Observatory and Fast Facts

In a study of pregnant women in the United States, Cedars-Sinai investigators found that a specific imbalance of two placental proteins could predict which women were at risk of developing a severe form of preeclampsia, a life-threatening blood pressure disorder.

The study is published in the journal NEJM Evidence.

The blinded, prospective study of women initially hospitalized for preterm hypertension involved 1,014 patients from 18 hospitals across the nation.

Investigators found that a specific protein imbalance revealed in blood tests of the hospitalized pregnant women provided a way to quantify their risk of developing severe preeclampsia. It involves levels of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PIGF) in the bloodstream.

NIH’s Climate and Health Initiative tackles global health effects associated with a changing climate

Leaders from the National Institutes of Health discuss the agency’s plan to address the risk to human health posed by a changing climate in a commentary published in The Lancet. As floods, hurricanes, tornados, wildfires, and heat waves become more extreme, the risk to human health grows, exacerbating existing health threats and creating new public health challenges around the world.

The authors, a coalition of leaders at NIH, outline how the NIH Climate Change and Health Initiative is uniquely poised to lead and engage with communities and agencies globally to address the health effects associated with climate change.

Effect of ivermectin vs placebo on time to sustained recovery in outpatients with mild to moderate COVID-19

A new study showed that among outpatients with mild to moderate COVID-19, treatment with ivermectin, compared with placebo, did not significantly improve time to recovery in this trial that enrolled more than 1,500 participants in the United States.  

A lack of treatment effect was also seen for secondary clinical outcomes including hospitalization, death, or acute care visits. These findings do not support the use of ivermectin in patients with mild to moderate COVID-19. 

The study was published in JAMA. 

Cancer deaths continue downward trend; modest improvements in survival for pancreatic cancer

Overall cancer death rates continued to decline among men, women, children, and adolescents and young adults in every major racial and ethnic group in the United States from 2015 to 2019, according to the latest Annual Report to the Nation on the Status of Cancer.  

From 2014 to 2018, overall cancer incidence, or new cases of cancer, remained stable for men and children but increased for women and adolescents and young adults. This year’s report, published October 27, 2022, in Cancer, also highlights longer-term trends in pancreatic cancer, as well as racial and ethnic disparities in incidence and death rates for many individual cancer sites. 

All of the findings in this report are based on data from before the COVID-19 pandemic. 

The report shows that from 2015 to 2019, overall cancer death rates decreased by 2.1% per year in men and women combined. Among men, death rates decreased by 2.3% per year; among women, death rates decreased by 1.9% per year. The annual declines in death rate accelerated from 2001 to 2019 in both men and women. 

The declines in death rates were steepest in lung cancer and melanoma (by 4% to 5% per year) among both men and women. Death rates increased for cancers of the pancreas, brain, and bones and joints among men, and for cancers of the pancreas and uterus among women. 

The report showed that cancer incidence rates were relatively stable in men and women combined from 2014 to 2018. Among men, incidence rates remained stable during this period, but among women incidence rates rose by 0.2% per year. 

Over the same time period, incidence rates increased for three of the 18 most common cancers among men: pancreas, kidney, and testis. Incidence rates in men remained stable for seven of the most common cancers and decreased for the remaining eight cancers. For women, incidence rates increased for seven of the 18 most common cancers: liver, melanoma, kidney, myeloma, pancreas, breast, and oral cavity and pharynx. Incidence rates among women remained stable for four of the most common cancers and decreased for the other seven cancers. 

In men, the greatest incidence rate increase was seen in pancreatic cancer, which increased by 1.1% per year, and the steepest incidence rate decrease was seen in lung cancer, which fell by 2.6% per year. In women, melanoma had the steepest increase in incidence, rising by 1.8% per year, and thyroid cancer had the sharpest decrease, falling by 2.9% per year. 

Overall cancer incidence rates during 2014 to 2018 were highest among non-Hispanic American Indian and Alaska Native (AI/AN) people, followed closely by non-Hispanic White people and non-Hispanic Black people. Overall cancer incidence rates were lowest among non-Hispanic Asian/Pacific Islander (API) and Hispanic people. 

Incidence rates for all sites combined decreased among non-Hispanic Black, non-Hispanic API, and Hispanic men, but increased among non-Hispanic White, non-Hispanic API, non-Hispanic AI/AN, and Hispanic women from 2014 to 2018. Incidence rates were stable among non-Hispanic White and non-Hispanic AI/AN men and non-Hispanic Black women. 

Among children younger than 15, overall cancer death rates decreased from 2015 to 2019, and incidence rates remained stable from 2014 to 2018. Overall cancer incidence rates were stable for non-Hispanic Black children over this period but increased for non-Hispanic White, non-Hispanic API, non-Hispanic AI/AN, and Hispanic children. 

Among adolescents and young adults ages 15 to 39, overall cancer incidence rates increased by 0.9% per year from 2014 to 2018. The overall cancer death rate decreased by 3.0% per year from 2001 to 2005, but the decline slowed to 0.9% per year from 2005 to 2019. 

The incidence of breast cancer, the most common cancer among adolescents and young adults, increased by an average of 1.0% per year from 2010 to 2018. 

The researchers noted that racial and ethnic disparities exist for many individual cancer sites. For example, from 2014 to 2018, incidence rates for bladder cancer declined in non-Hispanic White, non-Hispanic Black, non-Hispanic API, and Hispanic men but increased among non-Hispanic AI/AN men. Incidence rates for uterine cancer increased among women of every racial and ethnic group from 2014 to 2018 except for non-Hispanic White women, who had stable rates. 

From 2015 to 2019, prostate cancer death rates were stable among non-Hispanic White and non-Hispanic Black men but decreased among non-Hispanic API, non-Hispanic AI/AN, and Hispanic men. Colorectal cancer death rates were stable among non-Hispanic AI/AN men but decreased in men of all other racial and ethnic groups. Among women, death rates for lung, breast, and colorectal cancer decreased in nearly every racial and ethnic group. The exceptions were non-Hispanic API women, among whom breast cancer death rates remained stable, and non-Hispanic AI/AN women, among whom breast cancer death rates increased and colorectal cancer death rates remained stable. 

This year’s report includes a special focus on trends in pancreatic cancer incidence, death, and survival rates. Although pancreatic cancer accounts for only 3% of new cancer diagnoses, it accounts for 8% of cancer deaths and is the fourth leading cause of cancer deaths in the United States for both men and women.

Study finds personalized kidney screening for people with type 1 diabetes could reduce costs, detect disease earlier

Taking a personalized approach to kidney disease screening for people with type 1 diabetes (T1D) may reduce the time that chronic kidney disease (CKD) goes undetected, according to a new analysis performed by the Epidemiology of Diabetes Interventions and Complications study group.

The finding was published in Diabetes Care and provides the basis for an evidence-based kidney screening model for people with T1D.

According to the model’s findings:

• People with AER of 21-30 mg per 24 hours and a HbA1c of at least 9% are at high risk for developing CKD and could be screened for urine albumin every six months.
• Those with AER ≤ 10 mg per 24 hours and a HbA1c ≤ 8% are at lower risk for developing CKD and could be screened every two years.
• All others with T1D ≥ 5 years could continue to be screened annually. 

Which COVID vaccine you get can impact myocarditis risk

Incidence of myocarditis, pericarditis or myopericarditis is two- to threefold higher after a second dose of the Moderna Spikevax COVID-19 vaccine when compared to the Pfizer BioNTech COVID-19 vaccine; however, overall cases of heart inflammation with either vaccine are very rare, according to a study in the Journal of the American College of Cardiology.

The study showed males younger than 40 years old who received the Moderna vaccine were shown to have the highest rates of myocarditis, which according to the authors, may have implications for choosing specific vaccines for certain populations.

While there have been many studies on either vaccine, few studies have been conducted to directly compare the safety of the two mRNA vaccines. Researchers in this study sought to compare the risk of myocarditis, pericarditis and myopericarditis between the Pfizer and Moderna COVID-19 vaccines.

People in the study were 18 years old or older and had received two primary doses of either Pfizer or Moderna vaccine in British Columbia, Canada, with the second dose between Jan. 1, 2021 and Sept. 9, 2021. Individuals whose first or second shot were administered outside of British Columbia or had a history of myocarditis or pericarditis within one year prior to second dose were excluded.

In all, more than 2.2 million second Pfizer doses were given and more than 870,000 Moderna doses. Within 21 days of the second dose, there were a total of 59 myocarditis cases (21 Pfizer and 31 Moderna) and 41 pericarditis cases (21 Pfizer and 20 Moderna). Researchers also looked at rates per million doses and the rate was 35.6 cases per million for Moderna and 12.6 per million for Pfizer—an almost threefold increase after Moderna shots vs. Pfizer. Comparatively, rates of myocarditis in the general population in 2018, were 2.01 per million in people under age 40 and 2.2 per million in people over age 40.

Rates of myocarditis and pericarditis were higher with the Moderna vaccine in both males and females between ages 18 and 39, with the highest per million rates in males ages 18-29 after a second dose of Moderna.