Prostate cancer screening programme leads to bigger fall in death rates than surrounding areas.

There is no evidence that trends in the Tyrol and the rest of Austria were significantly different before free testing was introduced.

"Prostate specific antigen (PSA) testing was introduced to the Tyrol in 1988 and since 1993 it has been freely available to all men aged from 45 to 75 and to men under 40 with a family history of the disease" explains lead author Professor Georg Bartsch from the University of Innsbruck, one of the international team of medical experts that makes up the Tyrol Prostate Cancer Screening Group.

"Our findings suggest that the combination of free PSA testing and free treatment for any resulting prostate cancer can lead to significant reductions in death rates. This free treatment normally involved surgical removal of the prostate.

"What was interesting about this study was that so many men came forward for testing after the programme was widely advertised in the print and broadcast media. People living in the Tyrol - one of the nine Federal states that make up Austria - tend to enjoy close proximity to health facilities and be very receptive to preventative medical programmes."

By 2005, just under 87 per cent of men aged between 45 and 75 living in the region had undergone a PSA test.

"Our study clearly shows that deaths from prostate cancer have declined much more quickly in the Tyrol since 1988, when this programme was introduced, compared with the rest of Austria.

"Before the programme was introduced, prostate cancer death rates in the Tyrol were similar to the rest of the country, but after the programme was launched the death rate in the Tyrol started falling by an average of 7.3 per cent a year, more than twice the 3.2 per cent observed in the rest of Austria."

The findings also have important implications for age-related prostate cancer deaths, say the researchers, especially as the number of older men is steadily increasing.

"Deaths from prostate cancer in the 80 plus age group have been increasing across Austria, but there has been no evidence of this happening in the Tyrol" says co-author Professor Boyle from the International Agency for Research on Cancer.

"This indicates that the screening programme in the Tyrol is picking up cases of prostate cancer at an earlier stage of the disease, when it can be treated more effectively. This early treatment reduces the risk of the disease coming back later in life and killing the patient when they are older."

The authors conclude that the introduction of free screening has made an important contribution to reducing prostate cancer death rates in the Tyrol, a region where treatment is freely available to all patients with the disease.

But they acknowledge that there is still controversy surrounding some aspects of screening for prostate cancer that need to be resolved.

These include the effectiveness of PSA testing in all cases, whether aggressive treatment alters the outcome in men with advanced stages of the disease and whether testing and treatment seriously impinge quality of life.

"Our study shows that when widespread PSA testing was introduced to the Tyrol, and people with the disease received free treatment to cure their prostate cancer, the fall in death rates was significantly higher than in the rest of Austria" says Professor Boyle.

"This reduction in death rates is most probably due to the fact that cases of prostate cancer were detected at an earlier stage, when treatment for this disease tends to be more effective.

"However it is important to remember that screening is only the first step in the optimal management of patients with prostate cancer."

65% of women in U.S. have eating disorders.

"Our survey found that these behaviors cut across racial and ethnic lines and are not limited to any one group," said Cynthia R. Bulik, Ph.D., William and Jeanne Jordan Distinguished Professor of Eating Disorders in the UNC School of Medicine's department of psychiatry and director of the UNC Eating Disorders Program. "Women who identified their ethnic backgrounds as Hispanic or Latina, white, black or African American and Asian were all represented among the women who reported unhealthy eating behaviors."

"What we found most surprising was the unexpectedly high number of women who engage in unhealthy purging activities," said Bulik, who is also a nutrition professor in the School of Public Health. "More than 31 percent of women in the survey reported that in an attempt to lose weight they had induced vomiting or had taken laxatives, diuretics or diet pills at some point in their life. Among these women, more than 50 percent engaged in purging activities at least a few times a week and many did so every day."

Lucy Danziger, the editor-in-chief of SELF Magazine said: "SELF's investigation will help our 5.8 million readers determine whether their eating habits could be considered disordered, and the survey results show that more women than expected will identify with various disordered eating behaviors," said "Recognizing what's normal and what's dangerous is the first step all women can take in developing a more positive body image and a healthier approach to food."

Although the type of disordered eating behaviors the survey uncovered don't necessarily have potentially lethal consequences like anorexia or bulimia nervosa, women report they are associated with emotional and physical distress. And despite the stereotype that eating issues affect mostly young women, the survey found that those in their 30s and 40s report disordered eating at virtually the same rates. Findings show that:

75 percent of women report disordered eating behaviors or symptoms consistent with eating disorders; so three out of four have an unhealthy relationship with food or their bodies
67 percent of women (excluding those with actual eating disorders) are trying to lose weight
53 percent of dieters are already at a healthy weight and are still trying to lose weight
39 percent of women say concerns about what they eat or weigh interfere with their happiness
37 percent regularly skip meals to try to lose weight
27 percent would be "extremely upset" if they gained just five pounds
26 percent cut out entire food groups
16 percent have dieted on 1,000 calories a day or fewer
13 percent smoke to lose weight
12 percent often eat when they're not hungry; 49 percent sometimes do
Eating habits that women think are normal - such as banishing carbohydrates, skipping meals and in some cases extreme dieting - may actually be symptoms of disordered eating.

The online survey garnered responses from 4,023 women who answered detailed questions about their eating habits. Results and analysis appear in SELF's May 2008 issue, on newsstands from today (April 22) through May 19. SELF and UNC's goal was to discover the unfiltered reality of the eating habits of American women, and ultimately, to help women develop less obsessive, more accepting attitudes toward their bodies and a healthier relationship with food, Danziger said.

SELF's report includes tips to help all women even out their behavior by adopting a moderate approach to eating. Tips for staying healthy include: separating mood from food; eliminating extreme thinking; eating breakfast; and finding realistic body role models.

Bulik and study co-author Lauren Reba-Harrelson, a third year clinical psychology graduate student in UNC's College of Arts and Sciences, will give a presentation about the survey and their collaboration with SELF on May 17 at the Academy for Eating Disorders' 2008 International Conference on Eating Disorders in Seattle.