They said the increased risk is especially pronounced in younger people and suggests people who get these less serious forms of skin cancer may be more cancer-prone in general.

“It seems like non-melanoma skin cancer, even though it is a non-fatal disease, may be a warning sign for increased risk of other, more serious cancers,” said Anthony Alberg, a researcher at the Medical University of South Carolina in Charleston, whose study appears in the Journal of the National Cancer Institute.

Non-melanoma skin cancers, which include basal cell carcinoma and squamous cell carcinoma, affect an estimated 1 million people each year in the United States, according to the American Cancer Society.

“It is far and away the most common form of cancer,” Alberg said in a telephone interview. But they are slow-growing and cause no harm if they are removed.

Previous studies have found that people who get these types of skin cancers are at higher risk of developing melanoma, the deadly form of skin cancer.
Alberg said his research suggests that non-melanoma skin cancer may be a risk factor for other cancers as well.

He and colleagues analyzed data from a 16-year study of people in Washington County, Md., that compared cancer risks among 769 people who had been diagnosed with non-melanoma skin cancer and 18,405 people who had no history of skin cancer.

“People with a personal history of non-melanoma skin cancer were two times more likely to develop a subsequent cancer compared to people without a personal history of non-melanoma skin cancer,” Alberg said.

That was true even after they adjusted for age, obesity, history of smoking, level of education, skin type and sun exposure. “The differences didn’t go away,” Alberg said.

Link especially true for younger people
And people who developed skin cancer at a younger age, those 25 to 44, had 2.6 times higher risk of developing another cancer.

“The results were pretty clear in showing the earlier the age of developing non-melanoma skin cancer, the higher the increased risk for subsequent malignancies,” he said.

Alberg said the findings suggest some people may have a genetic predisposition to skin cancer that may also be linked to the development of other forms of cancer.

He suspects this may have something to do with a person’s ability to repair DNA in skin cells damaged by ultraviolet radiation from the sun. “If they are less adept at that, their risk for skin cancer increases,” Alberg said.

While more study is needed about individual risks, Alberg said people who have had non-melanoma skin cancer would be wise to mention it to their doctor.

“It seems to be a more important part of a personal health history than we thought before,” he said.

Experts from the Department of Health are considering the case for offering women the latest protection against the human papilloma virus (HPV) as part of a concerted assault on a cancer that affects 2,700 people every year. The threat cervical cancer poses was brought home last week when Big Brother star Jade Goody was informed that she had tested positive for the disease.

Health chiefs are set to begin vaccinating schoolgirls against HPV in one of the biggest public health campaigns in British history. After a long investigation into the programme, the Government will offer routine vaccinations to girls aged 12 to 13 from next month, in a move that some parents complained would “sexualise” their children at an early age. The Government claims that the action against HPV, which is mainly spread through sexual contact, will save up to 400 lives every year.

The Health minister, Dawn Primarolo, said last month that the campaign will be extended to 300,000 girls between the age of 17 and 18 who, under original plans for a catch-up programme beginning next year, would have missed out on the treatment.

Now The Independent on Sunday has established that the Government is planning to offer the vaccine to more than a million women who are at risk.

The proposal to extend the immunisation programme to women aged between 19 and 24 flatly contradicts the recommendations of the Government’s advisers, who said the move would not be “cost effective”. But ministers have chosen the cheaper Cervarix vaccine over its rival Gardasil.

“The hum-an papilloma virus vacc-ination programme will offer the HPV vaccine to girls and young women aged 12 to 18 years of age,” Ms Primarolo revealed in a written parliamentary answer slipped out before MPs went on their long summer holiday.

“We are currently considering the issues around offering the vaccine to those over 18 years of age, including the cost-effectiveness of such an intervention.”

The concession provoked astonishment among pressure groups and experts who had been campaigning for the vaccination programme to cover a wider swathe of the population.

But details of the plan received a mixed reception. One expert said the extension was a logical move to increase protection for the female population – but another warned that it could contribute to a decline in the number of women going for smear tests.

Professor Margaret Stanley, an adviser to the HPV subgroup of the Joint Committee for Vaccination and Immunisation (JCVI), which guides government policy on the issue, said the admission was “a remarkable volte-face”.

She said: “Vaccinating older girls and women who have active sexual lives will have an effect but it will be much less than immunising the virgins.

“There is the real anxiety that these older girls and women may think that they have had a magic bullet, are protected, don’t go for their smears and the cancers aren’t picked up at an early stage.”

Anne Szarewski, a senior consultant at the Wolfson Institute of Preventive Medicine, said: “This seems a logical approach to the issue and it is in line with the approach other countries have taken. I think if we are serious about tackling this cancer we must immunise everyone we can.

“I am glad that the Government is looking at older women. But if they really want herd immunity, they should be looking at vaccinating boys as well, because they will transmit this virus to girls in the future.”

Women will no longer have an excuse not to hit the gym with the latest research showing the earlier a girl becomes active, the lower the risk of breast cancer before menopause.

The analysis of the effects of exercise on premenopausal breast cancer, involving 65,000 women found that those who were physically active from the age of 12 had a 23 per cent lower risk of breast cancer.

In particular, high levels of physical activity between 12 and 22 contributed most to the lower risk.

Dr Helen Zorbas, CEO of the National Breast Cancer and Ovarian Cancer Centre, said the benefits of exercise were well known.

“It’s important and an empowering outcome for young women,” she said.

“It focused on detailed activity but the more you do, the better the effect.

“Thirteen hours a week for the most active woman but there were benefits for all levels of activity.”

For the greatest reduction, 13 hours of walking a week is recommended or 3.25 hours of running.

The study, by researchers at Washington University School of Medicine in St. Louis and Harvard University in Boston, also found recreational activity reduced the risk.

Household chores can have equal benefits but vigorous exercise is needed for optimum results.

“A number of studies show regular physical activity totalling four or more hours per week reduces the risk for breast cancer in post-menopausal women,” Dr Zorbas said.

“There hasn’t been a study before into pre-menopausal women.

“There are a number of theories to explain this reduction in risk, including the effect of exercise on reducing a woman’s exposure to estrogen, which is known to play a role in the development of breast cancer.”

A fourth of breast cancers are found in women before menopause.

Numerous studies have shown that the more estrogen a woman is exposed to, the greater her risk.

But women who begin menstruating later or enter menopause early have a lower risk of breast cancer.

For those like Denise Tobin, who like to exercise, the findings are welcome news.

The 24-year-old from Bondi has been into sports since she was young.

“I’ve always done about two or three sports,” she said.

“I go to the gym three times a week and go for a walk every other day.

“I do it because I know it’s good for me and I like to keep fit.”

Researchers surveyed 65,000 nurses in America on their physical activity between the ages of 12 and 35.

They found the rate of breast cancer dropped significantly in women who said they started exercising while at school and remained active throughout their lives.

“We can carefully say that experiencing more than one severe and/or moderate life event is a risk factor for breast cancer among young women. On the other hand, a general feeling of happiness and optimism can play a protective role.

“Young women who have been exposed to a number of negative life events should be considered an ‘at-risk’ group for breast cancer and should be treated accordingly,” lead researcher Ronit Peled was quoted by British media as saying.

In fact, Dr Peled and colleagues at the Ben-Gurion University of Negevin in Israel have based their findings on an analysis of a group of women — 255 breast cancer patients and 367 healthy ladies, all aged between 25 and 45 years. The breast cancer pat ients were asked to detail personal tragedies or losses, including the death of a parent or husband, divorce or loss of a job. Then their answers were compared with those of the healthy women.

Analysis showed a clear link between outlook and risk of breast cancer, with optimists 25 per cent less likely to have developed the disease. Conversely, women who suffered two or more traumatic events had a 62 per cent greater risk.

“It was found that a feeling of happiness and optimism has a ‘protective effect’,” according to the researchers whose study has been published in the latest edition of ‘BMC Cancer’ journal. – PTI

The vaccine against the HPV virus was licensed in 2006 for use in girls and women ages 9 to 26. Health officials recommend it for girls at age 11 or 12, and some doctors offer it to women in their 20s in “catch-up” vaccination campaigns.

The maker of the Gardasil vaccine, Merck & Co., also wants to market it to women ages 27 to 45, but so far the U.S. Food and Drug Administration has denied that request.

The government-funded study found the HPV vaccine is very cost-effective when given to girls at age 12, but raises questions about the value of pushing for vaccinating adults.

Two researchers at the Harvard School of Public Health did the study, one of the most sophisticated analyses of the issue so far. Results are in Thursday’s New England Journal of Medicine.

Gardasil is given in three doses over six months and costs about $375. It targets the two types of HPV, or human papillomavirus, believed to be responsible for about 70 percent of cervical cancer cases, and two other types that cause most genital warts. The virus spreads through sex.
Health officials say it’s best to give the shots to girls at age 11 or 12, before they begin having sex. Some parents think that age is too young for a vaccination campaign against a sexually transmitted disease.

But that is when the shots make the most economic sense, the researchers found.

They used computer models to predict the health outcomes of girls and women who get the vaccination as well as Pap tests or other screenings, which are still recommended for vaccine recipients. Their calculation included the cost of the vaccine, screenings and treating cervical cancer and other illnesses targeted by the vaccine.

To determine cost-effectiveness, the researchers used widely accepted economic measures of how much society is willing to pay to extend the life of a person by a year. They set a figure of $43,600 per year for the Gardasil vaccination of each 12-year-old girl, well below the $100,000 mark seen as an upper range for cost-effectiveness.

Lifetime protection not certain
That assumes the vaccine gives lifetime protection — something doctors don’t know is true, because the shot is too new.

“Their base-case assumptions are quite optimistic,” wrote Dr. Charlotte Haug, a Norwegian physician, in an editorial that accompanies the study.

The figure would rise if a booster shot is needed, but would still be under the cost-effective threshold, experts said. Another caveat: Costs could rise if there is an increase in the types of cancer-causing HPV not included in the vaccine.

Vaccinating “catch-up” campaigns for women in their 20’s, however, would not be cost-effective, the researchers said. They didn’t calculate cost-effectiveness of vaccinating women ages 27 to 45, but a trend seems clear, said Jane Kim, the study’s lead author.

“As you get older, the vaccine becomes less cost-effective,” she said.
Experts believe that the earlier a female is vaccinated, the better the odds she will avoid HPV-caused cervical disease, thus lowering health-care costs down the road.

Even though Merck can’t promote its use for them, women older than 26 can get the shot from their doctors, as part of an “off-label” use. An individual woman may decide that getting vaccinated is worth it even if vaccinating everyone her age isn’t considered cost-effective, some policy experts noted.

Many women in their 30s and 40s have not been exposed to the HPV types in the vaccine and could benefit from the shots, said Dr. Richard Haupt, Merck’s executive director for Gardasil research.

GlaxoSmithKline PLC has developed another HPV vaccine, called Cervarix, which it sells in other countries. That vaccine has not yet been approved for the U.S. market.

The survey, part of a wider-ranging continuing study on student suicidal behaviors being conducted by David Drum, a professor of education psychology at the University of Texas at Austin, questioned 26,000 undergraduate and graduate students at 70 U.S. institutions. The results raise the startling suggestion that suicidal thoughts could be a common experience on par with substance abuse, depression and eating disorders, Drum said.

The survey defined considering suicide as having at least one episode of suicidal thinking at some point. Slightly more than half of students said they fit that category, which is known as suicide ideation. When researchers asked about more serious episodes, 15 percent said they had “seriously considered” attempting suicide.

5 percent try to kill themselves
More than 5 percent of students said they had actually attempted suicide, which is the second-leading cause of death for college students, compared to its ranking of ninth among the U.S. population at large, according to the National Alliance on Mental Health.

“Relief from emotional or physical pain” was the top reason students cited for suicidal thinking, followed by problems with romantic relationships. A generalized desire to end their lives was next, followed by problems with school or academics.

The study extrapolated that at an average college with 18,000 undergraduate students, 1,080 of them would seriously contemplate taking their lives in any year, numbers that pose troubling issues for college administrators.

The survey identified growing levels of distress among college students and diminishing resources to handle the consequences. They found that half of students who had had suicidal thoughts never sought counseling or treatment.

“We know only a quarter of suicide patients are our clients, which means 75 percent of them never come through our doors,” said Chris Brownson, director of the Counseling and Mental Health Center at the University of Texas.

Drum and other researchers said colleges needed a new model, shifting the emphasis from narrowly focused treatments involving suicidal students and a small number of mental health professionals, to one that involved the entire campus in addressing student stresses.

“Suicide is a public mental health issue,” Brownson said. “We need to focus on prevention, building resilience in students and creating communities.”

In this Jan. 27, 2008 file photo, Christina Applegate is shown at the 14th Annual Screen Actors Guild Awards in Los Angeles. (AP Photo/Kevork Djansezian, file)

NEW YORK (AP) — Christina Applegate says she has a clean bill of health after undergoing treatment for breast cancer. “I’m clear,” Applegate tells ABC News’ “Good Morning America” in an interview airing Tuesday. “Absolutely 100 percent clear and clean. It did not spread. They got everything out, so I’m definitely not going to die from breast cancer.”

Applegate’s interview with “GMA” was taped Monday.

The actress’ publicist, Ame Van Iden, announced earlier this month that Applegate was being treated for the disease after it was detected through a doctor-ordered MRI.

“I was so mad,” she says in the “GMA” interview when she first heard the news. “I was just shaking and — and then also immediately, I had to go into … `take-care-of-business-mode,’ which was … I asked them, `What do I do now? What — what is it that I do? I get a doctor, I get a surgeon, I get an oncologist? What do I do?’”

Applegate, 36, says she “immediately made those appointments and immediately called around for … someone to start teaching me how to live macrobiotically.” She was referring to following a healthy diet of fish, grains, beans and vegetables, and avoiding processed foods.

The actress, whose mother battled breast cancer, says she began getting mammograms at the age of 30.

Applegate is scheduled to appear on a one-hour TV special, “Stand Up to Cancer,” to be aired on ABC, CBS and NBC on Sept. 5 to raise funds for cancer research.

She has been nominated for an Emmy and a Golden Globe for the ABC show “Samantha Who?”, in which she plays a woman who wakes from a coma with no memory of who she is.

There has been a debate over whether such medications are the best way to treat ADHD, a condition marked by inattention, hyperactivity and impulsive behavior that appears more often in boys than girls. Some experts have worried these drugs could make children more prone to substance abuse later on.

Two teams of researchers who examined the issue in studies published in American Journal of Psychiatry said their findings should offer some reassurance about using these stimulants.

A team led by Salvatore Mannuzza of New York University followed for 17 years a group of 176 young men who had been prescribed Ritalin for ADHD as boys. Those who began taking Ritalin at ages 6 or 7 had essentially the same rate of drug abuse as young adults — 27 percent — as a group of young men who did not have ADHD and did not take Ritalin — 29 percent.

Those with ADHD who started taking Ritalin at a slightly older age — 8 through 12 — did have a higher rate of future drug abuse — 44 percent, the study found.

Mannuzza said it was premature to conclude it was the Ritalin, rather than the mere fact of having a condition like ADHD, that increased their likelihood of later drug abuse.

No increased abuse risks
He said that question could be better answered by comparing children with ADHD treated with the medication starting at ages 8 to 12 with others with ADHD who were not treated with medication at all, to see if those groups had differing rates of drug abuse as adults.

“You can’t conclude that late-treated cases will develop substance abuse even though that’s what our findings seem to suggest,” Mannuzza said.

Another team led by Dr. Joseph Biederman of Massachusetts General Hospital tracked for 10 years another group of boys with ADHD, some of whom were treated with stimulant medications and some not.

Those treated with medications had neither an increased nor decreased risk for subsequent drug or alcohol abuse compared to those not given drugs for their ADHD.

“Considering that ADHD affects 5 to 10 percent of children worldwide, and addictions are worldwide problems as well, I think the fact that these drugs do not have an adverse effect in increasing those risks is very important information for families and doctors taking care of children with ADHD,” Biederman said in a telephone interview.

The U.S. National Institutes of Health, which helped fund the studies, estimates that between 3 and 5 percent of children have ADHD.

As Fike tried to remedy the problem, she realized that the bullies seemed to be the kids in class who couldn’t sit still and listen. They didn’t do their homework. They were almost constantly in motion.

Turns out, those behaviors could have been the first clue to parents and school officials that these boys might be the ones who were going to turn into bullies.

A new study shows that children with attention deficit hyperactivity disorder are almost four times as likely as others to be bullies. And, in an intriguing corollary, the children with ADHD symptoms were almost 10 times as likely as others to have been regular targets of bullies prior to the onset of those symptoms, according to the report in the February issue of the journal Developmental Medicine & Child Neurology.

The study followed 577 children — the entire population of fourth graders from a municipality near Stockholm — for a year. The researchers interviewed parents, teachers and children to determine which kids were likely to have ADHD. Children showing signs of the disorder were then seen by a child neurologist for diagnosis. The researchers also asked the kids about bullying.

The results underscore the importance of observing how kids with ADHD symptoms interact with their peers, says study co-author Dr. Anders Hjern, a professor in pediatric epidemiology at the University of Uppsala in Stockholm. These kids might be making life miserable for their fellow students. Or it might turn out that the attention problems they’re exhibiting could be related to the stress of being bullied.

“You can’t learn if you’re being bullied, if every day you’re frightened of how you’re going to be treated,” says William Pollack, an assistant clinical professor of psychiatry at Harvard Medical School.

As for the bullies, they often need help with other issues, Pollack says. It’s not uncommon, for instance, to find that the aggressor is acting out because he’s depressed. And often, the kids who are doing the bullying have been bullied themselves, he adds.

Alan Kazdin, a specialist in child development, says the new results may help sensitize parents and teachers to the possibility that some kids with ADHD might have issues that go beyond antsy behaviors and attention problems. Estimates of how many kids have ADHD range from 4 percent to 12 percent.

Unfortunately though, treating ADHD won’t remedy the bullying because drugs for the condition impact a child’s ability to focus in school but not the aggression that could lead to bullying, says Kazdin, a professor of psychology and child psychiatry and director of the Parenting Center and Child Conduct Clinic at Yale University, and president of the American Psychological Association.

Battling bullying
Still, the new study could help teachers and parents identify who’s at potential risk of bullying and being bullied.

“This is a huge problem in the schools,” says Dr. Joyce Nolan Harrison, an assistant professor of psychiatry at the Johns Hopkins School of Medicine and director of Preschool Clinical Programs at the Johns Hopkins Bayview Medical Center. Studies show it’s particularly common in grades 6 through 10, when as many as 30 percent of students report they’ve had moderate or frequent involvement in bullying, she says.

The best solution for bullying is for schools to develop programs that help both the bullies and the bullied, experts say.

“Bullies are like the lion looking for a deer that’s left the herd,” says Patrick Tolan, director of the Institute for Juvenile Research at the University of Illinois. “They try to single out the weakest kid. The best way to stop this is to work on increasing inclusion by helping the bullied kids with social skills.”

Another strategy that can work: Help the bullied kids find each other. “If there are a bunch of them together, they can stand the bully down,” Pollack says. “They don’t have to beat the bully up. They just have to say, ‘Why are you treating my friend this way?’ The bully will often move on.”

Parental role
In the end, though, schools might not have the inclination or resources to deal with bullying. In that case, parents need to take matters into their own hands. To do this, you’ll need to enlist the help of all the other parents of bullied children, says Pollack. “Parents have to work as a group,” he explains. “One parent is a pain in the [butt]. A group of parents can be an educational experience for school authorities.”

One thing you shouldn’t do, Pollack says, is call up the bully’s parents. “You have no idea of what is going on in that kid’s home,” he says. “He may get hell for bullying your kid — or he may be told to keep it up.”

Ultimately, you may not be able to stop the bullying. “If schools are not prepared to take action, which is sometimes the unfortunate case, I believe parents should consider changing schools,” Hjern says. 

That’s what Fike chose to do a few years ago. “I moved him to a different school where there’s a lot more parent participation,” she says. “It had gotten so he didn’t want to go to school and would cry in the morning. Now he can’t wait to go.”

Linda Carroll is a health and science writer living in New Jersey. Her work has appeared in The New York Times, Newsday, Health magazine and SmartMoney.

WASHINGTON - Crucial parts of brains of children with attention deficit disorder develop more slowly than other youngsters’ brains, a phenomenon that earlier brain-imaging research missed, a new study says.

Developing more slowly in ADHD youngsters — the lag can be as much as three years — are brain regions that suppress inappropriate actions and thoughts, focus attention, remember things from moment to moment, work for reward and control movement. That was the finding of researchers, led by Dr. Philip Shaw of the National Institute of Mental Health, who reported the most detailed study yet on this problem in Monday’s online edition of Proceedings of the National Academy of Sciences.

“Finding a normal pattern of cortex maturation, albeit delayed, in children with ADHD should be reassuring to families and could help to explain why many youth eventually seem to grow out of the disorder,” Shaw said in a statement.

But not all children do outgrow the disorder, and co-author Dr. Judith Rapoport, also of the NIMH Child Psychiatry Branch, said the researchers are working to determine the differences between those that have a good outcome and those who do not.

Between 3 percent and 5 percent of school-age children are thought to have attention deficit hyperactivity disorder.

Biologically driven
Dr. Louis J. Kraus, chief of child psychiatry at Rush University Medical Center in Chicago, said “what is really important about this study is it shows us there is clearly something biologically driven for children with ADHD.”

Kraus, who was not part of the research team, said that with this finding no one can argue that children are making it up. “We don’t know what the meaning is yet, whether it would change any type of treatment, but it is showing that there is something biologically different.”

It is important that parents don’t immediately jump out and want to get some type of MRI of their child’s brain, or functional study to support a diagnosis,” Kraus added in a telephone interview.

Shaw agreed: “Brain imaging is still not ready for use as a diagnostic tool in ADHD. Although the delay in cortex development was marked, it could only be detected when a very large number of children with the disorder were included. It is not yet possible to detect such delay from the brain scans of just one individual. The diagnosis of ADHD remains clinical, based on taking a history from the child, the family and teachers.”

The research team used scans to measure the cortex thickness at 40,000 points in the brains of 223 children with ADHD and 223 others who were developing in a typical way. The scans were repeated two, three or four times at three-year intervals.

In both groups the sensory processing and motor control areas at the back and top of the brain peaked in thickness earlier in childhood, while the frontal cortex areas responsible for higher-order executive control functions peaked later, during the teen years, they said.

Delayed in the ADHD children was development the higher-order functions and which coordinate those with the motor areas.

The only part of the brain that matured faster in the ADHD children was the motor cortex, a finding that the researchers said might account for the restlessness and fidgety symptoms common among those with the disorder.

Earlier brain imaging studies had not detected the developmental lag, the researchers said, because they focused on the size of the relatively large lobes of the brain.

The sharp differences were discovered only after a new image analysis technique allowed the researchers to pinpoint the thickening and thinning of thousands of cortex sites in hundreds of children and teens, with and without the disorder.

“If you’re just looking at the lobes, you have only four measures instead of 40,000,” explained Shaw. “You don’t pick up the focal, regional changes where this delay is most marked.”

Slowest to mature in ADHD children were parts of the front and side of the brain that integrate information from the sensory areas with the higher-order functions. One area lagged five years in those with the disorder.

Also participating in the study were researchers at the Montreal Neurological Institute, McGill University, Canada. The research was funded by the Intramural Research Program at NIH.