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Largest, Longest Study on Mammograms Again Finds No Benefit

Largest, Longest Study on Mammograms Again Finds No Benefit

February 26, 2014 | 174,841 views

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By Dr. Mercola

It appears once again, major industry defenders will remain in complete denial and do anything possible to put profits before people.

An annual mammogram is the conventional go-to "prevention" strategy for breast cancer. But researchers increasingly agree that mammography is ineffective at best and harmful at worst.

Unfortunately, breast cancer is big business, and mammography is one of its primary profit centers. This is why the industry is fighting tooth and nail to keep it, even if it means ignoring the truth.

Several studies over the past few years have concluded that mammograms do not save lives, and may actually harm more women than they help, courtesy of false positives, overtreatment, and radiation-induced cancers.

The latest study to reach this conclusion is also one of the longest and largest. As reported by the New York Times:1

"One of the largest and most meticulous studies of mammography ever done, involving 90,000 women and lasting a quarter-century, has added powerful new doubts about the value of the screening test for women of any age.

It found that the death rates from breast cancer and from all causes were the same in women who got mammograms and those who did not.  And the screening had harms: one in five cancers found with mammography and treated was not a threat to the woman's health and did not need treatment such as chemotherapy, surgery or radiation."

Where's the Wisdom in Using a Cancer Screen That Causes Cancer?

Besides the harm caused by overtreatment, the wisdom of radiating your breasts year after year, for decades, is questionable at best, considering the fact that ionizing radiation can cause cancer.

Results published in the British Medical Journal2 (BMJ) in 2012 show that women carrying a specific gene mutation called BRCA1/2 are particularly vulnerable to radiation-induced cancer.

Women carrying this mutation who were exposed to diagnostic radiation before the age of 30 were twice as likely to develop breast cancer, compared to those who did not have the mutated gene.

They also found that the radiation-induced cancer was dose-responsive, meaning the greater the dose, the higher the risk of cancer developing. The authors concluded that:

"The results of this study support the use of non-ionizing radiation imaging techniques (such as magnetic resonance imaging) as the main tool for surveillance in young women with BRCA1/2 mutations."

I've warned against the use of routine mammograms for years, despite vehement attacks from radiologists and individuals hell-bent on attacking me. In the final analysis, it's been worth the legal fees I've had to pay to defend myself against these attacks over the years, as ever-mounting research repeatedly confirms my stance.

At this point, the controversy is pretty much settled—at least if you take the published research into account.  To all of my opponents out there who have attacked me for my opinion regarding mammograms, I know they will remain in denial.  The big lie must continue to be told to avoid the guilt associated with the damage done. The attacks only make us better at defending controversial views.

Biggest Mammography Study to Date Finds No Benefit

The featured study, published in the British Medical Journal (BMJ),3  included a five-year screening period, with a total follow-up period of 25 years. The women, aged 40-59, were randomly assigned to receive either five annual mammography screens, or an annual physical breast examination without mammography.

Over the course of the study, 3,250 of the women who received mammography were diagnosed with breast cancer, compared to 3,133 in the non-mammography group. Of those, 500 women in the mammography group, and 505 in the control group, died from the disease.

However, after 15 years of follow-up, the mammography group had another 106 extra cancer diagnoses, which were attributable to over-diagnosis. As previously explained by Dr. Otis Webb Brawley, chief medical officer of the American Cancer Society, the term "overdiagnosis" in cancer medicine refers to:4

"...a tumor that fulfills all laboratory criteria to be called cancer but, if left alone, would never cause harm. This is a tumor that will not continue to grow, spread and kill. It is a tumor that can be cured with treatment but does not need to be treated and/or cured."

The authors of the featured study concluded that:5

"Annual mammography in women aged 40-59 does not reduce mortality from breast cancer beyond that of physical examination or usual care when adjuvant therapy for breast cancer is freely available. Overall, 22 percent of screen detected invasive breast cancers were over-diagnosed, representing one over-diagnosed breast cancer for every 424 women who received mammography screening in the trial."

More Studies Disputing the Value of Routine Mammograms

The rate of overdiagnosis (22 percent) is virtually identical to that found in a 2012 Norwegian study,6 which found that as many as 25 percent of women are consistently overdiagnosed with breast cancer that, if left alone, would never have caused them any harm. Other studies that support the findings of the featured study include the following:

• In 2007, the Archives of Internal Medicine7 published a meta-analysis of 117 randomized, controlled mammogram trials. Among its findings: rates of false-positive results are high (20-56 percent after 10 mammograms)
• Similar results were found in a 2009 meta-analysis by the Cochrane Database Review,8 which found that breast cancer screening led to a 30 percent rate of overdiagnosis and overtreatment, which actually increased the absolute risk of developing cancer by 0.5 percent.  The review concluded that for every 2,000 women invited for screening throughout a 10-year period, the life of just ONE woman was prolonged, while 10 healthy women were treated unnecessarily.
• Another Norwegian study,9 published in 2010, concluded that the reduction in mortality as a result of mammographic screening was so small as to be nonexistent—a mere 2.4 deaths per 100,000 person-years were spared as a result of the screening.
• Research published in The Lancet Oncology in 2011,10 described the natural history of breast cancers detected in the Swedish mammography screening program between 1986 to 1990, involving 650,000 women. Since breast lesions and tumors are aggressively treated and/or removed before they can be determined with any certainty to be a clear and present threat to health, there has been little to no research on what happens when they are left alone.
• This study however, demonstrated for the first time that women who received the most breast screenings had a higher cumulative incidence of invasive breast cancer over the following six years than the control group who received far less screenings.

False Negatives—Another Hazard of Mammography

Besides false positives that lead to unnecessary treatments, there's also the risk of getting a false negative, meaning that a life-threatening cancer is missed. According to the National Cancer Institute (NCI), mammograms miss up to 20 percent of breast cancers that are present at the time of screening. If a mammogram detects an abnormal spot in your breast, the next step is typically a biopsy. This involves taking a small amount of tissue from your breast, which is then looked at by a pathologist under a microscope to determine if cancer is present.

The problem is that early stage cancer like ductal carcinoma in situ (DCIS) can be very hard to diagnose, and there are no diagnostic standards for it. Furthermore, pathologists doing the readings are not required to have specialized expertise. As Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine in Jacksonville, told the New York Times in 2010:11

"There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin."

It's important to realize that a negative mammogram cannot be equated with a clean bill of health. All a negative mammogram can tell you is that IF you do have cancer, it hasn't grown large enough yet to be detected. This is particularly true for women with dense breast tissue. Forty-nine percent of women have high breast tissue density,12 and mammography's sensitivity for dense breasts is as low as 27 percent13—meaning about 75 percent of dense-breasted women are at risk for a cancer being missed if they rely solely on mammography. Even with digital mammography, the sensitivity is still less than 60 percent.

Women Faced with Increasingly Confusing Choices

The featured study has reignited the debate about whether or not an annual mammogram is a wise choice for most women. Complicating matters further is the fact that, over the past few years, a number of medical groups have created divergent recommendations with regards to if and when you should get a mammogram. 

In November of 2009, the US Preventive Services Task Force, a federal advisory board, revised their cancer screening recommendations,14 saying annual mammograms weren't necessary for women under age 50 and that screenings were recommended only every two years after that. The panel based the new guidelines on data indicating that mammography does more harm than good when used on younger women.

Many cancer groups refused to adopt these guidelines however, and still recommend women over the age of 40 to be screened annually. This includes the American Cancer Society, the National Cancer Institute, and the American College of Radiology.

In 2011, the American Congress of Obstetricians and Gynecologists (ACOG) threw women for yet another loop when it changed its guidelines to include MORE screening compared to its previous recommendations. ACOG had previously recommended annual mammograms starting at age 50. As of 2011, it began urging women to get an annual mammogram starting at the age of 40. As stated by the New York Times:15

"[T]he days of one-size-fits-all screening may be ending. Now patients and their doctors will face much more nuanced choices, based on each woman's risk for breast cancer and her feelings about the prospect of unnecessary treatment. 'The balance between benefits and harms is more and more up in the air,' said Dr. Russell P. Harris, a professor of medicine at the University of North Carolina, Chapel Hill. 'Reasonable people will disagree.'"

3D Tomosynthesis—The Crazy Alternative That Increases Your Risks Even Further

Unfortunately, instead of admitting the flaws and inherent dangers of mammography, the industry unveiled a "new and improved" type of mammogram in 2011 called 3D tomosynthesis, which actually exposes you to even HIGHER doses of radiation than a standard mammogram. What's worse, they also recommend you continue receiving your traditional 2D mammogram when you get tomosynthesis, thereby multiplying your radiation exposure even further. According to surgeon Dr. Susan Love,16 tomosynthesis exposes you to about twice the amount of radiation compared to a standard mammogram.

According to one 2010 study,17 annual screening using standard digital or screen-film mammography on women aged 40–80 years is associated with an induced cancer incidence and fatal breast cancer rate of 20–25 cases per 100, 000. Meaning, annual mammograms CAUSE 20-25 cases of fatal cancer for every 100,000 women getting the test. Further increasing—perhaps doubling—the number of fatal breast cancer caused as a direct result of the screening procedure itself can hardly be called progress.

Cancer Prevention Begins with Your Lifestyle Choices

Mammograms are portrayed as the best form of "prevention" a woman can get. But early diagnosis is not the same as prevention. And cancer screening that does more harm than good can hardly qualify as "your best bet" against becoming a cancer statistic! I believe the vast majority of all cancers could be prevented by strictly applying basic, common-sense healthy lifestyle strategies, such as the ones below.

• Avoid sugar, especially fructose, and processed foods. All forms of sugar are detrimental to health in general and promote cancer. Refined fructose, however, is clearly one of the most harmful and should be avoided as much as possible. This automatically means avoiding processed foods, as most are loaded with fructose (typically in the form of high fructose corn syrup, HFCS).
• Optimize your vitamin D levels. Vitamin D influences virtually every cell in your body and is one of nature's most potent cancer fighters. Vitamin D is actually able to enter cancer cells and trigger apoptosis (cell death). If you have cancer, your vitamin D level should probably be between 70 and 100 ng/ml. Vitamin D works synergistically with every cancer treatment I'm aware of, with no adverse effects. Ideally, your levels should reach this point by exposure to the sun or a safe tanning bed, not oral vitamin D.
• Limit your protein. Newer research has emphasized the importance of the mTOR pathways. When these are active, cancer growth is accelerated. One way to quiet this pathway is by limiting your protein to one gram of protein per kilogram of lean body mass, or roughly a bit less than half a gram of protein per every pound of lean body weight. For most people this ranges between 40 and 70 grams of protein a day, which is typically about 2/3 to half of what they are currently eating.
• Avoid unfermented soy products. Unfermented soy is high in plant estrogens, or phytoestrogens, also known as isoflavones. In some studies, soy appears to work in concert with human estrogen to increase breast cell proliferation, which increases the chances for mutations and cancerous cells.
• Improve your insulin and leptin receptor sensitivity. The best way to do this is by avoiding sugar and grains and restricting carbs to mostly fiber vegetables. Also make sure you are exercising, especially with Peak Fitness.
• Exercise regularly. One of the primary reasons exercise works to lower your cancer risk is because it drives your insulin levels down, and controlling your insulin levels is one of the most powerful ways to reduce your cancer risks. It's also been suggested that apoptosis (programmed cell death) is triggered by exercise, causing cancer cells to die. Studies have also found that the number of tumors decrease along with body fat, which may be an additional factor. This is because exercise helps lower your estrogen levels, which explains why exercise appears to be particularly potent against breast cancer.
• Maintain a healthy body weight. This will come naturally when you begin eating right for your nutritional type and exercising. It's important to lose excess body fat because fat produces estrogen.
• Drink a pint to a quart of organic green vegetable juice daily. Please review my juicing instructions for more detailed information.
• Get plenty of high-quality, animal-based omega-3 fats, such as krill oil. Omega-3 deficiency is a common underlying factor for cancer.
• Curcumin. This is the active ingredient in turmeric and in high concentrations can be very useful adjunct in the treatment of cancer. It actually has the most evidence-based literature18 supporting its use against cancer of any nutrient, including vitamin D. For example, it has demonstrated major therapeutic potential in preventing breast cancer metastasis.19 It's important to know that curcumin is generally not absorbed that well, so I've provided several absorption tips here. Newer preparations have also started to emerge, offering better absorption. For best results, you'll want to use a sustained release preparation.
• Avoid drinking alcohol, or at least limit your alcoholic drinks to one per day.
• Avoid electromagnetic fields as much as possible. Even electric blankets can increase your cancer risk.
• Avoid synthetic hormone replacement therapy, especially if you have risk factors for breast cancer. Breast cancer is an estrogen-related cancer, and according to a study published in the Journal of the National Cancer Institute, breast cancer rates for women dropped in tandem with decreased use of hormone replacement therapy. (There are similar risks for younger women who use oral contraceptives. Birth control pills, which are also comprised of synthetic hormones, have been linked to cervical and breast cancers.)
• If you are experiencing excessive menopausal symptoms, you may want to consider bioidentical hormone replacement therapy instead, which uses hormones that are molecularly identical to the ones your body produces and do not wreak havoc on your system. This is a much safer alternative. 
• Avoid BPA, phthalates, and other xenoestrogens. These are estrogen-like compounds that have been linked to increased breast cancer risk.
• Make sure you're not iodine deficient, as there's compelling evidence linking iodine deficiency with certain forms of cancer. Dr. David Brownstein,20 author of the book Iodine: Why You Need It, Why You Can't Live Without It, is a proponent of iodine for breast cancer. It actually has potent anticancer properties and has been shown to cause cell death in breast and thyroid cancer cells.
• For more information, I recommend reading Dr. Brownstein's book. I have been researching iodine for some time ever since I interviewed Dr. Brownstein as I do believe that the bulk of what he states is spot on. However, I am not at all convinced that his dosage recommendations are correct. I believe they are far too high.
• Avoid charring your meats. Charcoal or flame-broiled meat is linked with increased breast cancer risk. Acrylamide—a carcinogen created when starchy foods are baked, roasted, or fried—has been found to increase cancer risk as well.

This is not an exhaustive list. There are many other strategies that can be useful as well. One excellent resource is Dr. Christine Horner's book, Waking the Warrior Goddess: Dr. Christine Horner's Program to Protect Against and Fight Breast Cancer, which contains research-proven all-natural approaches for protecting against and treating breast cancer.

Experts Tell Radiologists to Stop Lying About Mammograms

Dr. H. Gilbert Welch of the Dartmouth Institute for Health Policy and Clinical Practice on CNN explains why the American College of Radiology two main arguments against the Canadian National Breast Screening Study are wrong as he explains in the video below

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PBS NEWSHOUR

Debating the value and effectiveness of mammograms

Premiere Date: February 12, 2014

Watch Debating the value and effectiveness of mammograms on PBS. See more from PBS NEWSHOUR

Arm Yourself with Information So You Can Take Control of Your Health

Many women are still unaware that the science backing mammograms is sorely lacking. Instead of being told the truth, women are guilt-tripped into thinking that skipping their yearly mammogram is the height of irresponsibility. It can be hard to stand your ground against such tactics. After all, you expect health professionals to know what they're talking about, and to give you the best advice possible.

When it comes to cancer prevention however, many doctors are just as brainwashed as the average person on the street, having succumbed to industry propaganda that downplays or ignores research conflicting with their profit-based agenda. Mounting research shows that more women are being harmed by regular mammograms than are saved by them. In light of such facts, avoiding an annual mammogram is hardly an irresponsible act. Ditto for saying "no thanks" to 3D tomosynthesis, which exposes you to an even greater amount of cancer-causing radiation for virtually no benefit.

Please understand that there are other screening options, each with their own strengths and weaknesses, and you have a right to utilize those options. Also remember that in order to truly avoid breast cancer, you need to focus your attention on actual prevention and not just early detection.

Anam Thubten and others teaching at the Vajrayana Foundation

https://soundcloud.com/vajrayanfoundhttps://soundcloud.com/vajrayanfound

Older Fathers Linked To Higher Risk Of Cognitive, Behavioral Issues In Their Offspring

Older Fathers Linked To Higher Risk Of Cognitive, Behavioral Issues In Their Offspring

February 27, 2014

1

Image Credit: Thinkstock.com

Brett Smith for redOrbit.com – Your Universe Online

A large new study conducted by a team of American and Swedish researchers has found a connection between paternal age and the risk of a child developing cognitive or behavioral problems.

The finding is particularly alarming considering the recent trend of couples putting off raising a family to pursue their careers or other interests.

“We were shocked by the findings,” said study author Brian D’Onofrio, an associate professor of psychology and brain sciences at Indiana University Bloomington.

“The specific associations with paternal age were much, much larger than in previous studies,” D’Onofrio added. “In fact, we found that advancing paternal age was associated with greater risk for several problems, such as ADHD, suicide attempts and substance use problems, whereas traditional research designs suggested advancing paternal age may have diminished the rate at which these problems occur.”

Published in JAMA Psychiatry, the study was based on a massive data set: everyone born in Sweden from 1973 to 2001. The study team found that a child born to a 45-year-old father is 3.5 times more likely to develop autism, 13 times more likely to develop ADHD, twice as likely to develop a psychotic disorder, 25 times more likely to receive a diagnosis for bipolar disorder and 2.5 times more likely to exhibit suicidal behavior or a substance abuse problem when compared to a child with a 24-year-old father.

For most of these issues, the odds of development increased steadily with paternal age, indicating there is no age threshold at which childbearing suddenly becomes riskier.

The study team compared siblings in their research, which considers factors for children living in the same house to be very similar. When they did this, they found that the connections with advancing paternal age were much stronger than for the general population. The team also compared the development of first-cousins to control for sibling relationships and birth order.

The authors also considered parents’ highest level of education and income, because older parents are considered to be more mature and financially secure. However, the findings were extremely consistent, as the connections between mental problems and advancing paternal age continued.

“The findings in this study are more informative than many previous studies,” D’Onofrio said. “First, we had the largest sample size for a study on paternal age. Second, we predicted numerous psychiatric and academic problems that are associated with significant impairment. Finally, we were able to estimate the association between paternal age at childbearing and these problems while comparing differentially exposed siblings, as well as cousins.”

“These approaches allowed us to control for many factors that other studies could not,” he concluded.

The conclusions of the study are particularly troubling as the average age for having a child has been escalating for both men and women over the last four decades. For men the average age is three years older than it was in 1970, according to the study researchers. They noted that the implications of this trend are yet to be understood.

“While the findings do not indicate that every child born to an older father will have these problems,” D’Onofrio said, “they add to a growing body of research indicating that advancing paternal age is associated with increased risk for serious problems. As such, the entire body of research can help to inform individuals in their personal and medical decision-making.”

Source: Brett Smith for redOrbit.com - Your Universe Online

Read more at http://www.redorbit.com/news/health/1113082679/children-older-fathers-increased-mental-health-risks-022714/#Lsw5TSi1ulkuV44T.99

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Mental Illness Risk Higher for Children of Older Fathers, Study Finds

Mental Illness Risk Higher for Children of Older Fathers, Study Finds

By BENEDICT CAREYFEB. 26, 2014

Children born to middle-aged men are more likely than those born to younger fathers to develop any of a range of mental difficulties, including attention deficits, bipolar disorder, autism and schizophrenia, according to the most comprehensive study to date of paternal age and offspring mental health.

In recent years, scientists have debated based on mixed evidence whether a father’s age is linked to his child’s vulnerability to individual disorders like autism and schizophrenia. Some studies have found strong associations, while others have found weak associations or none at all.

The new report, which looked at many mental disorders in Sweden, should inflame the debate, if not settle it, experts said. Men have a biological clock of sorts because of random mutations in sperm over time, the report suggests, and the risks associated with later fatherhood may be higher than previously thought. The findings were published on Wednesday in the journal JAMA Psychiatry.

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RELATED COVERAGE

• 
  
  Motherlode Blog: Older Fathers: Assessing the RisksFEB. 26, 2014
  
  
• Father’s Age Is Linked to Risk of Autism and SchizophreniaAUG. 22, 2012
  
  

“This is the best paper I’ve seen on this topic, and it suggests several lines of inquiry into mental illness,” said Dr. Patrick F. Sullivan, a professor of genetics at the University of North Carolina, who was not involved in the research. “But the last thing people should do is read this and say, ‘Oh no, I had a kid at 43, the kid’s doomed.’ The vast majority of kids born to older dads will be just fine.”

Dr. Kenneth S. Kendler, a professor of psychiatry and human molecular genetics at Virginia Commonwealth University, also urged caution in interpreting the results. “This is great work from a scientific perspective,” he said. “But it needs to be replicated, and biomedical science needs to get in gear and figure out what accounts for” the mixed findings of previous studies.

The strengths of the new report are size and rigor. The research team, led by Brian M. D’Onofrio of Indiana University, analyzed medical and public records of about 2.6 million people born in Sweden from 1973 to 2001. Like many European countries, Sweden has centralized medical care and keeps detailed records, so the scientists knew the father’s age for each birth and were able to track each child’s medical history over time, as well as that of siblings and other relatives. Among other things, the analysis compared the mental health of siblings born to the same father and found a clear pattern of increased risk with increasing paternal age.

Compared with the children of young fathers, aged 20 to 24, those born to men age 45 and older had about twice the risk of developing psychosis, the signature symptom of schizophrenia; more than three times the likelihood of receiving a diagnosis of autism; and about 13 times the chance of having a diagnosis of attention deficit disorder. Children born to older fathers also tended to struggle more with academics and substance abuse.

The researchers controlled for every factor they could think of, including parents’ education and income. Older couples tend to be more stable and have more income — both protective factors that help to temper mental problems — and this was the case in the study. But much of the risk associated with paternal age remained.

“We spent months trying to make the findings go away, looking at the mother’s age, at psychiatric history, doing sub-analyses,” Dr. D’Onofrio said. “They wouldn’t go away.”

Dr. D’Onofrio had seven co-authors, including Paul Lichtenstein of the Karolinska Institute in Stockholm and Dr. Catarina Almqvist of the Karolinska Institute and Astrid Lindgren Children’s Hospital in nearby Solna.

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The researchers say that any increased risk due solely to paternal age is most likely a result of the accumulation of genetic mutations in sperm cells. Unlike women, who age with a limited number of eggs, men have to replenish their supply of sperm cells. Studies suggest that the cells’ repeated reproductions lead to the accumulation of random errors over time, called de novo mutations. Most such mutations are harmless, geneticists say, but some have been linked to mental disorders.

Continue reading the main story

RECENT COMMENTS

Krish 58 minutes ago

I couldn't tell from this article at what age this problem develops or they are diagnosed for the late born children.I would be very...

JK 58 minutes ago

Why is there - reading some reader comment - such joy "Ha! Those men are subject to aging too. not only us, sisters?"

wedge1 58 minutes ago

I am 57.Sarah 35.She is due in April.The midwife who has delivered 300 Amish babies says things are perfect. I believe her.Andy my 19 year...

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“It’s a plausible hypothesis at this point,” Dr. Sullivan said.

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COMMENTS

Experts say the numbers in the study look more alarming than they probably are. For example, Dr. Sullivan said, the overall prevalence of autism is 0.5 percent to 1 percent of the population, depending on the estimate and the location. But for the children of healthy parents in their 20s, the rate is perhaps one in 300, or even lower. A threefold increase would put the odds at about one in 100, still very low. The same goes for the risk of psychosis. The baseline rate is tiny for the children of young, healthy parents, and remains quite low even when doubled.

The researchers found much larger increases in risk for attention deficits (13-fold) and bipolar disorder (25-fold) associated with late fatherhood. “I don’t know what to do with those numbers,” Dr. Sullivan said, noting that two recent genetic studies found that the contribution of de novo mutations to the risk of mental disorders was “probably pretty low” compared with other factors.

“The question we now need to ask,” Dr. Kendler said, “is what else is going on with respect to older and younger siblings that could cause these differences.”

A version of this article appears in print on February 27, 2014, on page A6 of the New York edition with the headline: Mental Health Risks Seen for Children of Older Fathers . Order Reprints|Today's Paper|Subscribe

Which isolated sperm abnormality is most related to sperm DNA damage in men presenting for infertility evaluation.

J Assist Reprod Genet. 2014 Feb 25. [Epub ahead of print]

Which isolated sperm abnormality is most related to sperm DNA damage in men presenting for infertility evaluation.

Belloc S1, Benkhalifa M, Cohen-Bacrie M, Dalleac A, Chahine H, Amar E, Zini A.

Author information

Abstract

BACKGROUND:

Sperm DNA damage is common in infertile men and is associated with poor semen parameters but the impact of an isolated sperm abnormality on sperm DNA damage has not been studied.

OBJECTIVE:

To evaluate sperm DNA damage in a large cohort of infertile men with isolated sperm defects.

DESIGN, SETTING AND PARTICIPANTS:

Retrospective study of 1084 consecutive, non-azoospermic infertile men with an isolated sperm defect: isolated oligozoospermia (iOligo), isolated asthenozoospermia (iAstheno) or isolated teratozoospermia (iTerato).

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:

We examined and compared clinical parameters, conventional semen parameters and %sperm DNA fragmentation (%SDF, assessed by flow cytometry-based Terminal deoxynucleotidyl transferase-mediated dUTP Nick End-Labeling assay) in the three groups of men.

RESULTS AND LIMITATIONS:

The mean (±SD) %SDF was significantly higher in the iAstheno compared to the iOligo and iTerato groups (25.0 ± 14.0 vs. 19.2 ± 11.6 and 20.7 ± 12.1 %, respectively, P < 0.0001). Similarly, the proportion of men with high %SDF (>30 %) was significantly higher in the iAstheno compared to the iOligo and iTerato groups (31 % vs. 18 % and 19 %, respectively, P < 0.0001). In the group of 713 men with iAstheno, %SDF was positively correlated with paternal age (r = 0.20, P < 0.0001) and inversely correlated with %progressive motility (r = -0.18, P < 0.0001). In the subset of 218 men with iTerato, %SDF was also positively correlated with paternal age (r = 0.15, P = 0.018) and inversely correlated with %progressive motility (r = -0.26, P = 0.0001).

CONCLUSIONS:

In this large cohort of infertile men with isolated sperm abnormalities, we have found that the sperm DNA fragmentation level is highest in the men with sperm motility defects and that 31 % of these men have high levels of sperm DNA fragmentation. The data indicate that poor motility is the sperm parameter abnormality most closely related to sperm DNA damage.

PMID: 24566945 [PubMed - as supplied by publisher]

Parental age and the risk of bipolar disorders.

Bipolar Disord. 2014 Feb 6. doi: 10.1111/bdi.12182. [Epub ahead of print]

Parental age and the risk of bipolar disorders.

Chudal R, Gissler M, Sucksdorff D, Lehti V, Suominen A, Hinkka-Yli-Salomäki S, Brown AS, Sourander A.

Author information

Abstract

OBJECTIVES:

Studies on the association between parental age and bipolar disorder (BPD) are scarce and with inconsistent findings. The aim of this study was to examine the association of parental age and age difference between parents with risk of BPD in offspring.

METHODS:

This nested case-control study identified 1,861 cases of individuals with BPD born in Finland during 1983-1998 and diagnosed by the end of 2008, and 3,643 sex- and date of birth-matched controls from nationwide population-based registers. Conditional logistic regression was used to examine the association adjusting for potential confounding due to age of the other parent, parental psychiatric history, educational level, and place of birth.

RESULTS:

A U-shaped association of unadjusted odds ratios (ORs) for BPD risk was seen in different paternal age categories, with the odds increasing at both ends of the age spectrum. In the adjusted analyses, offspring of fathers aged ≥50 years had a 2.8-fold increased odds [OR = 2.84, 95% confidence interval (CI): 1.32-6.12] of BPD as compared to those with fathers aged 30-34 years. The odds were increased 1.3-fold (OR = 1.35, CI: 1.06-1.72) in fathers aged 20-24 years. No significant association was found between maternal age and BPD in the adjusted analyses. Age difference between parents was not associated with BPD.

CONCLUSIONS:

The increased risk of BPD in offspring of the youngest and oldest fathers in the study suggests the involvement of different biological and psychosocial factors at the two ends of the paternal age spectrum. These findings may be significant in the context of advancing parental age in recent times.

© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KEYWORDS:

U-shaped, bipolar disorder, epidemiology, parental age