WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

___

Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

WHO report: http://bit.ly/YDCXcb

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IHT Rendezvous: Muslims Seek Dialogue With Next Pope

LONDON — As the Catholic Church’s cardinal electors gather at the Vatican to choose a new pope, Muslim leaders are urging a revival of the often troubled dialogue between the two faiths.

During the papacy of Benedict XVI, relations between the world’s two largest religions were overshadowed by remarks he made in 2006 that were widely condemned as an attack on Islam.

In a speech at Regensburg University in his native Germany, Benedict quoted a 14th-century Byzantine emperor as saying, “Show me just what Muhammad brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached.”

In the face of protests from the Muslim world, the Vatican said the pope’s remarks had been misinterpreted and that he “deeply regretted” that the speech “sounded offensive to the sensibility of Muslim believers.”

For many in the Muslim world, however, the damage was done and the perception persisted that Benedict was hostile to Islam.

Juan Cole, a U.S. commentator on the Middle East, has suggested that although the pope backed down on some of his positions, “Pope Benedict roiled those relationships with needlessly provocative and sometimes offensive statements about Islam and Muslims.”

Despite the Vatican’s efforts to renew the interfaith dialogue by hosting a meeting with Muslim scholars, hostilities resumed in 2011 when the pope condemned alleged discrimination against Egypt’s Coptic Christians in the wake of a church bombing in Alexandria.

Al Azhar University in Cairo, the center of Islamic learning, froze relations with the Vatican in protest.

Following the pope’s decision to step down, Mahmud Azab, an adviser on interfaith dialogue to the head of Al Azhar, said, “The resumption of ties with the Vatican hinges on the new atmosphere created by the new pope. The initiative is now in the Vatican’s hands.”

Mahmoud Ashour, a senior Al Azhar cleric, insisted that “the new pope must not attack Islam,” according to remarks quoted by Agence France-Presse, the French news agency, and said the two religions should “complete one another, rather than compete.”

A French Muslim leader, meanwhile, has called for a fresh start in the dialogue with a new pope.

In an interview with Der Spiegel of Germany this week, Dalil Boubakeur, rector of the Grand Mosque in Paris, said of Benedict, “He was not able to understand Muslims. He had no direct experience with Islam, and he found nothing positive to say about our beliefs.”

Reem Nasr, writing at the policy debate Web site, Policymic, this week offered Benedict’s successor a five-point program to bridge the Catholic and Muslim worlds.

These included mutual respect, more papal contacts with Muslim leaders and a greater focus on what the religions had in common.

“There has been a long history of mistrust that can be overcome,” she wrote. “No one should give up just yet.”

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Paris Jackson Rocks a New Punk Look

By Andrea Billups

03/01/2013 at 08:30 AM EST

Punk rock Paris!

Michael Jackson's daughter Paris, now 14, debuted a more edgy and downtown look this week when she Tweeted photos of herself wearing a knotted Pink Floyd T-shirt with a short, spiked jet black coif and exposed back tattoo.

Titling her Wednesday Tweet "late night creativity," Paris sported a new look that included black liner rimming her striking light-blue eyes, and dagger-style earrings.

Her transformation from long-haired and girlie draws comparisons to the latest cropped, rock-inspired look of Miley Cyrus.

Paris, an aspiring actress, Tweeted in August that she got her back tattoo to honor her late father. She had previously posted photos of herself on Valentine's Day in a short black wig, perhaps a tryout for her future makeover.

Paris is Michael Jackson's only daughter with former wife Debbie Rowe. She has said in the past that she loves her famous family but hopes to be taken seriously in her own right.

To that end, she shot her first movie role last year, for Lundon's Bridge and the Three Keys, a mixed live-action and animation film. She plays a girl who survives being brainwashed by a jellyfish queen in the ocean.

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WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

___

Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

__

Online:

WHO report: http://bit.ly/YDCXcb

Read More..

IHT Rendezvous: IHT Quick Read: Feb. 28

NEWS Miguel Díaz-Canel Bermúdez, 52, the top contender to succeed the Castros in Cuba, will need to display the authority of a future president while acting as if he does not want the job. Damien Cave reports from Mexico City.

In the waning hours of his troubled tenure, tens of thousands of believers gathered in St. Peter’s Square for Pope Benedict XVI’s valedictory address. Daniel J. Wakin reports from Vatican City.

The former mayor of Greece’s second city, Salonika, and two of his top aides were sentenced to life in prison on Wednesday after being found guilty of embezzling almost €18 million, or $23.5 million, in public money — a rare conviction in a case involving the political corruption that has contributed to the country’s dysfunction and economic decline. Niki Kitsantonis reports from Athens.

After Lars Hedegaard, a Danish polemicist, faced an attack for his anti-Islamic views, Muslim groups rallied to defend his right to free speech. Andrew Higgins reports from Copenhagen.

Islamic bonds, or sukuk, have long been popular with investors in the Middle East. Now they are being discovered in Europe and the United States. Sara Hamdan reports from Dubai.

The European Commission on Wednesday blocked the third attempt by Ryanair to acquire Aer Lingus, saying a union of the two Irish airlines would damage competition and raise prices on air routes to Ireland. James Kanter reports from Brussels.

At the Mobile World Congress, the industry’s largest convention in Europe, Samsung appears to be taking a page from Apple. Kevin J. O’Brien reports from Barcelona.

FASHION Fifteen years after much of its fashion manufacturing left for cheaper markets, Spain is trying to rebuild the sector and train new craftsmen. Raphael Minder reports from Madrid.

ARTS Van Cliburn, the American pianist whose first-place award at the 1958 International Tchaikovsky Competition in Moscow made him an overnight sensation and propelled him to a phenomenally successful and lucrative career, though a short-lived one, died on Wednesday at his home in Fort Worth, Texas. He was 78. Anthony Tommasini reports.

Giuseppe De Nittis was an original and innovative force and responsible for evocative images, persuasively demonstrated by an exhibition of 118 of his works in Italy. Roderick Conway Morris reviews from Padua, Italy.

SPORTS Real Madrid beat its archrival, 3-1, in Barcelona, less than a week after the Catalan club lost in the Champions League. Rob Hughes reports from Barcelona.

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Debbie Reynolds: Carrie Fisher Will Be 'Just Fine' After Hospitalization

By Elaine Aradillas

02/28/2013 at 08:40 AM EST

Carrie Fisher (left) and Debbie Reynolds

Ethan Miller/Getty

Carrie Fisher was briefly hospitalized last week for her bipolar disorder after a bizarre performance aboard a cruise ship, but her mother Debbie Reynolds says she'll be fine.

"She's had manic depression bipolar since she was 13. It's an illness, and she's doing much better," Reynolds told PEOPLE exclusively Wednesday night. "I'm very proud of her, and she's doing exceptionally well. She'll be just fine, just great, and continue her writing as she always does."

Fisher, 56, who has spoken openly about her mental illness, performed on the Holland American cruise liner Eurodam in the Caribbean. The actress and author gave a rambling performance, leaving many in the audience wondering what was wrong.

"She clearly had trouble remembering things," says Chris Smith, a guest on the cruise. "She tried to tell some stories about her parents and Hollywood, but was having a hard time."

After a video of the performance went viral, her publicist released the following statement: "There was a medical incident related to Carrie Fisher's bipolar disorder. She went to the hospital briefly to adjust her medication and is feeling much better now."

Reynolds, 80, who spoke Wednesday to a sold-out audience attending the Rancho Mirage Lecture Series at Eisenhower Medical Center in Rancho Mirage, Calif., talked about the effects of mental illness.

"[It's] really dreadful, and you are so alone because you're criticized, and people think you're doing it on purpose, and that you're misbehaving or having a spell because you want attention," she says. "It's not true. It's extremely difficult for everyone to deal with."

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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On the Web:

The OIG report: http://1.usa.gov/VaztQm

The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1

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Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.

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S&P 500 index futures briefly turn negative

MADRID, Feb 27 (Reuters) - Lionel Messi has rarely been accused of failing to deliver in big games, having scored in two European Cup finals, but after subdued performances against AC Milan and Real Madrid, questions are being asked. The four-times World Player of the Year and leading scorer in one of the greatest club teams of all time, was a shadow of his usual self at the San Siro in a Champions League last-16 first leg last week, when Barcelona slumped to a 2-0 defeat. ...

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Prince Harry Dances, Cooks with Kids In South Africa

By Simon Perry

02/27/2013 at 08:30 AM EST

Prince Harry, at Lesotho's St. Bernadette's Centre for the Blind

Chris Jackson/Getty

From the slopes of the Alps to the southern African mountain kingdom of Lesotho, Prince Harry is now giving back.

Just returned from his skiing holiday with girlfriend Cressida Bonas, Harry is spending a couple of days in Africa, to work with the Sentebale charity he set up with Lesotho's Prince Seeiso.

Early Wednesday, the Prince, 28, visited the Kananelo Center for the Deaf just outside the capital Maseru, where he was welcomed with a huge "Hi Harry" sign on the chalkboard.

As he attempted to learn some sign language from the children, he quipped to his friend Seeiso, "I'm never going to get this right."

The two princes, who set up the charity (Sentebale means "Forget Me Not") in honor of their late mothers, were then taken to the school's kitchen, where Harry slipped on a purple apron decorated with teddy bears before they tried their hand at making Sotho sweet bread cooked in boiling oil – also known as "fat cakes."

They also got down on their knees to join the kids in a dance.

Following that visit, the pair headed to St. Bernadette's School for the Blind in the capital, Maseru. There, Harry was welcomed with a song sung in the Sesotho language.

The charity supports tens of thousands of children who are either suffering from HIV/Aids, have been orphaned, or have disabilities.

Later, he is to be guest of honor at a fundraising dinner in Johannesburg.

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Advanced breast cancer edges up in younger women

CHICAGO (AP) — Advanced breast cancer has increased slightly among young women, a 34-year analysis suggests. The disease is still uncommon among women younger than 40, and the small change has experts scratching their heads about possible reasons.

The results are potentially worrisome because young women's tumors tend to be more aggressive than older women's, and they're much less likely to get routine screening for the disease.

Still, that doesn't explain why there'd be an increase in advanced cases and the researchers and other experts say more work is needed to find answers.

It's likely that the increase has more than one cause, said Dr. Rebecca Johnson, the study's lead author and medical director of a teen and young adult cancer program at Seattle Children's Hospital.

"The change might be due to some sort of modifiable risk factor, like a lifestyle change" or exposure to some sort of cancer-linked substance, she said.

Johnson said the results translate to about 250 advanced cases diagnosed in women younger than 40 in the mid-1970s versus more than 800 in 2009. During those years, the number of women nationwide in that age range went from about 22 million to closer to 30 million — an increase that explains part of the study trend "but definitely not all of it," Johnson said.

Other experts said women delaying pregnancy might be a factor, partly because getting pregnant at an older age might cause an already growing tumor to spread more quickly in response to pregnancy hormones.

Obesity and having at least a drink or two daily have both been linked with breast cancer but research is inconclusive on other possible risk factors, including tobacco and chemicals in the environment. Whether any of these explains the slight increase in advanced disease in young women is unknown.

There was no increase in cancer at other stages in young women. There also was no increase in advanced disease among women older than 40.

Overall U.S. breast cancer rates have mostly fallen in more recent years, although there are signs they may have plateaued.

Some 17 years ago, Johnson was diagnosed with early-stage breast cancer at age 27, and that influenced her career choice to focus on the disease in younger women.

"Young women and their doctors need to understand that it can happen in young women," and get checked if symptoms appear, said Johnson, now 44. "People shouldn't just watch and wait."

The authors reviewed a U.S. government database of cancer cases from 1976 to 2009. They found that among women aged 25 to 39, breast cancer that has spread to distant parts of the body — advanced disease — increased from between 1 and 2 cases per 100,000 women to about 3 cases per 100,000 during that time span.

The study was published Tuesday in the Journal of the American Medical Association.

About one in 8 women will develop breast cancer in their lifetime, but only 1 in 173 will develop it by age 40. Risks increase with age and certain gene variations can raise the odds.

Routine screening with mammograms is recommended for older women but not those younger than 40.

Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, said the results support anecdotal reports but that there's no reason to start screening all younger women since breast cancer is still so uncommon for them.

He said the study "is solid and interesting and certainly does raise questions as to why this is being observed." One of the most likely reasons is probably related to changes in childbearing practices, he said, adding that the trend "is clearly something to be followed."

Dr. Ann Partridge, chair of the federal Centers for Disease Control and Prevention's advisory committee on breast cancer in young women, agreed but said it's also possible that doctors look harder for advanced disease in younger women than in older patients. More research is needed to make sure the phenomenon is real, said Partridge, director of a program for young women with breast cancer at the Harvard-affiliated Dana-Farber Cancer Institute.

The study shouldn't cause alarm, she said. Still, Partridge said young women should be familiar with their breasts and see the doctor if they notice any lumps or other changes.

Software engineer Stephanie Carson discovered a large breast tumor that had already spread to her lungs; that diagnosis in 2003 was a huge shock.

"I was so clueless," she said. "I was just 29 and that was the last thing on my mind."

Carson, who lives near St. Louis, had a mastectomy, chemotherapy, radiation and other treatments and she frequently has to try new drugs to keep the cancer at bay.

Because most breast cancer is diagnosed in early stages, there's a misconception that women are treated, and then get on with their lives, Carson said. She and her husband had to abandon hopes of having children, and she's on medical leave from her job.

"It changed the complete course of my life," she said. "But it's still a good life."

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Online:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov/cancer/breast/index.htm

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