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WASHINGTON (Reuters) - Women who never get mammograms are far more likely to die of breast cancer than women who are regularly screened, U.S. researchers reported on Tuesday.

They said 75 percent of the women they studied who died of breast cancer had never had a mammogram, or were diagnosed after their very first mammogram. Only 25 percent of the women they studied who died of breast cancer had received more than one mammogram.

"The most effective method for women to avoid death from breast cancer is to have regular mammographic screening," Dr. Blake Cady of Cambridge Hospital Breast Center and Harvard Medical School in Massachusetts told reporters in a telephone briefing.

"Women who are in screening programs have only a 4.7 percent mortality. Women who are not screened have a 56 percent mortality," added Cady, who will present his findings later this week to a meeting of the American Society of Clinical Oncology.

"That is the same as the overall mortality we used to see in breast cancer up to 1970, prior to the onset of wide mammography screening."

A mammogram is an X-ray of the breast that can spot tumors before they are large enough to feel, and potentially before they spread.

Cady and colleagues examined 6,997 Massachusetts breast cancer patients, some who got regular mammograms and some who did not, between 1990 and 1999.

The patients were followed through 2007.

After about 12.5 years of follow-up, 461 of the women died of their breast cancer. Nearly 75 percent of these were women who had not had regular mammograms.

Cady said it is not clear why some women did not get mammograms and said it is possible these women got less medical care in general.

"We didn't pretend to understand the reasons for not getting mammograms," he said.

People who are ill, who do not speak English or who are poor could all be among those not getting regular medical care and thus not getting mammograms, which in the United States are recommended for all women over the age of 50.

There has been some debate about the value of mammograms.

Most cancer societies and many governments recommend that women be screened regularly but a few studies have shown that mammograms may detect many false positives -- meaning a woman does not have a tumor but may undergo more testing, involving worry and perhaps a biopsy.

Breast cancer kills more than 400,000 women a year globally.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Eating lots of whole grains could ward off high blood pressure, according to a study in the American Journal of Clinical Nutrition.

In the study, men with the highest whole-grain consumption were 19 percent less likely to develop high blood pressure than men who ate the least amount of whole grains.

While refining grains removes their outer coating, whole grains retain their bran and germ, so they are richer in many nutrients, Dr. Alan J. Flint of the Harvard School of Public Health in Boston and his colleagues note in their report.

The most recent US guidelines recommend that people get at least 3 ounces, or 85 grams, of whole grains daily, and that they consume at least half of their grains as whole grains.

There's evidence, the investigators note, that women who eat more whole grains are less likely to develop high blood pressure, also called hypertension, but there is less information on how whole grains might affect men's heart health.

To investigate, Flint and his team looked at data from the Health Professionals Follow-up Study, which has followed 51,529 men since 1986, when the study participants were 40 to 75 years old. They looked at a subset of 31,684 men free of hypertension, cancer, stroke or heart disease at the study's outset. During 18 years of follow-up, 9,227 of them developed hypertension.

The men in the top fifth of whole grain consumption, who averaged about 52 grams daily, were 19 percent less likely than the men in the bottom fifth, who ate an average of about 3 grams of whole grains daily, to develop hypertension during follow-up.

When the researchers looked at separate components of whole grains, only bran showed an independent relationship with hypertension risk, with men who consumed the most at 15 percent lower risk of hypertension than men who ate the least. However, the researchers note, the amount of bran in the men's diet was relatively small compared to their total intake of whole grain and cereal fiber.

The relationship between whole grain intake and hypertension risk remained even after accounting for men's fruit and vegetable intake, use of vitamins, amount of physical activity, and whether or not they were screened for high cholesterol.

This suggests that the association was independent of these markers of a healthy lifestyle behavior pattern. It's possible, the researchers say, that the men who ate more whole grains gained less weight over time.

The current findings, Flint and colleagues conclude, "have implications for future dietary guidelines and for the prevention of hypertension."

SOURCE: American Journal of Clinical Nutrition, September 2009.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Being overweight, especially around the middle, may increase a woman's risk for developing asthma, study findings hint.

In the study women who were overweight or obese were much more apt to have asthma than women at a healthy weight, public health researcher Julie Von Behren, of Northern California Cancer Center in Berkeley, and colleagues found.

And regardless of a woman's weight, a large waist size -- more than 88 centimeters or 34 inches -- also conferred increased risk for asthma, Von Behren and colleagues report in the medical journal Thorax.

Moreover, "obesity may make asthma symptoms more severe," Von Behren noted in an email correspondence to Reuters Health. Among the 88,304 women in the study, those who were obese "were more likely to report urgent medical visits and hospital admission due to asthma," Von Behren said.

She and colleagues used information from the California Teachers Study to compare current and retired female teachers' self-reported 18-year old height and weight, and their later self-measured waist size. At the second measurement, the women ranged in age from younger than 40 to 70 years and older.

Overall, roughly 13 percent of the women were obese, having a body mass index (BMI) of 30 or more, and another 1.5 percent were extremely obese, having a BMI of 40 or more. BMI is a standard measure used to gauge how fat or thin a person is. A normal BMI is between 18.5 and 24.9.

All levels of obesity, the researchers report, were strongly associated with having asthma.

"Even being modestly overweight was associated with higher asthma prevalence in this population," they note. In addition, a large waist size was associated with modestly increased asthma prevalence among women who were at a normal weight.

"These findings are particularly troubling," Von Behren and colleagues say, given that the majority of American adults are now overweight or obese.

SOURCE: Thorax, October 2009

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters Health) - Two drugs used to prevent malaria in travelers appear to have a lower risk of side effects than a third commonly prescribed medication, according to a research review published Tuesday.

The review looked at eight clinical trials of various anti-malaria drugs -- including mefloquine, atovaquone-proguanil and the antibiotic doxycycline. All three are considered drugs of choice for travelers heading to most malaria-endemic regions.

However, the study found, both atovaquone-proguanil -- sold under the brand-name Malarone -- and doxycycline appear to have fewer side effects.

With these two drugs, there is lower risk of nausea, stomach pain and other gastrointestinal side effects, and also neurological and psychiatric side effects, such as dizziness, sleep disturbances, anxiety and depression.

There were no severe side effects -- problems that were life-threatening or required hospitalization -- in any of the studies.

The investigators did, however, find published case reports linking mefloquine to 22 deaths, including five suicides. No other anti-malaria drugs have been linked to deaths when taken at prescribed doses, the researchers note in their review, published in the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

Despite the higher risk of side effects with mefloquine, the findings do not necessarily mean that travelers should avoid this drug, according to the researchers.

Doctors prescribe anti-malaria medications based on a number of factors -- including which country travelers are visiting -- and mefloquine may still be appropriate, particularly for people who have taken it before without problems.

"The main message is that you have to take some malaria chemoprophylaxis (preventive treatment) if you go to an endemic area," lead researcher Dr. Frederique Jacquerioz, of Tulane University in New Orleans, noted in a written statement. "It's one of the best preventive measures we have."

Caused by a mosquito-borne parasite, malaria is endemic in large areas of Africa, Asia and South and Central America, where it kills about 1 million people a year.

An estimated 10,000 to 30,000 travelers develop malaria every year, of whom about 150 die.

Across the eight studies in the current review, there was no evidence that mefloquine, Malarone and doxycycline differed in their effectiveness.

When it came to side effects, however, Malarone was about half as likely as mefloquine to cause gastrointestinal side effects, and 14 percent to 50 percent less likely to have a neurological or psychiatric side effect.

In one study, 69 of 493 Malarone users developed some type of neuropsychiatric side effect -- including dizziness, insomnia or strange dreams. That compared with 139 of 483 mefloquine users.

Similarly, doxycycline users had a 16 percent lower risk of neurological or psychiatric symptoms.

Still, severe reactions to mefloquine are rare, noted Dr. Andrea Boggild of Toronto General Hospital in Canada, who was not involved in the study. In a written statement, Boggild said that severe neurological and psychiatric symptoms develop in just one out of every 6,000 to 10,000 people who take the drug.

Boggild advised people who are planning a trip to a malaria-endemic area to talk with a healthcare provider who specializes in travel medicine about how to best protect themselves.

SOURCE: Cochrane Library, online October 7, 2009.

Copyright © 2009 Reuters Limited.

NEW YORK (Reuters) - The number of employees calling in sick to work with fake excuses is holding steady at one-third among U.S. workers each year but fewer are getting fired for it, according to research released on Tuesday.

Most employers typically do not question absences, but 15 percent said they fired an employee for missing work without a legitimate excuse this year, said the survey conducted for CareerBuilder.com, an online jobs site.

Last year, more employers, 18 percent, fired employees absent without legitimate excuses, the research showed.

The number of U.S. employers who check up on absent workers declined to 29 percent this year from 31 percent last year and 35 percent the year before, the research showed.

This year, 28 percent of employers said they think more employees are absent with fake excuses due to stress and burnout caused by the recession, the survey said. The researchers did not ask a similar question in earlier surveys.

"Especially in this economy, employers respect the fact that a lot of employees are burned out and probably more likely to understand their excuses, regardless of what they are," said Allison Nawoj, spokeswoman for CareerBuilder.com.

The number of workers calling in sick when they are not at least once a year has held steady at one-third in 2009, 2008 and 2007, the survey said.

Also holding steady has been the two-thirds of employers who say they let workers use sick days as so-called mental health days, the research showed.

Of employers who check on absent employees, most required a doctor's note. Others called the employee at home, had another worker call or drove by the employee's home, it said.

Among the reasons for falsely calling in sick, the most frequently cited was not feeling like going to work, followed by doctor's appointments, a need to relax, catching up on sleep, errands, avoiding a work-related event, housework and spending time with family and friends. Childcare was not listed as an option in the survey.

The online survey was conducted by Harris Interactive on behalf of CareerBuilder.com among 3,163 U.S. hiring managers and human resource professionals and 4,721 U.S. full-time adult workers between August 20 and September 9.

The margin of error among the workers was plus or minus 1.74 percentage points. Among the hiring managers and human resource professionals, the margin of error was plus or minus 1.43 percentage points.

CareerBuilder is owned by Gannett Co, Tribune Company, The McClatchy Co and Microsoft Corp Corp.

Copyright © 2009 Reuters Limited.