News

Searching for the presence of colorectal cancer can be a messy business.

It normally starts with a fecal occult blood test (FOBT). The patient collects some stool samples that are sent to a lab for analysis. If blood is found in the feces, a doctor usually recommends the patient have a colonoscopy, in which a flexible tube with a camera is inserted up the rectum for a closer inspection.

Few patients are fond of either procedure. Many shun them. And that means a lot of people aren't being screened for a disease that is Canada's second biggest cancer killer, claiming 8,900 lives each year.

But now a Canadian biotech company, GeneNews Ltd., has introduced a "patient-friendly" prescreening test known as ColonSentry. All that's needed is a blood sample, which can be collected at a medical clinic. The blood is analyzed for the presence of biomarkers - in particular, messenger RNA, which indicates specific genes are responding to an active case of colon cancer.

If the test results turned out positive, the patient would have a colonoscopy to confirm the results.

Gailina Liew, chief operating officer of GeneNews, said the company's new test is far more accurate than the FOBT. So, in theory at least, far fewer patients would have to undergo unnecessary and costly colonoscopies.

However, the test isn't cheap - it costs $750. "This is an expensive technology that has lots of costs associated with it," said Wayne Marshall, the company's chief clinical scientist. He said the firm may be able eventually to develop a cheaper testing kit, "but that will be a couple of years down the road."

In the meantime, Ms. Liew said GeneNews is trying to get private insurance companies and large employers interested in footing the bill for the innovative technology.

AIDS flap

The Swiss Federal Commission for HIV/AIDS has sparked furor in the international medical community by suggesting that some HIV patients don't need to wear condoms when having sex with an uninfected partner.

Earlier this year, the Swiss body pointed out that medications are now so good that they can dramatically reduce the levels of the virus circulating in the bloodstream. It concluded that patients receiving proper treatment can't transmit HIV through sexual contact.

The message, in part, was meant to allay exaggerated fears of transmission when the risk is quite small. (And that's good news for couples trying to get pregnant when one of them is infected with HIV, the virus that causes AIDS.)

But many AIDS experts are now worried about a potential explosion in AIDS cases if couples stop using condoms on a regular basis.

"Although the risk of HIV transmission from people on effective therapy is low, it is unlikely to be zero," AIDS researchers warn in the current edition of The Lancet, a British-based medical journal.

"I do believe that the Swiss were ill-advised to release such a statement," said one of the authors of The Lancet report, David Wilson of the University of New South Wales in Sydney, Australia. "They stated that an effectively treated patient is non-infectious. There is not evidence for such a bold claim and there is a massive difference between no risk and a very small risk. Semantics make all the difference here."

He said the Swiss message, if embraced by infected individuals, could lead to a quadrupling of HIV infections within a decade.

"Treatment [with anti-AIDS drugs] should not replace condoms and should only be a complement to consistent condom use," Dr. Wilson said in an e-mail interview.

A lifetime of regret

Women are far more likely than men to regret getting a tattoo, a U.S. study suggests.

The study, published in the journal Archives of Dermatology, found that women represent two-thirds of the patients who seek laser treatment for tattoo removal.

Although the body images have grown in popularity in recent years, there can still be a stigma attached to wearing one, noted Jerome Koch, one of the researchers, at the Texas Tech University Health Sciences Center in Lubbock.

"I think people judge women more harshly if they are a little bit out of the ordinary than they judge men," he said.

When asked why they wanted to have their tattoo removed, some women said they felt embarrassed by the image and also feared a tattoo could hurt their job prospects. "Men don't seem to worry about that as much," he said.

Still, getting rid of a tattoo is easier said than done. The treatments are costly, painful and often can't completely remove the markings.

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