Cancer

A quarter of the women in the study who were offered the free screening test decided not to get it because they feel claustrophobic in the tunnel-like scanners. But many also said they declined because of costs involved if the test reveals something that needs to be followed up.

Some said they simply could not spare the time.

"Very early on we were surprised to notice that very few women would accept that invitation, even though it would be no cost to them," said Dr. Wendie Berg, a breast imaging specialist at American Radiology Services in Lutherville, Maryland, and Johns Hopkins University, whose study appears in the journal Radiology.

Her team studied the reasons why high-risk women who are recommended for the more sensitive MRI breast screening test do not get it.

Magnetic resonance imaging, or MRI, can help identify early breast cancer in high-risk women who tend to develop cancer earlier than women at average risk.

For the study, they identified 1,215 women who were at intermediate or high risk for breast cancer and were taking part in larger clinical trial.

All of the women were at increased risk for breast cancer, but even in a group of high risk women, who have a 25 percent greater lifetime risk of breast cancer because of they have known or suspected genetic mutations in the BRCA1 or BRCA2 genes, the willingness to undergo a breast MRI was limited.

"About 20 percent of our patients fall into that category," Berg said. "We would have expected virtually 100 percent participation in the study."

Berg said the chief reason women gave for not wanting a breast MRI was because they feel claustrophobic in the tunnel-like machines.

"That has been a common issue in MRI of the breast and other areas as well. It is usually something that can be overcome with sedation but it is still an issue," she said.

Of the 512 women who declined, 25.4 percent refused because of claustrophobia, 18.2 percent cited time constraints, 12 percent cited financial concerns if the tests identifies any cancers or has false-positive results, 9.2 percent said their doctor would not refer them and 7.8 percent said it was because they were not interested.

Women who are at high risk for breast cancer currently are recommended to get a yearly mammogram and an MRI test.

Berg said the study points to the need for alternative ways of screening high-risk women, including training more experts in breast ultrasound, a quicker, more convenient test.

In a large study of some 25,000 British adults, researchers failed to find any "significant" differences in cancer risk related to dietary intake of these compounds.

Phytoestrogens are found in a wide range of foods including dairy products, soy foods, cereals, fruits, vegetables, nuts, seeds, coffee and tea. Previous studies have suggested dietary phytoestrogen intake is associated with increased breast cancer risk and reduced colorectal cancer risk in women. The results from earlier studies were hampered, however, by limited data about phytoestrogen content in food.

No previous research has examined the association between phytoestrogen intake and prostate cancer risk.

In the current study, reported in the American Journal of Clinical Nutrition, researchers assigned phytoestrogen values to nearly 11,000 foods following chemical analyses. For the first time, phytoestrogen values were assigned to animal products.

Unlike plants, which themselves contain phytoestrogens, phytoestrogens are generated by the digestion of animal products like meat and dairy products by microbes in the gut, the researchers explain.

Phytoestrogen consumption was estimated for cancer-free adult participants in the European Prospective Investigation into Cancer and Nutrition - Norfolk (EPIC-Norfolk). EPIC-Norfolk participants, recruited between 1993 and 1997, filled out a diet diary for a week and provided information about age, height, weight, smoking, aspirin use, menopausal status, and family history of cancer among other things.

Cancers that developed within 12 months of study recruitment were identified from a cancer registry totaling 244 breast cancers, 221 colorectal cancers, and 204 prostate cancers. The diets and other relevant information from those who developed cancer were compared to information from other participants (controls) who did not develop cancer.

While acknowledging more study is needed, the authors concluded that there is "little evidence" that phytoestrogen intake is "associated with subsequent risk of breast or prostate cancer."

However, phytoestrogens found in eggs and dairy products "may influence the risk of prostate cancer and colon cancer in women," they report.

The associations are weak and without further study do not warrant changes in diet, lead investigator Heather Ward, of the MRC Center for Nutrition and Cancer in the Department of Public Health and Primary Care at Strangeways Research Laboratory in Cambridge, England, told Reuters Health.

"The results of the present study do not suggest that anyone should alter their phytoestrogen intake, in part because the majority of the associations between phytoestrogen intake and cancer risk were not significant," the doctoral candidate wrote in an email.

"It is worth noting that phytoestrogen intake within an Asian-style diet is more than ten-fold greater than in Western diets, without evidence of an increase in cancer risk," she added.

Because phytoestrogen consumption is on the rise in Britain, the authors urge further monitoring because "the relation between phytoestrogen and cancer may change over time."

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