an assessment
in the capital cities of 7 countries.
A systematic literature review reveals 3 useful signs predictive of dehydration in children.
For your patients: Information about cancer clinical trials.
This Week in JAMA. JAMA. 2004;291(22):2673. doi:10.1001/jama.291.22.2673