WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

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Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

WHO report: http://bit.ly/YDCXcb

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Asian shares capped by China PMI slip, U.S. budget worry

TOKYO (Reuters) - Asian shares were capped on Friday, with sentiment dented by lackluster manufacturing data from China and worries over the economic fallout from Italy's political confusion as well as possible U.S. spending cuts.

European markets are seen narrowly mixed, with financial spreadbetters predicting London's FTSE 100 <.ftse>, Paris's CAC-40 <.fchi> and Frankfurt's DAX <.gdaxi> would open between a 0.1 percent rise and a 0.2 percent fall. Italy's main FTSE MIB <.ftmib> stock market index is expected to open down 0.2 percent. <.l><.eu/>

A 0.1 percent drop in U.S. stock futures also hinted at a weak Wall Street start. <.n/>

But losses were limited by renewed confidence that major central banks will keep taking stimulative steps to support their economies.

China's factory growth cooled in February to multi-month lows after domestic demand dipped to weigh on firms already hit by slack foreign sales, two surveys showed on Friday, underlining the country's patchy economic recovery. But it does not signal China's economy is slipping into another slowdown, analysts said.

China's February official purchasing managers' index (PMI) came in at 50.1, slightly below a 50.2 Reuters poll consensus and the 50.4 posted in January. A private survey showed the final HSBC PMI fell to 50.4 after seasonal adjustments from January's two-year high of 52.3, in line with a flash reading.

"While comfort can be sought from the fact that the Chinese economy remains in expansion territory, the dip from prior PMI readings does illustrate that the recovery is far from linear and that there are still a few bumps in the road," said Tim Waterer, senior trader at Sydney-based CMC Markets.

The MSCI's broadest index of Asia-Pacific shares outside Japan <.miapj0000pus> was down 0.1 percent, after ending February up 0.5 percent, showing muted reaction to Chinese data.

Australian shares <.axjo> slipped 0.4 percent, pulling back from 4-1/2-year highs touched in the previous session, as big miners lost ground on lower metal prices. South Korean markets were closed on Friday for a public holiday.

The Australian dollar, which is sensitive to data from China, Australia's largest trading partner, was up 0.2 percent to $1.0230.

Japan's Nikkei stock average <.n225> erased earlier losses to rise 0.5 percent, lifted by expectations for strong reflationary measures from the Bank of Japan in coming months. <.t/>

Stocks in Indonesia edged higher to a fresh record. Data showed Indonesia's trade deficit narrowed slightly in January from the previous month as exports posted their smallest fall in nearly a year, reflecting recovering global demand and providing early hope that the nation's external balances may improve in 2013.

From Japan, Friday's data showed Japanese companies cut spending on plant and equipment in October-December by 8.7 percent from the same period last year, down for the first time in five quarters amid a slump in exports, showing the world's third-largest economy was still struggling to find a solid footing.

In contrast, a drop in new U.S. claims for jobless benefits last week and a sharp rise in factory activity in the Midwest in February suggested the U.S. economy is improving.

The relative outperformance of the world's leading economy over Japan's may soon turn the Japan-based yen selling into U.S.-led dollar buying, giving a fresh push higher in the dollar/yen, traders say.

The dollar inched up 0.1 percent to 92.65 against the yen.

One factor that could cloud such a positive outlook is the uncertainty over the possible extent of economic damage from the $85 billion in automatic across-the-board "sequestration" spending cuts in the United States set to begin taking effect on Friday.

"Financial markets are eerily calm about the issue. Nobody is talking about the sequestration, and I worry about the seeming lack of interest when market sentiment is far from stable after sharp swings following the Italian election," said Hiroshi Maeba, head of FX trading Japan at UBS in Tokyo.

He said reaction, if any, will likely come in equities and bonds first and spill over to forex, hitting risk-sensitive currencies which may possibly underpin the dollar.

The International Monetary Fund said on Thursday it would likely cut its 2013 growth forecasts for the United States by at least a 0.5 percentage point if the cuts are fully implemented. The IMF now projects that the U.S. economy will grow 2 percent this year.

"The $85 billion in spending cuts is simply too small to make much of a difference to the economy and although it could cause some problems, it will have no bearing on influencing investor allocations among different asset classes," said Ed Meir, an analyst at INTL FCStone, in a note.

U.S. crude fell 0.1 percent to $91.93 a barrel, after earlier hitting a 2013 low of $91.43. Brent crude fell 0.3 percent to $111.05 after falling to a six-week low of $110.86 earlier. Oil prices were weighed by concerns about the global economy and the strength of demand.

Spot gold inched down 0.1 percent to $1,578.81 an ounce after dropping more than 1 percent on Thursday and ending February with its fifth straight monthly drop, the longest string of monthly declines since 1996.

The euro was up 0.1 percent to $1.3074, but near a seven-week trough of $1.3018 plumbed earlier in the week.

(Additional reporting by Luke Pachymuthu and Rujun Shen in Singapore; Editing by Eric Meijer)

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India Ink: India’s Slowing Economy Forces Budget Decisions

NEW DELHI — Not too long ago, when India’s economy was roaring amid predictions of high growth rates for years to come, the finance minister could be forgiven for strutting during budget week. He got to march into India’s Parliament with the ceremonial briefcase bearing a budget stuffed with goodies.

But on Thursday, when the current finance minister, Palaniappan Chidambaram, arrives in Parliament, his steps will be heavier, and the mood is likely to be, too. Faced with slowing growth, persistent inflation and sagging investor confidence, India’s government is pinned between conflicting pressures: economists warn that tough steps are needed to avoid long-term fiscal problems, even as political leaders are leery of introducing unpopular measures before important elections this year.

On Wednesday, the government sought to change the pessimistic narrative, as the Finance Ministry released its annual economic survey and projected that economic growth would jump somewhere above 6 percent during the next fiscal year, predicting that the downturn was “more or less over and the economy is looking up.” Some economists were skeptical, given that similar rosy predictions in recent budgets have proved wrong.

“Let me remind you that last year the economic survey spoke of about 7.6 percent projected growth — and what we had was 5 percent growth,” said Ajay Bodke, head of investment strategy and advisory at Prabhudas Lilladher, a Mumbai brokerage. “That is not just a miss but a humongous miss.”

The consequences of the budget plans are especially high because India, once a darling of global investors and an anointed power-in-waiting, is struggling to regain its lost luster.

India’s estimated 5 percent growth rate for the current fiscal year compares with 8 percent in 2010. Ratings agencies have threatened to downgrade the country’s investment rating to “junk” status. Meanwhile, India’s political class has spent more than three years enmeshed in scandals, as a bickering Parliament has accomplished almost nothing.

“It’s a supercritical moment, actually,” said Rajiv Kumar, an economist with the Center for Policy Research in New Delhi. “If you get it right, and this is a budget that can shore up the government’s credibility, they can turn it around.”

For investors and business leaders, the question is whether the government will make tough calls to address the country’s large fiscal and account deficits, curb huge subsidies for diesel fuel and petroleum products, unclog bureaucratic bottlenecks on stalled manufacturing, energy and infrastructure projects and create incentives to entice new investment.

Only a year ago, Pranab Mukherjee, then finance minister, unveiled a budget now regarded by many analysts as a major mistake. Desperate to increase revenues, the government spooked investors by giving broad latitude for tax collectors to pursue multinationals for billions of dollars in new, unexpected taxes. Investment slowed markedly, while investors and political opponents complained that India’s coalition government, led by the Indian National Congress Party, was endangering one of the world’s fastest-growing economies.

“The economy is in a deep crisis at the moment,” said Yashwant Sinha of the opposition Bharatiya Janata Party, a former finance minister, “and I only hope the crisis doesn’t become any deeper with more pre-election sops.”

Mr. Sinha and many independent economists warn that the economy cannot afford a repeat of 2008, when the government was preparing for national elections the following year. Then, the pre-election budget was filled with big spending measures, including pay raises for government workers and the forgiveness of billions of dollars in loans to farmers. The government was easily re-elected in 2009, but the new spending contributed to a fiscal deficit that rose to roughly 6 percent, from about 2 percent the previous year.

Neha Thirani Bagri contributed reporting from Mumbai, India.

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American Idol Reveals Its Top 10 Women

TV Watch

American Idol

02/27/2013 at 10:45 PM EST

From left: Randy Jackson, Mariah Carey, Ryan Seacrest, Nicki Minaj, Keith Urban

Michael Becker/FOX

American Idol's's list of the top 10 women is complete!

After the first week of sudden-death rounds, the judges gave their stamp of approval to five more female singers Wednesday night. And they sent five others home.

Keep reading to find out who's in and who's out on Idol ...

Here are the five contestants who are moving on in the competition:

1. Zoanette Johnson: The Tulsa resident, 20, was the first to be put through by the judges, who showered her with praise for singing a spirited version of "Circle of Life" from The Lion King. Keith Urban declared her "queen of the jungle." Nicki Minaj told Zoanette, "You make me so emotional ... You're the person we're going to remember tonight."

2. Aubrey Cleland: After singing a slowed-down version of Beyoncé's "Sweet Dreams," Mariah Carey told Cleland, 19, "You're limitless." Nicki and Randy Jackson pointed out her commercial appeal. "Lookin' like a current artist, soundin' like one, feelin' like one," said Nicki of the performance.

3. Candice Glover: Taking on Aretha Franklin's "(You Make Me Feel Like) A Natural Woman" paid off for the singer, 23, who earned a standing ovation from Keith. Randy said she was "one of my favorite singers in the whole competition."

4. Breanna Steer: "You're extremely marketable and gorgeous and talented," Mariah told the singer, 18, after she sang a dramatic version of Jazmine Sullivan's "Bust Your Windows" that had Randy wanting to sign her up for a recording contract. "You got the whole package," he said. "You brought so much drama."

5. Janelle Arthur: She beat out the other country singer in the competition, Rachel Hale, for the final spot in the women's top 10 after singing Lady Antebellum's "Just a Kiss." Though Randy called Arthur, 23, his "favorite country singer in this competition," the other judges questioned her song choice. "[The song] doesn't give you a chance to really soar," Keith said. "The melody kept pulling you back."

These five will join the five female finalists announced last week – Kree Harrison, Amber Holcomb, Adriana Latonio, Angela Miller and Tenna Torres – as well as the five men – Charlie Askew, Curtis Finch Jr., Paul Jolley, Elijah Liu and Devin Velez. Ten more guys will sing Thursday (8 p.m. ET) and five will move on to round out season 12's top 20.

Did the judges make the right decisions? Sound off in the comments below.

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and cost are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to AP. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall nursing home operators are well regulated and follow federal guidelines but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, NY. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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On the Web:

http://1.usa.gov/VaztQm

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Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.

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India Ink: A Difficult Budget Balancing Act for India

India’s fiscal budget will be announced on Thursday amid slowing economic growth, soaring inflation, a growing fiscal deficit and flagging investor confidence. But with national elections only a year away, analysts fear that instead of cutting the deficit, the government will buckle under political pressure and increase spending on social programs.

“As the country is going into an election period, there is a tendency to try to create a feel-good factor amongst the electorate by enhancing access to welfare schemes and income growth for the masses,” said Sujan Hajra, chief economist and executive director at Anand Rathi Financial Services.

The government has been under pressure to rein in spending as ratings agencies have warned that a failure to cut the deficit could result in a crippling downgrade to India’s sovereign debt.

“The need of the hour is a growth-supportive budget that reinforces reform initiatives and minimizes populist impulses that may act as a drain on the already stretched fiscal condition and raise a red flag for the ever-watchful rating agencies,” said Ajay Bodke, the head of investment strategy and advisory at Prabhudas Lilladher, a Mumbai brokerage.

India’s economy has slowed considerably in recent quarters. On Feb. 7, advance estimates released by India’s Central Statistics Office pegged the growth rate for the current fiscal year, which ends in March, at 5 percent, a significant drop from the central bank’s earlier projections of 5.5 percent and 5.8 percent, and down from over 8 percent in 2010.

In the second quarter of this financial year, the current account deficit reached a record high of $22.4 billion, or 5.4 percent of the gross domestic product, according to data released by the Reserve Bank of India in December.

Prime Minister Manmohan Singh attributed the slowdown to outside forces. “We are meeting against the background of global slowdown of economic activity which has also affected us,” he said in Parliament on Feb. 21. “The way we conduct the financial business now before Parliament will be a crucial determinant of our country’s ability to cope with the formidable challenges that our country faces.”

The government has introduced a series of measures to narrow the deficit, including a rise in passenger rail fares, an increase in fuel prices and the opening of the aviation and retail sectors for foreign direct investment.

Reducing the fiscal deficit has been a priority for the government in recent months. In October, India’s finance minister, Palaniappan Chidambaram, presented a plan  aimed at reducing the fiscal deficit over the next five years, which included a significant reduction in subsidies and tight controls on government expenditure.

In an interview with The Financial Times in January while in England to promote India to investors, Mr. Chidambaram said that the coming budget would be “responsible,” adding, “The red lines are that the fiscal deficit for the current year will be no more than 5.3 percent and the fiscal deficit for the next year will be no more than 4.8 percent.”

Additional measures to overhaul the economy are necessary to reach that target, analysts said. The government is likely to rely on a mix of revenue and spending measures, including proceeds from the divestment of state-run companies and telecom spectrum sales, an increase in indirect taxes and improved tax administration, predicted Leif Lybecker Eskesen, the chief economist for India at HSBC Global Research.

“Debt dynamics depend importantly on broader structural reforms progress, which is needed to raise the economy’s growth potential,” he said. “It is, therefore, imperative to continue and step up the reform push.”

What worries analysts in particular is the National Food Security Bill 2011, which aims to lower the cost of food for the poor.

“If the bill is passed by Parliament, the total food subsidy expense alone would be approximately $14.6 billion per year, or 12 percent of the annual budget,” said Akshay Mathur, head of research at Gateway House, a research institution in Mumbai. Total subsidy expenses, including fuel and fertilizer would be almost 20 percent of the budget, he added.

Critics of the bill argue that the legislation is being introduced with the sole intention of garnering votes for the Congress party in the national elections in 2014.

“There is definitely a political impetus behind the Food Security Bill, but the need is not only a political one,” said Mr. Mathur. “However, the question is how we can pay for it. At this point, given that we have a fiscal deficit and a current account deficit, any added expenditure is a pure drain on the government.”

Meanwhile, fear of a sovereign ratings downgrade by international credit rating agencies is haunting the government. “Rating agencies are also closely watching out for any further fiscal slippage,” said Dipen Shah, head of private client group research at Kotak Securities.

Ratings agencies are looking to the budget for signs of the Indian government’s commitment to fiscal consolidation and structural reform.

“The Union budget will be an important gauge of the government’s commitment to fiscal consolidation and reform in general,” said a report by Fitch Ratings on Feb. 4. “India’s patchy performance on policy implementation, and the approach of elections in 2014 could impede fiscal consolidation, suggesting political and implementation risk remain significant.”

Lalit Thakkar, a managing director at Angel Broking, said that perhaps the ratings agencies’ scrutiny will compel the government to act responsibly.

“We believe that the government cannot afford any adverse economic developments at this juncture on the back of the still-looming threat of sovereign ratings downgrade by credit rating agencies,” he said.

Given that a ratings downgrade from the lowest investment grade to junk status could significantly hamper capital flow, have an adverse impact on the currency, business confidence and the availability of international finance for the corporate sector, perhaps it is this threat that will prove pivotal.

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Bobby Brown Sentenced to 55 Days in Jail in Drunk Driving Case

02/26/2013 at 09:30 PM EST

Bobby Brown has been sentenced to 55 days in jail and four years probation in his most recent drunk driving arrest.

Brown, 44, was pulled over in Studio City, Calif., on Oct. 24 for driving erratically and was arrested when the officer detected "a strong scent of alcohol." He was charged with DUI and driving on a suspended license.

He was also arrested for driving under the influence in March of 2012.

Brown pled no contest to the charges on Tuesday, reports TMZ. He was also ordered to complete an 18-month alcohol treatment program.

The singer, who married Alicia Etheredge in Hawaii in June of 2012, must report to jail by March 20.

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Advanced breast cancer edges up in younger women

CHICAGO (AP) — Advanced breast cancer has increased slightly among young women, a 34-year analysis suggests. The disease is still uncommon among women younger than 40, and the small change has experts scratching their heads about possible reasons.

The results are potentially worrisome because young women's tumors tend to be more aggressive than older women's, and they're much less likely to get routine screening for the disease.

Still, that doesn't explain why there'd be an increase in advanced cases and the researchers and other experts say more work is needed to find answers.

It's likely that the increase has more than one cause, said Dr. Rebecca Johnson, the study's lead author and medical director of a teen and young adult cancer program at Seattle Children's Hospital.

"The change might be due to some sort of modifiable risk factor, like a lifestyle change" or exposure to some sort of cancer-linked substance, she said.

Johnson said the results translate to about 250 advanced cases diagnosed in women younger than 40 in the mid-1970s versus more than 800 in 2009. During those years, the number of women nationwide in that age range went from about 22 million to closer to 30 million — an increase that explains part of the study trend "but definitely not all of it," Johnson said.

Other experts said women delaying pregnancy might be a factor, partly because getting pregnant at an older age might cause an already growing tumor to spread more quickly in response to pregnancy hormones.

Obesity and having at least a drink or two daily have both been linked with breast cancer but research is inconclusive on other possible risk factors, including tobacco and chemicals in the environment. Whether any of these explains the slight increase in advanced disease in young women is unknown.

There was no increase in cancer at other stages in young women. There also was no increase in advanced disease among women older than 40.

Overall U.S. breast cancer rates have mostly fallen in more recent years, although there are signs they may have plateaued.

Some 17 years ago, Johnson was diagnosed with early-stage breast cancer at age 27, and that influenced her career choice to focus on the disease in younger women.

"Young women and their doctors need to understand that it can happen in young women," and get checked if symptoms appear, said Johnson, now 44. "People shouldn't just watch and wait."

The authors reviewed a U.S. government database of cancer cases from 1976 to 2009. They found that among women aged 25 to 39, breast cancer that has spread to distant parts of the body — advanced disease — increased from between 1 and 2 cases per 100,000 women to about 3 cases per 100,000 during that time span.

The study was published Tuesday in the Journal of the American Medical Association.

About one in 8 women will develop breast cancer in their lifetime, but only 1 in 173 will develop it by age 40. Risks increase with age and certain gene variations can raise the odds.

Routine screening with mammograms is recommended for older women but not those younger than 40.

Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, said the results support anecdotal reports but that there's no reason to start screening all younger women since breast cancer is still so uncommon for them.

He said the study "is solid and interesting and certainly does raise questions as to why this is being observed." One of the most likely reasons is probably related to changes in childbearing practices, he said, adding that the trend "is clearly something to be followed."

Dr. Ann Partridge, chair of the federal Centers for Disease Control and Prevention's advisory committee on breast cancer in young women, agreed but said it's also possible that doctors look harder for advanced disease in younger women than in older patients. More research is needed to make sure the phenomenon is real, said Partridge, director of a program for young women with breast cancer at the Harvard-affiliated Dana-Farber Cancer Institute.

The study shouldn't cause alarm, she said. Still, Partridge said young women should be familiar with their breasts and see the doctor if they notice any lumps or other changes.

Software engineer Stephanie Carson discovered a large breast tumor that had already spread to her lungs; that diagnosis in 2003 was a huge shock.

"I was so clueless," she said. "I was just 29 and that was the last thing on my mind."

Carson, who lives near St. Louis, had a mastectomy, chemotherapy, radiation and other treatments and she frequently has to try new drugs to keep the cancer at bay.

Because most breast cancer is diagnosed in early stages, there's a misconception that women are treated, and then get on with their lives, Carson said. She and her husband had to abandon hopes of having children, and she's on medical leave from her job.

"It changed the complete course of my life," she said. "But it's still a good life."

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Online:

JAMA: http://jama.ama-assn.org

CDC: http://www.cdc.gov/cancer/breast/index.htm

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IHT Rendezvous: Thank you, Xiexie, Namaste: a Movie Undercuts Old Rivalries

BEIJING — After the Taiwan-born film director Ang Lee won big at the Oscars on Sunday evening in Los Angeles, including scooping Best Director for “Life of Pi,” he effusively thanked his place of birth. But his thanks didn’t make it into China, at least not via the official media.

Why? At almost the same time as Mr. Lee’s speech there was a meeting in Beijing between Xi Jinping, the head of China’s Communist Party, and Lien Chan, the honorary chairman of Taiwan’s Kuomintang party, the latest twist in a political rivalry now dating back 64 years to the end of the Chinese civil war in 1949, when the Kuomintang fled to Taiwan and set up the Republic of China. Communist Party-run China, the People’s Republic of China, still claims Taiwan and has not dropped threats to take it by force, if necessary. Even for Xinhua to quote Mr. Lee thanking Taiwan would be to unacceptably recognize the de facto reality that Taiwan is a separate state.

It’s all deep politics, with Mr. Lee’s victory bound to lead to a debate about whether Mr. Lee is “Chinese or not.” Mr. Lee, who has never denied he is culturally Chinese and appears keen to work in and with the mainland of China, is known to be proud of his Taiwan roots and sees himself as an internationalist.

In its account of the event, Xinhua, the official news agency, merely described him as “Coming from China’s Taiwan”, which fits into China’s ongoing claims.

Here’s what Mr. Lee said about Taiwan: “I cannot make this movie without the help of Taiwan. We shot there. I want to thank everybody there helped us. Especially the city of Tai Chong.” He went on to thank “My family in Taiwan.”

In another story, Xinhua also left out Mr. Lee’s thanks to Taiwan, quoting only this version of his words: “Thank you, movie God. I really need to share this with all 3,000, everybody who worked with me in ‘Life of Pi’, I want to thank you for, I really want to thank you for believing this story, and sharing this incredible journey with me. Thank you, Academy, xie xie, namaste.”

Readers of the Taipei Times, however, learned also that backstage, “Lee thanked his home country, where he said 90 percent of the film was shot. ‘They gave us a lot of physical help and financial help,’ he said. ‘I’m glad that Taiwan contribute this much to the film. I feel like this movie belongs to the world,’” he said in a story carried by the Taiwan newspaper.

As the Taipei Times cited Mr. Lien as saying in the meeting with Mr. Xi, “core issues” remain unresolved. Taiwan and China can work out a reasonable arrangement, Mr. Lian said, according to the newspaper, sounding pragmatic.

Mr. Xi’s had a different, more dramatic take of the situation, speaking of China and Taiwan working together for the “great rejuvenation of the Chinese nation,” in the China Daily’s words, reflecting speeches he has made frequently since becoming party leader.

Meanwhile, Mr. Lee offered something completely different in his speech: a multicultural, multilingual salutation that reflected the deeply globalized nature of his movie, which explores human survival, animals, and religions.

“Thank you, Academy. Xie xie, Namaste,” he said, in English, Mandarin Chinese and Hindi.

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The Bachelor's Sean Lowe Reveals Final Two

TV Watch

The Bachelor

02/25/2013 at 10:30 PM EST

From left: AshLee, Lindsay and Catherine

Kevin Foley/ABC(3)

And then there were two.

After three incredible dates in Thailand with the remaining women, The Bachelor's Sean Lowe faced a difficult decision at the end of Monday's episode: Would he send home AshLee, Catherine or Lindsay?

Keep reading to find out who got a rose – and who was left heartbroken ...

Sean said goodbye to early favorite AshLee in a surprising elimination that left her virtually speechless.

Visibly upset, AshLee left Sean's side without saying goodbye. She even asked him to not walk her to the waiting car that would take her away.

But Sean did get to explain. "I thought it was you from the very beginning," he said. "This was honestly the hardest decision I've ever had to make ... I think the world of you. I did not want to hurt you."

"This wasn't a silly game for me," AshLee said as the car drove away. "This wasn't about a joy ride. It wasn't about laughing and joking and having fun."

She added: "It's hard to say goodbye to Sean because I let him in ... It's the ultimate [rejection]."

Check back Tuesday morning for Sean Lowe's blog post to read all about his Thailand dates and why he chose to send AshLee home

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