Saturday, October 25, 2008

Roundup of Oddball Medical News

I don't set out to collect this stuff, but because I track gender-related health news for my work, medical weirdness tends to come my way.

One recent headline: "Talc Use in Genital Area Linked to Increased Risk for Ovarian Cancer" (via Medscape, free registration). The latest studies are actually just confirming a whole body of prior research, but it was still news to me.
The latest findings come from an analysis of data from 2 separate study populations. Researchers obtained records for 1231 epithelial ovarian cancer cases and 1244 controls from the New England Case Control (NECC) Study, and on 210 cases and 600 controls from the prospective Nurses' Health Study (NHS). In the questionnaire about talc use, "regular" use was defined as the application of powder to the genital/perineal region at least once a week.

Genital talc use was associated with an increased risk for ovarian cancer in both study populations, although the 95% confidence intervals were wide in the NHS because of the limited sample size, the researchers comment. In the pooled analysis, the relative risk for the association with regular talc use was 1.36 for total ovarian cancer and 1.60 for the serous invasive subtype.

This is broadly similar to the findings from the meta-analysis of 16 previous studies, which reported an approximately 30% increase in the risk for total epithelial ovarian cancer with regular genital exposure to talc (Anticancer Res. 2003;23:1955-1960).

Talc use elsewhere on the body was not associated with an increase in ovarian cancer risk, the researchers point out.

"It is unclear whether talc applied to the perineum can reach the ovaries, although some studies have shown that inert particles can travel through the female genital tract to the fallopian tubes and ovaries, and others have found talc particles in ovarian tissue," the researchers write. They also note that some studies have shown that talc particles can induce an inflammatory response in vivo, whereas others have suggested an immune-mediated mechanism.
Okey dokey. So you can use cornstarch instead, the researchers suggest. Talc is probably harmless elsewhere on the body, but it's still strongly suspected of being a carcinogen.

But for the love of Georgia O'Keeffe, why is anyone powdering themselves down there in the first place? This is not a region that was intended to have a desert climate! If it's meant to have a rainforest ecosystem, why do women feel compelled to muck with it? Thirty-five years after the publication of Our Bodies, Ourselves, why don't women feel comfortable just leaving it alone? (And while I'm on a rant: Why are scented douches still on the market?)

Of course, it's not just women who have a fraught relationship with our genitals. The next oddity comes from a study examining the satisfaction of 1,567 men taking tadalafil (Cialis) over the course of a year. Note what mattered most to them:
Treatment expectations identified as important included: erection hardness and ability to maintain erection through intercourse completion (>92% of patients); confidence, partner satisfaction, and naturalness (>84% of patients); rapid effect and long duration of treatment (>75% of patients).
It's a cliche, but that doesn't make it less true: Men put more stock in being hard than in satisfying a partner. Now, I'm not suggesting the two things are unrelated. For many couples - for many heterosexual women - they correlate pretty darn strongly. What's fascinating, though, is that hardness is so important in its own right.

Now that we've covered men and women, let's not forget about the children. And here the news is just shitty. Via Medscape again:
The U.S. ranks 29th worldwide in infant mortality, tying Slovakia and Poland but lagging behind Cuba, the CDC reports.

The CDC's latest estimates for international rankings are based on 2004 data. But as of 2005, the numbers haven't changed much since 2000.

Nearly seven U.S. babies die out of every 1,000 live births. More than 28,000 American babies die before their first birthday.

In Japan, ranked in third place behind Singapore and Hong Kong, the infant mortality rate is 2.8 per thousand live births -- less than half the U.S. rate.
This isn't just odd; it's inexplicable, and sad, and shameful, and downright pathetic. We know that prematurity is a major driver of infant mortality in the U.S. Women of color, especially African-American women, have prematurity rates far higher than their white counterparts. This in turn is due at least in part to their poorer access to prenatal control.

And I know this has been said before, but it obviously needs to be said again: Before we start conferring legal personhood on zygotes, how 'bout we pour some resources into at least catching up with Cuba on infant mortality? We all ought to be able to agree on that as a goal - apart from those folks who care about constraining women's sexuality more than saving babies.

Update 10/27/08: When I first wrote this post, I had a feeling that all three of these news items had something in common but I couldn't quite put my finger on it. I've now followed up with an attempt to articulate their common denominator - an "anti-life" attitude, by which I mean something different than how a doctrinaire "pro-life" advocate would probably define it.

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