A pilot study of an exercise & cognitive behavioral therapy intervention for epithelial ovarian cancer patients

Blogger's Note:
2011; small study; ("Consequently of the 46 participants who were eligible, 13 patients declined and 14 could not be reached for follow-up contact." (n=19)); no stage IV; mean age=52/57; CBT (cognitive behavioural therapy) had high attrition rate;  study (cognitive behaviour) did not describe if ovarian cancer survivours were also connected to online, face-to-face or other supportive/peer groups etc....

Blogger's Opinion - aside from recognizing (finally) that ovarian cancer patients' treatment/s can lead to increased weight gain, something rarely recognized or understood by media/public, the value of this study is limited



open access

Background

Ovarian cancer has the highest mortality rate of all gynaecologic cancers. Faced with poor prognoses, stressful treatment effects and a high likelihood of recurrence, survivors must confront significant physical and psychological morbidities that negatively impact health-related quality of life. Frequently reported side effects include cancer-related fatigue, peripheral neuropathy, and psychological distress. Exercise and cognitive behavioral therapy interventions have counteracted such adverse effects in other cancer populations.

Objective

To investigate the feasibility and benefits of a 24-week home-based exercise intervention, coordinated with 12 weeks of cognitive behavioral therapy (two sessions per month), developed for two types of patients diagnosed with epithelial ovarian cancer: 1) those undergoing primary treatment with adjuvant chemotherapy after primary surgery; 2) those on surveillance after completing treatment within the last 2 years.

The relation between cancer patient treatment decision-making roles and quality of life (Minnesota)

Abstract

BACKGROUND

The objective of this study was to explore relations between patient role preferences during the cancer treatment decision-making process and quality of life (QOL).

METHODS

One-year cancer survivors completed a survey in 2000 as part of a larger survey conducted by the American Cancer Society. The current report was based on survey respondents from Minnesota (response rate, 37.4%). Standardized measures included the Profile of Mood States (scores were converted to have a range, from 0 to 100, with 100 indicating the best mood), the Medical Outcomes Survey 36-item short-form health survey (SF-36) (standardized scores), and the Control Preferences Scale. Patients' actual and preferred role preference distributions and concordance between roles were compared with QOL scores using 2-sample t test methodology.

RESULTS

The actual role of survivors (n = 594) in cancer care was 33% active, 50% collaborative, and 17% passive. Their preferred role was 35% active, 53% collaborative, and 13% passive. Overall, 88% of survivors had concordant preferred and actual roles. Survivors who had concordant roles had higher SF-36 Physical Component Scale (PCS) scores (P < .01), higher vitality (P = .01), less fatigue (P < .01), less confusion (P = .01), less anger (P = .046), and better overall mood (P  = .01). These results were similar among both women and younger individuals (aged <60 years). Survivors who had active actual roles had higher PCS scores (P < .01), less tension (P = .04), and higher vitality (P  = .04) than survivors who were either collaborative or passive. No differences existed in QOL scores according to preferred role.

CONCLUSIONS

Survivors who experienced discordance between their actual role and their preferred role reported substantial QOL deficits in both physical and emotional domains. These results indicate the need to support patient preferences.

The effect of multiple primary rules on population-based cancer survival

abstract

Purpose

Different rules for registering multiple primary (MP) cancers are used by cancer registries throughout the world, making international data comparisons difficult. This study evaluates the effect of Surveillance, Epidemiology, and End Results (SEER) and International Association of Cancer Registries (IACR) MP rules on population-based cancer survival estimates.

open access - The Personal Health Record Paradox: Health Care Professionals

open access: JMIR--The Personal Health Record Paradox: Health Care Professionals&#8217; Perspectives and the Information Ecology of Personal Health Record Systems in Organizational and Clinical Settings | Nazi | Journal of Medical Internet Research

Introduction

Personal health records (PHRs) are designed as tools to engage patients in their health care and to enable them to manage their personal health information [1-6]. Significant investments have been made by organizations to offer PHRs based on the desire to enhance patient-centered care [7-11], and the perceived potential for health care system improvement [12,13]. Historically, most PHR implementation efforts have focused on broad conceptions of consumer empowerment in which advocates emphasize the potential for PHRs to (1) increase consumer access to and control over health information, and (2) enable active patient participation in health care decision making and health management [14,15]. Despite high consumer interest in PHRs [16-21] and growing availability [22-25], a paradox exists in that adoption remains relatively low overall [26-28]. A national consumer survey conducted by the Markle Foundation revealed that only 10% of American adults currently use a PHR [29]. One notable exception to the low rate of PHR adoption is Kaiser Permanente: at the end of 2012, 4 million of its 9 million members had registered to use its patient portal, My Health Manager [30]. Among veterans, 71% utilize the Internet, and approximately one-fifth report using the US Department of Veterans Affairs (VA) PHR, My HealtheVet [31].....

Aeterna Zentaris to Present Update on its LHRH Receptor-Targeted Disorazol Z Cytotoxic Conjugates

Drugs.com MedNews


 QUÉBEC CITY, April 3, 2013 /PRNewswire/ - Aeterna Zentaris Inc. (NASDAQ: AEZS) (TSX: AEZ) (the "Company") today announced that Babette Aicher, PhD, Director of Preclinical Development, will be making a poster presentation on updated proof-of-concept results for Disorazol Z cytotoxic conjugates, such as AEZS-125 and AEZS-138, in human ovarian and endometrial cancer xenograft models, at the upcoming American Association for Cancer Research ("AACR") annual meeting, which will be held April 6-10, 2013, in Washington D.C. The study is funded through a grant from the German Ministry of Education and Research.

 "....According to the literature, LHRH receptors occur in a number of human tumors, specifically in about 80% of ovarian and endometrial cancers. They are also expressed in prostate, urinary bladder and triple-negative breast cancer, while they are rarely found in normal tissues, except for the pituitary gland and reproductive organs. The LHRH receptor displays ideal properties for selective drug targeting.....

video: Class action lawsuit planned for chemotherapy patients

video

diluted chemo >1 year - Law firms prepare class action suit in chemotherapy drug case

media

 "Cancer Care Ontario said the drugs, cyclophosphamide and gemcitabine, were watered down an estimated three to 20 per cent. The diluted chemotherapy was given to patients for at least a year in some of the hospitals."

open access: Radiotherapy-Induced Malignancies: Review of Clinical Features, Pathobiology, and Evolving Approaches for Mitigating Risk

 Blogger's Note: please read the full paper for context

open access

One of the most significant effects of radiation therapy on normal tissues is mutagenesis, which is the basis for radiation-induced malignancies. Radiation-induced malignancies are late complications arising after radiotherapy, increasing in frequency among survivors of both pediatric and adult cancers. Genetic backgrounds harboring germline mutations in tumor suppressor genes are recognized risk factors. Some success has been found with using genome wide association studies to identify germline polymorphisms associated with susceptibility. The insights generated by genetics, epidemiology, and the development of experimental models are defining potential strategies to offer to individuals at risk for radiation-induced malignancies. Concurrent technological efforts are developing novel radiotherapy delivery to reduce irradiation of normal tissues, and thereby, to mitigate the risk of radiation-induced malignancies. The goal of this review is to discuss epidemiologic, modeling, and radiotherapy delivery data, where these lines of research intersect and their potential impact on patient care.

Radiation-Induced Tumors:

Atomic Bomb Survivors

Radiation-Induced Tumors after Radiotherapy for Non-Oncologic Diseases

Second Malignant Neoplasms - Second malignant neoplasms (SMNs) are late complications arising after exposure to genotoxic therapies, which include radiotherapy and some chemotherapeutic agents...see Table 1

Radiotherapy for Leukemia

Thoracic Irradiation

(The risk of breast cancer is influenced by hormone status, as women with histories of ovarian irradiation of 5 Gy or more had reduced risk of breast cancer compared to women who did not (Travis et al., 2003). Consistent with the hormone-dependence, radiation-induced breast cancers were significantly less likely to develop in women who were menopausal before the age of 40 (Travis et al., 2003). )

Head and Neck Irradiation

Genitourinary Irradiation

Hematologic Malignancies as SMNs

 

Modifiers of Radiation-Induced Tumorigenesis:

Genetic Background 

( ...."In general, individuals with tumor predisposition syndromes should be considered at risk for SMNs after radiation.)

Influence of Age

Pathogenesis of Radiation-Induced Tumors

Mathematical Models of Radiation-Induced Tumorigenesis

Microenvironmental Contributions to Radiation-Induced Tumorigenesis

The Bystander Effect

Clinically Based Animal Models of SMNs

Radiotherapy Techniques

Field Size

Consideration of Radiotherapy Treatment Modality

Intensity Modulated Radiation Therapy

Proton Therapy

Clinical Comparison of Modalities

 

Conclusion

Radiotherapy continues to be a critical component of oncologic care. As cancer survival improves, the late effects of radiotherapy can impact long-term patient health. The most significant and life-threatening of late effects is the development of an SMN. A review of the literature demonstrates that radiation-induced tumors develop after relatively long latencies of often several years, but that this risk often persists for decades without a plateau. Defining the conditions that promote this complication will allow us to develop both treatments and cancer preventive strategies for individuals diagnosed with cancer (Figure 1). Low dose radiation is associated with an increased risk of tumor development in a variety of normal tissues, and susceptibility can be strongly influenced by genetic background and likely additional factors. These data should influence how we evaluate technologies and the care of cancer survivors moving forward..........

 Figure 1. Schematic of secondary malignant neoplasm (SMN) development.

Blogger's Note: aside from the excerpt noted under Thoracic, the only reference material to ovarian is:

(open access - 1996) Travis, L. B., Curtis, R. E., Boice, J. D. Jr., Platz, C. E., Hankey, B. F., and Fraumeni, J. F. Jr. (1996). Second malignant neoplasms among long-term survivors of ovarian cancer. Cancer Res. 56, 1564–1570.

 

Amorfix Chief Science Officer to present latest on ovarian cancer therapeutic program (AMF-1c-120)

Press Release - Digital Journal

Sizing up a slow assault on cancer : Nature News & Comment

Nature News

A combined blood based gene expression and plasma protein abundance signature for diagnosis of epithelial ovarian cancer - A study of the OVCAD consortium

open access

Published: 3 April 2013

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

Background

The immune system is a key player in fighting cancer. Thus, we sought to identify a molecular 'immune response signature' indicating the presence of epithelial ovarian cancer (EOC) and to combine this with a serum protein biomarker panel to increase the specificity and sensitivity for earlier detection of EOC.

Methods

Comparing the expression of 32,000 genes in a leukocytes fraction from 44 EOC patients and 19 controls, three uncorrelated shrunken centroid models were selected, comprised of 7, 14, and 6 genes. A second selection step using RT-qPCR data and significance analysis of microarrays yielded 13 genes (AP2A1, B4GALT1, C1orf63, CCR2, CFP, DIS3, NEAT1, NOXA1, OSM, PAPOLG, PRIC285, ZNF419, and BC037918) which were finally used in 343 samples (90 healthy, six cystadenoma, eight low malignant potential tumor, 19 FIGO I/II, and 220 FIGO III/IV EOC patients). Using new 65 controls and 224 EOC patients (thereof 14 FIGO I/II) the abundances of six plasma proteins (MIF, prolactin, CA125, leptin, osteopondin, and IGF2) was determined and used in combination with the expression values from the 13 genes for diagnosis of EOC.

Results

Combined diagnostic models using either each five gene expression and plasma protein abundance values or 13 gene expression and six plasma protein abundance values can discriminate controls from patients with EOC with Receiver Operator Characteristics Area Under the Curve values of 0.998 and bootstrap .632+ validated classification errors of 3.1% and 2.8%, respectively. The sensitivities were 97.8% and 95.6%, respectively, at a set specificity of 99.6%.

Conclusions

The combination of gene expression and plasma protein based blood derived biomarkers in one diagnostic model increases the sensitivity and the specificity significantly. Such a diagnostic test may allow earlier diagnosis of epithelial ovarian cancer.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

(reported as 990 patients yesterday)Watered down chemo drugs given to 1,200 cancer patients - News - MSN CA

Watered down chemo drugs given to 1,200 cancer patients - News - MSN CA

Researchers Warn Against A Potential Backfiring Of Certain Cancer Therapies In Development

medical news

"The anticancerous strategies targeting this protein (TRAP1) could therefore have adverse effects on tumors capable of promoting one metabolic pathway over another according to their needs. While simultaneously inhibiting cell proliferation, this type of treatment could actually stimulate progression into a metastatic state. "

a reference (open access):
 Molecular Cancer 2012
Research

Role of TRAP1 and estrogen receptor alpha in patients with ovarian cancer -A study of the OVCAD consortium

 

CNN: Cancer patients in Canada got weak doses of chemo drugs

Cancer patients in Canada got weak doses of chemo drugs - CNN.com

"Sawka provided more details on the case when she spoke to CNN and CNN affiliate CTV.

She said the problem with the drugs, which are administered intravenously, was first identified by a pharmacy technician.

"We're working with the hospitals and will be working with the supplier to really go over this very, very carefully and try to determine the cause of the error," Sawka told CNN.

She declined to speculate on what the consequences might be for patients, stressing that each person and each treatment is different.

Speaking to CTV, Sawka estimated that the range of underdosing was from 3% to 20% less than what it should have been.

Affected patients and their families are being notified of the error this week.

"We want to learn from it. We want to make sure it never happens again," Sawka told the affiliate.

JAMA EHR Study: Misdiagnosis Poses Significant Potential for Harm | The Health Care Blog

thehealthcareblog

"An important study in the Journal of the American Medical Association finds that misdiagnosis is more common than you might think.  According to the study, almost 40% of patients who unexpectedly returned after an initial primary care visit had been misdiagnosed.  Almost 80% of the misdiagnoses were tied to problems in doctor-patient communication, and more than half of those problems had to do with things that were missed in the patient’s medical history.....

Reproductive, Lifestyle, and Anthropometric Risk Factors for Cancer in Elderly Women

Abstract

Background: With an increasing elderly population, the United States will experience an increased cancer burden in the coming years. We evaluated associations between anthropometric, lifestyle, and reproductive factors and risk of breast, ovarian, and colorectal cancer in a prospective study of postmenopausal women with a focus on diagnoses occurring among very elderly women (≥75 years). 

Methods: For each cancer type, we estimated associations with relevant exposures in 2 age bands (<75 vs. ≥75 years of age). During 22 years of follow-up, 322 ovarian, 1,311 colon, 315 rectal, and 2,664 breast cancers occurred among 37,459 postmenopausal women (mean age at baseline 62 years, range 55–71 years). 

Results: For ovarian cancer, we identified few significant associations in either age band. Colon cancer cases had a higher body mass index and were less likely to report estrogen or aspirin use than non-cases, yet these associations were consistent in both age bands. Few risk factors were identified for rectal cancer in women of 75 years of age or more. For breast cancer, notably different patterns were revealed, with alcohol consumption associated with risk in the younger group and previous hysterectomy associated with risk only in the older group. 

Conclusion: These analyses suggest some important differences in risk factors for cancer depending on the age at diagnosis. 

Impact: This study suggests that etiologic differences may exist in cancers occurring in the very elderly women. The ongoing demographic shift in the United States provides a strong rationale for studies evaluating cancer etiology in the elderly. Cancer Epidemiol Biomarkers Prev; 22(4); 681–7. ©2013 AACR.

Prevalence and Healthcare Actions of Women in a Large Health System with a Family History Meeting the 2005 USPSTF Recommendation for BRCA Genetic Counseling Referral

Abstract

Background: In 2005, the United States Preventive Services Task Force (USPSTF) released guidelines which outlined specific family history patterns associated with an increased risk for BRCA1/2 mutations, and recommended at-risk individuals be referred for genetic counseling and evaluation for BRCA testing. The purpose of this study was to assess the prevalence of individuals with a USPSTF increased-risk family history pattern, the frequency with which specific patterns were met, and resulting healthcare actions among women from the Henry Ford Health System.

Methods: As part of a study evaluating ovarian cancer risk perception and screening, 2,524 randomly selected participants completed a detailed interview (response rate 76%) from an initial eligible cohort of 16,720 women.

Results: Approximately 6% of participants had a family history fulfilling one or more of the USPSTF patterns. Although 90% of these women had shared their family history with their provider, less than 20% had been referred for genetic counseling and only 8% had undergone genetic testing. Caucasian women with higher income and education levels were more likely to receive referrals. Among the 95 participants in the total study cohort who reported BRCA testing, 78% did not have a family history that met one of the USPSTF patterns.

Conclusions: These results suggest a higher prevalence of women with an increased-risk family history than originally predicted by the USPSTF, and lack of provider recognition and referral for genetic services.

Impact: Improvements in healthcare infrastructure and clinician education will be required to realize population level benefits from BRCA genetic counseling and testing. Cancer Epidemiol Biomarkers Prev; 22(4); 728–35. ©2013 AACR.

The speakers’ bureau system: a form of peer selling | Reid | Array

open access

Conclusion

When the content of a physician’s presentation to any audience of physicians or other health care providers does not rest exclusively in the hands of the speaker and she or he understands—whether through an explicit term of a contract or an implied agreement—that the goal of the presentation is to increase uptake of a particular health care product, the physician is violating the CMA’s guideline against peer selling and the prohibition on product endorsement in the CMA’s Code of Ethics.
Although physician participation in promotional activities within the profession appears to be common, at least in some specialties, there is no record of disciplinary action in relation to this practice, even in provinces where regulatory colleges have adopted the CMA’s prohibition on peer selling. Academic medical centres in Canada, unlike those in the United States, may rely on the strong guidance of the CMA Code of Ethics prohibition on product endorsement in crafting institutional policies; however, they are not showing leadership in forbidding faculty participation in speakers’ bureaus. CME offices are in the process of clarifying and harmonizing policies, but they lack regulatory oversight of physicians’ activities outside of accredited CME. The current non-enforcement of the CMA guideline against peer selling in Canada adds new fodder to age-old debates about the merits of self-regulation in medicine. The failure of academic medical institutions and regulatory colleges to enforce the guideline against peer selling and product endorsement bolsters the argument for stronger government oversight of physician–industry interactions.

An intravenous (i.v.) route-compatible formulation of FL118, a survivin, Mcl-1, XIAP, and cIAP2 selective inhibitor, improves open access: FL118 antitumor efficacy and therapeutic index (TI)

pdf

Scientists Test New Formulation of Novel, Low-Toxicity Anticancer Agent - FL118

media

"...FL118 is a targeted therapy that selectively inhibits the expression of four major cancer-survival gene products: survivin, Mcl-1, XIAP and/or cIAP2. While both studies tested the agent’s effectiveness against models of head-and-neck and colon tumors, other research from Dr. Li’s lab suggests that mesothelioma, ovarian and pancreatic cancers, and potentially other solid tumors, may also be good targets for treatment with FL118. ....

"Xiang Ling, MD, PhD, a senior scientist in RPCI’s Department of Pharmacology & Therapeutics, is co-author of the paper, “An intravenous (i.v.) route-compatible formulation of FL118, a survivin, Mcl-1, XIAP, and cIAP2 selective inhibitor, improves FL118 antitumor efficacy and therapeutic index (TI).” The study was e-published today and is available at http://goo.gl/y0oZy."
 

media: 990 Ontario cancer patients received too-low doses of chemotherapy drugs

media

990 Ontario cancer patients received too-low doses of chemotherapy drugs

The Canadian Press Apr 2, 2013 06:47:05 PM

TORONTO, Ont. – Cancer Care Ontario says four hospitals are informing patients that they received lower than intended doses of the chemotherapy drugs cyclophosphamide and gemcitabine.
A total of 990 patients treated or being treated at London Health Sciences Centre, Windsor Regional Hospital, Lakeridge Health and Peterborough Regional Health Centre are affected.
As each case is patient-specific, Cancer Care Ontario says affected patients are being encouraged to discuss the possible effects of the underdosing with their oncologists.
The two medications were purchased by the hospitals from a supplier and Cancer Care Ontario and the hospitals are working with the supplier to find the cause of the error.
All four hospitals immediately removed the medications received from the drug manufacturer when the problem was discovered in late March, and informed the manufacturer of the error.
Each hospital has secured new supplies of the medications for all subsequent treatments, and Cancer Care Ontario says patients’ treatment cycles will not be interrupted.
“It’s important to note that chemotherapy preparation and delivery is a complex process and as a result of this complexity, there are sources for potential error,” Dr. Carol Sawka, Cancer Care Ontario’s vice-president of clinical programs and quality initiatives, said in a statement.
“We have put in many steps to minimize these potential sources of error and we will continue to ensure that patient safety and high quality care are the focus and the strength of the system,” Sawka said.
The underdosing affected 665 patients at London Health Sciences Centre, 290 patients at Windsor Regional Hospital, 34 at Lakeridge Health, and one patient at Peterborough Regional Health Centre.
All four hospitals hope to notify the affected patients or their families this week and have patient lines in place to respond to questions they may have.
Health Minister Deb Matthews noted only about 7.5 per cent of cancer patients being treated at London Health Sciences Centre were affected.
“People have to talk to their oncologist,” Matthews said Tuesday. “I wouldn’t want people to panic about it because every patient will need that conversation with their oncologist to determine if they might need additional chemo treatments or whatever.”

open access: JAMA - Effect of Duloxetine on Pain, Function, and Quality of Life Among Patients With Chemotherapy-Induced Painful Peripheral NeuropathyA Randomized Clinical TrialDuloxetine and Chemotherapy-Induced Pain

open access


Importance  There are no known effective treatments for painful chemotherapy-induced peripheral neuropathy.

Objective  To determine the effect of duloxetine, 60 mg daily, on average pain severity.

Conclusion and Relevance  Among patients with painful chemotherapy-induced peripheral neuropathy, the use of duloxetine compared with placebo for 5 weeks resulted in a greater reduction in pain..........

Stipend applications announced for 2013 Cochrane Colloquium | The Cochrane Collaboration apply by May 16th

 2013 Cochrane Colloquium | The Cochrane Collaboration

Are you interested in attending the 2013 Cochrane Colloquium (19-23 September, Quebec City, Canada) but in need of financial support? A limited number of stipends to help cover registration, travel, accommodation and other expenses associated with attending the 2013 Cochrane Colloquium are available for Cochrane consumers and contributors from developing countries.Consumer and Developing Country stipend applications open 4 April and close 16 May 2013. Please follow the link below for full information on applying.

External link for more information: 

http://colloquium.cochrane.org/colloquium-stipends

Patients' understanding of medical terminology used (breast clinic)

Abstract

"This study evaluated patients' understanding of common terms used by breast surgeons in order to identify words which may need to be defined and explained during a clinic consultation. 95 patients completed the survey. 87% defined 'Surgeon' correctly whereas 'Radiographer' and 'Radiologist' were correctly defined by only 19% and 28% respectively. 26% correctly defined 'Pathologist' and 43% 'Oncologist'. Two-thirds of patients correctly defined 'Benign' (66%) and 'Malignant' (65%). 'Mammogram' and 'Ultrasound' were correctly defined by 39% and 8% respectively. 21% of patients correctly defined 'Multi-Disciplinary Team Meeting'. 1 in 5 patients correctly defined 'Chemotherapy' (20%) and 'Radiotherapy' (19%). This study has identified that many of the medical terms used in a consultation are not understood by patients. Education must be incorporated as a routine part of the consultation to enhance the patient experience and ensure they can actively participate in making informed decisions about their care."

ScienceDirect.com - Fertility and Sterility - Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS)

Abstract

Objective

To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis.

Design

Cross-sectional analysis.

Setting

Multicenter, randomized controlled trial.

Patient(s)

Recently menopausal women (n = 868) screened for the Kronos Early Estrogen Prevention Study (KEEPS).

Intervention(s)

None.

Main Outcome Measure(s)

Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum E₂ levels, and measures of atherosclerosis were assessed. Atherosclerosis was quantified using coronary artery calcium (CAC) Agatston scores (n = 771) and carotid intima-media thickness (CIMT). Logistic regression model of menopausal symptoms and E₂ was used to predict CAC. Linear regression model of menopausal symptoms and E₂ was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, E₂, CAC, and CIMT were assessed.

Result(s)

In early menopausal women screened for KEEPS, neither E₂ nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations and depression approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E₂ predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness, and E₂.

Conclusion(s)

Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine whether baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease.

Clinical Trial Registration Number

NCT00154180.