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Hormone replacement therapy (HRT) cuts a woman’s risk of developing colon cancer, new research confirms.

Millions of women stopped taking HRT when a Women’s Health Initiative study showed in 2002 that the hormones raised the risk of stroke, heart disease and breast cancer.

But the Women’s Health Initiative had also found that HRT protected against colon cancer. Some studies have also suggested that oral contraceptives might reduce the risk of the disease, while the fact that women are at lower risk of colon cancer than men also hints at a hormonal role in disease risk.

To investigate ties between HRT and colon cancer further, Dr. Millie D. Long of the University of North Carolina at Chapel Hill and her colleagues matched 443 women diagnosed between 2001 and 2006 with distal large bowel cancer (meaning tumors at the far end of the colon and the rectum) to 405 healthy control women. The average age of the study participants was around 63.

Long’s team found that women who had ever used HRT were at half the risk of this type of colon cancer compared to women who’d never used hormone replacement, and the longer a woman was on HRT, the lower the risk.

For example, women who used hormones for less than four years cut their colon cancer risk by about one-quarter; four to eight years of HRT cut risk by a third; nine to 14 years of use halved risk; and 15 years or more of HRT reduced risk by two-thirds. The effects were the same for African-American women and white women.

However, there was no relationship between oral contraceptive use and colon cancer risk, the study team reports in the American Journal of Gastroenterology.

Long-term hormone therapy is no longer recommended for postmenopausal women, Long and her team note, although it is still sometimes prescribed on a short-term basis to help women with menopausal symptoms such as hot flashes. The major drop off in distal large bowel cancer in recent years could have been related to widespread use of HRT, the researchers say.

More research is needed to determine if HRT’s protective effects persist after women stop taking hormones, the researchers add, or whether there might be a “rebound” effect with more pre-cancerous polyps developing after a woman halts

HRT.

“It may become important in the future to tailor timing of women’s colorectal screening based on cessation of hormonal therapy,” Long and her colleagues conclude.

SOURCE: The American Journal of Gastroenterology

Nicotine withdrawal can create serious problems for smokers who have a medical condition that puts them in intensive care, according to a new study.

Researchers from Caen University Hospital in France found that hospital patients going through nicotine withdrawal can become highly agitated and accidentally remove tubes and catheters, require additional sedation, analgesic or anti-psychotic medicines, or need physical restraints.

Agitation, for example, occurred twice as often among smokers as non-smokers, the researchers found.

Their study, published online April 9 in Critical Care, compared 44 smokers and a control group of 100 non-smokers treated in the hospital’s intensive care unit (ICU).

“These results suggest the need to be aware of nicotine withdrawal syndrome in critically ill patients and support the need for improved strategies to prevent agitation or treat it earlier,” study author Damien du Cheyron said in a news release from the journal’s publisher.

None of the smokers were allowed nicotine replacement therapy (NRT) during the study.

“NRT remains a controversial topic in intensive care and has been associated with mortality,” du Cheyron said. “Due to the serious consequences of withdrawal-induced agitation, including sedation and physical restraint, we suggest the use of nicotine replacement therapy should be tested by a well-designed, randomized controlled clinical trial in the ICU setting.”

SOURCE: BioMed Central

People who are trying to stay trim may want to make sure they get plenty of sleep.

In a study, researchers found that normal-weight young men ate a Big Mac’s-worth of extra calories when they’d gotten four hours of sleep the night before compared to when they slept for eight hours.

Given the findings, and the fact that people have been sleeping less and getting fatter over the past few decades, “sleep restriction could be one of the environmental factors that contribute to the obesity epidemic,” they write in the American Journal of Clinical Nutrition.

A number of studies have linked shorter sleep duration with higher body mass index (BMI) — a measure of weight in relation to height used to gauge whether someone is overweight or obese. But no experimental studies to date have actually looked at what happens to a normal-weight person’s eating patterns when he or she sleeps less.

To investigate, Dr. Laurent Brondel of the European Center for Taste Sciences in Dijon, France, and colleagues looked at sleep, eating, and energy expenditure in 12 healthy young men across two 48-hour sessions.

Two days served as a control period, during which the study participants stuck to their normal routines but kept track of their sleep, eating and activities in a diary. During the second two-day period, the men went to bed at midnight and woke up at 8 a.m. on one day, and on the other day went to bed at 2 a.m. and woke up at 6 a.m. They were allowed to eat as much as they liked.

After the night of short sleep, the researchers found, the men took in 22 percent more calories, on average, than when they were allowed to sleep for eight hours. They ate more at breakfast and dinner, but not at lunch. The average calorie increase was about 560.

It’s possible that people might eat more after a short sleep because mammals have evolved to store up calories in the summer, when nights are short and food is plentiful, Brondel and his colleague Dr. Damien Davenne of the University de Caen in Caen, France noted in an email to Reuters Health.

The findings make it clear that people need to do their best to get an adequate amount of sleep so their bodies can function properly, Brondel and Davenne add. “It is time to understand that sleep is not just losing time, besides the recovery processes that occur, there are many other functions (energy conservation, memory and so on) which are going on.”

SOURCE: American Journal of Clinical Nutrition

Once-a-year screening for chlamydia isn’t likely to protect women from developing pelvic inflammatory disease, researchers say.

A new study has found that most cases of pelvic inflammatory disease occur in women who didn’t have chlamydia infection when they were screened, which suggests they may have become infected later.

Chlamydia is the most common sexually transmitted infection in Europe and the United States. An estimated 3 million new infections are diagnosed annually, and because there are often no symptoms, many cases remain undiagnosed, according to background information provided in a news release about the study. Undiagnosed chlamydia infection may lead to pelvic inflammatory disease.

The study included 2,529 sexually active females, aged 16 to 27, who completed questionnaires and provided vaginal swabs to check for chlamydia. Some of the swabs (1,254) were tested immediately while others (1,265) were tested after a year.

Chlamydia was found in 68 (5.4 percent) of the women who were screened at the start of the study and in 75 (5.9 percent) of those screened a year later. During the study period, pelvic inflammatory disease developed in 15 (1.3 percent) of the women who were screened immediately and in 23 (1.9 percent) of those who were screened after one year.

The majority of cases of pelvic inflammatory disease (79 percent) were among women who tested negative for chlamydia at their initial screening, the study authors found. This suggests that, among high-risk people, frequent testing for chlamydia may be more effective at preventing pelvic inflammatory disease than annual screening, said Dr. Pippa Oakeshott, of the University of London, and colleagues.

Public campaigns should emphasize the need for screening whenever a woman has a new sexual partner, the study authors recommended in the report published online April 9 in BMJ.

“It is disappointing but not surprising that this study could not provide a clear answer as to whether screening is effective in reducing the incidence of pelvic inflammatory disease,” Jessica Sheringham, of University College London, wrote in an editorial accompanying the study.

SOURCE: BMJ