When big business mixes with medicine and/or public policy, the results can be good?or disastrous. In two recent cases, having to do with breast cancer in women and AIDS in men, it has been both.

In 2003, breast cancer incidence in the United States dropped sharply, and researchers now think that this decline may largely be due to the fact that millions of older women stopped using hormone replacement therapy (HRT) in 2002. Another study has been stopped early due to preliminary results indicating that medical circumcision of men reduces their risk of acquiring HIV during heterosexual intercourse by 53%.

Investigators report that there was an overall 7% relative decline in breast cancer between 2002 and 2003, and that the steepest decline (12%) occurred in women between the ages of 50 and 69 who would normally have been diagnosed with what?s called estrogen receptor positive (ER-positive) breast cancer. This is the kind of breast cancer that is dependent on hormones for tumor growth.

The researchers conclude that as many as 14,000 fewer women were diagnosed with breast cancer in 2003 than in 2002, a year in which the American Cancer Society estimates 203,500 new cases of breast cancer were diagnosed. Researcher Peter Ravdin says, “It is the largest single drop in breast cancer incidence within a single year I am aware of. Something went right in 2003, and it seems that it was the decrease in the use of hormone therapy, but from the data we used we can only indirectly infer that is the case.” Many women remember how their doctors, under pressure from drug companies, pushed HRT as a kind of “fountain of youth.” These companies stood to make a lot of money by creating a whole new category of drugs.

A randomized controlled trial conducted in Kenya has demonstrated that male circumcision is an effective measure for reducing HIV incidence in young men. The National Institutes of Health actually decided to stop the study before its completion because the evidence was overwhelming that circumcision saves men’s lives. Researcher Stephen Moses says, “Evidence has been accumulating that male circumcision may play an important role in explaining the substantial variations in the HIV epidemic in different parts of Africa, but now we have conclusive data demonstrating that male circumcision reduces the risk of HIV acquisition in men?Despite all efforts, rates of HIV remain high in many African countries. Although circumcision alone does not prevent someone from becoming infected with HIV, it clearly lowers the risk of becoming infected, and the results of this trial show that male circumcision can be considered an important HIV prevention strategy.”

Art credit: freeimages.co.uk

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