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Antibiotic Prescribing Should Be Standardized Across Europe To Help Tackle Resistance

Antibiotic prescribing for respiratory illnesses should be standardised across Europe to help reduce inappropriate prescribing and resistance, say experts in a study published on bmj.com.
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Blacks More Likely To Die Of Ovarian, Breast Cancer When Receiving Same Treatment As Whites

Blacks receiving treatment equal to whites are more likely to die of breast, prostate and ovarian cancers but not many other types of cancer, according to a study published online Wednesday in the Journal of the National Cancer Institute, the Washington Post reports. Previous research has found that lower survival rates for many diseases, including cancer, among low-income populations and minorities often can be attributed to inferior care. These groups are less likely to have insurance and receive routine preventive care, and they are more likely to be diagnosed later and receive less aggressive treatment, research has shown. The new study is the first "that offers provocative evidence" to suggest that biological factors play a role in at least some racial disparities, according to the Post.For the study, Kathy Albain of Loyola University and colleagues examined data collected on nearly 20,000 patients between 1974 and 2001 by the Southwest Oncology Group, a national cooperative of NCI-funded clinical trials. Because all participants received the same care, if socioeconomic factors were affecting survival rates, then differences in those rates would remain constant across all forms of cancer, the researchers reasoned. An analysis of the data found no statistically significant association between race and survival for lung cancer, colon cancer, leukemia, lymphoma or myeloma. However, blacks were 49% more likely than whites to die from early stage postmenopausal breast cancer, 41% more likely to die from early stage premenopausal breast cancer, 61% more likely to die from advanced ovarian cancer and 21% more likely to die from advanced prostate cancer.Albain said, "When there"s a level playing field with the same quality of care, African-Americans survive just as well as other races from some of our most common cancers, which is reassuring news and points us nationally toward a need to make sure there is quality of care and equal access to all." She added that "for prostate, ovarian and breast (cancer), it"s not access to care. There"s something else. And we need to sort that out." Although some of the difference in breast cancer survival rates could be explained by a higher likelihood of black women developing a more aggressive form of the disease, Albain said that this factor could not account for the entire difference in survival rates. Albain also said that because all the cancers with persisting disparities were gender-specific, the gap in survival rates "is almost certainly related to a mix of factors across races pertaining to tumor biology and inherited factors," such as genes that control metabolism of drugs and hormones.However, American Cancer Society Chief Medical Director Otis Brawley said that access to adequate care remains the dominant problem and that socioeconomic factors that occur earlier in life may explain the findings. He said, "These differences are not due to inherent genetics. They are due to the effects of environmental factors like diet and exercise and obesity on biology" (Stein, Washington Post, 7/8).