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Childhood TB Shot May Offer Long-Term Protection from Lung Cancer

TUESDAY, Oct. 1, 2019 — A tuberculosis vaccine commonly used in other parts of the world might reduce a person’s risk of developing lung cancer if given early in childhood, a six-decade-long study reports.

The Bacille Calmette-Guerin (BCG) vaccine is the only vaccine approved for preventing tuberculosis (TB) — a potentially fatal infectious disease that typically attacks the lungs. Because TB risk is low in the United States, the vaccine isn’t often given to American children, according to the U.S. Centers for Disease Control and Prevention.

But the new study suggests the vaccine may have some positive side effects.

“BCG-vaccinated participants had a significant 2.5-fold lower rate of lung cancer,” said study senior author Dr. Naomi Aronson, director of infectious diseases at Uniformed Services University in Bethesda, Md.

She said lower lung cancer rates persisted in those who received the vaccine no matter where they lived, and whether they smoked, drank alcohol or had tuberculosis.

Aronson said BCG affects the immune system somehow and may provide even more benefit in the lungs.

The initial study was conducted in 3,000 American Indian and Alaska Native children in the 1930s. If the findings are confirmed in different groups, Aronson said the use of BCG vaccine in childhood “might be considered for risk reduction for lung cancer over a lifetime.”

Dr. Len Lichtenfeld, interim chief medical officer of the American Cancer Society, reviewed the study and called the findings fascinating. “And you rarely see this duration of follow-up,” he added. “The authors went to great lengths to validate their information.”

But, he said, it’s unlikely that BCG will be used for lung cancer prevention. While the study found a statistically significant reduction in the rate of lung cancer, the actual number of cases was very low. Just 42 people in the study were diagnosed with lung cancer.

There’s also a serious, ongoing shortage of BCG vaccine that would limit any such efforts, Lichtenfeld said. The vaccine is an effective treatment for a certain type of bladder cancer, and doctors find it hard to get enough for that purpose.

In addition, the BCG vaccine has been tested as a treatment in a number of other cancers with mixed results. In some cases, it looked as if lesions had shrunk, but the vaccine didn’t prolong survival, he explained.

Plus, Lichtenfeld said, there’s a very effective way to prevent many cases of lung cancer — don’t smoke. And, if you do, quit. “Tobacco causes most, but not all lung cancers. Not smoking helps prevent many cancers,” he said.

The initial study was conducted between 1935 and 1938. About 3,000 children from nine American Indian and Alaska Native tribes at multiple U.S. sites were randomly given the BCG vaccine or a placebo.

None of the youngsters had had tuberculosis. They were vaccinated between 5 and 11 years of age, with a median age of 8 years. Half were younger when they got the shot, half were older.

From 1992 to 1998, researchers reviewed health information from the trial participants.

There was no statistically significant differences in overall cancer rates between the vaccine and placebo groups. But the odds of lung cancer were significantly lower, the study found.

Researchers noted that lung cancer is a leading cause of death for Alaska Natives and Native Americans.

The study was published Sept. 25 in the journal JAMA Open.

More information

Read more about ways to prevent lung cancer from the American Cancer Society.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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Childhood Cancer Steals 11 Million Years of Life: Study

By Robert Preidt
HealthDay Reporter

TUESDAY, July 30, 2019 (HealthDay News) — Researchers are closing in on the toll of childhood cancer, finding it stole 11.5 million years of healthy life lost worldwide in 2017.

Premature death took 97% of that toll, and impaired quality of life about 3%, the study found.

“Estimating the years of healthy life children have lost due to cancer allows policy makers to compare the lifelong implications of childhood cancer with other diseases, potentially helping them determine the most effective way to spend limited resources and identify high-impact cancer-control planning decisions,” said study leader Lisa Force.

Children in the poorest countries accounted for 82% of years of healthy life lost (9.5 million years) worldwide due to cancer in 2017, according to the study. The findings were published July 29 in The Lancet Oncology.

How common is childhood cancer?

The number of new cancer cases in children and teens up to age 19 was about 416,500 worldwide in 2017, the report said.

Children with cancer in high-income countries tend to have good survival, with around 80% surviving five years after diagnosis. But survival is 35% to 40% in most low- and middle-income countries, with some estimates suggesting it could be as low as 20%, the study authors noted.

Also, about 90% of children at risk of developing cancer live in low- and middle-income countries.

The study examined the years of healthy life that children and teens with cancer lose due to illness, disability and premature death, a measurement called disability-adjusted life years (DALYs). One DALY equals one year of healthy life lost.

However, the study was limited to the first 10 years after cancer diagnosis so it likely underestimates the tally, according to the researchers.

“By assessing the global burden of childhood cancer through the lens of disability-adjusted life years, we can more comprehensively understand the devastating impact of cancer on children globally,” said Force, of St. Jude Children’s Research Hospital in Memphis, Tenn.

“Our findings are an important first step in establishing that childhood cancer has a role in frameworks that address global oncology and global child health,” Force added in a journal news release.

But future progress will require much work, she explained.

“Improving childhood cancer survival will require considerable planning by policy makers to ensure well-functioning health systems capable of early diagnosis and treatment,” Force said.

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SOURCE:The Lancet Oncology, news release, July 29, 2019

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More Active Lupus Linked to Childhood Events

By Robert Preidt

HealthDay Reporter

FRIDAY, May 10, 2019 (HealthDay News) — Lupus patients who had difficult childhoods have higher disease activity, worse depression and poorer overall health than those with better childhoods, a new study finds.

Bad childhood experiences included abuse, neglect and household challenges.

The study included 269 lupus patients in California. Of those, about 63% reported at least one type of bad childhood experience, and about 19% reported at least four. Rates in the lupus patients were similar to those in the general population.

Bad childhood experiences were more common among lupus patients who were older, female, Hispanic or black, did not have a college degree, and had kidney inflammation from lupus (lupus nephritis).

The greater the number of bad childhood experiences, the worse a patient’s self-reported lupus activity, depression and overall health.

For example, those with more than four bad childhood experiences reported nearly double the disease activity scores of those with no adverse childhood experiences.

These findings were not significantly associated with doctor-assessed lupus activity, damage or severity, according to the University of California, San Francisco study.

“Our results support the notion that stress in the form of [negative childhood experiences] may be a factor in poor health in systemic lupus, both in disease development and in more severe outcomes,” said lead author Dr. Kimberly DeQuattro, a clinical fellow in rheumatology.

She called for more effort to prevent abuse and neglect in childhood, “as well as clinical and mental health interventions that foster resilience in adulthood,” DeQuattro said in a university news release.

Lupus is an autoimmune disease in which the immune system attacks the body’s tissues, causing widespread inflammation and damage in affected organs.

Genetics and the environment play a role in lupus, and stress is a potential trigger of disease onset and flares, and can lead to chronic disability.

“This work in lupus patients supports more broadly the body of studies on adversity and trauma in childhood” that have found a link between negative experiences and health, DeQuattro said, although the study only found an association between the two.

“Our next steps are to look at other types of stress and trauma, how the body responds, and how they relate to lupus outcomes,” she noted.

The study was published online May 9 in the journal Arthritis Care & Research.

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SOURCE: University of California, San Francisco, news release, May 9, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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Better Food Assistance Programs Might Lower Childhood Obesity Rates

THURSDAY, April 25, 2019 — Changes made to improve nutrition in a U.S. government food assistance program seem to have triggered a drop in obesity rates among young, poor children, a new study finds.

In 2009, food packages from the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) were made more healthy by adding fruits, vegetables and whole grains, and by reducing the amount of juice, milk and cheese.

The program also reduced fat levels allowed in milk and started to determine infant formula amounts based on infants’ age and needs.

“Our study shows that improving nutrition quality made a measurable impact in lowering obesity risk for children receiving the new food package, compared to those receiving the old,” said study author Pia Chaparro. She’s an assistant professor of nutrition at Tulane University’s School of Public Health and Tropical Medicine in New Orleans.

“Our results suggest that changes in children’s diet early in life could have a positive effect on their growth and reduce obesity risk, which could be informative for policymakers considering further improvements to the WIC program,” Chaparro added in a Tulane news release.

In the study, Chaparro and colleagues analyzed data from more than 180,000 children served by the WIC program in Los Angeles County and found that the nutrition improvements reduced obesity risk among 4-year-olds.

Children are eligible to remain in the program until age 5.

Specifically, the risk of obesity among children who received the new food package from birth to age 4 was 12% lower for boys and 10% lower for girls, compared with children who received the old food package from birth until age 4.

The biggest differences between the two groups began to appear at 6 months of age, suggesting that a more nutritious diet was associated with healthier growth early in life, according to the researchers.

“The beneficial effect of being exposed to the new food package, compared to the old one, was much stronger during the 6-months-to-1-year age interval, and this difference between the two groups during this age interval was large enough to set children in the new food package group on a healthier growth trajectory through age 4,” said Chaparro.

Among children who started receiving the new package at age 2, there was an 11% lower risk of obesity at age 4 among boys, but no reduced risk among girls. The reasons for this difference are unclear.

The study was published April 23 in the American Journal of Clinical Nutrition.

More information

The American Academy of Pediatrics has more on childhood obesity.

© 2019 HealthDay. All rights reserved.

Posted: April 2019

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AHA: Traumatic Childhood Could Increase Heart Disease Risk in Adulthood