Medical research shifts its attention to women

April 22, 1991|By Susan FitzGerald | Susan FitzGerald,Knight-Ridder News Service

The medical discovery seemed so important that researchers interrupted their experiment to announce the good news: An aspirin taken every other day could cut the risk of a first heart attack nearly in half.

The startling finding, reported in 1988, was based on a study of 22,000 doctors -- all of them men.

But what about women? Could aspirin help them as well?

Women -- for whom the No. 1 killer is heart disease, just as it is for men -- were left to wonder.

They've also been left to wonder whether low-fat diets really help their cholesterol problem, and whether high-fat diets can give them breast cancer.

Clearly, when it comes to medical research, women have been repeatedly overlooked.

"Women make up 50 percent of the population or more. How can you ignore a group like that?" said Dr. Luigi Mastroianni Jr., director of the division of human reproduction at the Hospital of the University of Pennsylvania.

Nearly all the classic heart-disease studies have been conducted exclusively on men.

Women are routinely left out of many research tests on new drugs.

And as for those health problems specific to women -- breast cancer, ovarian cancer, endometriosis -- critics charge that these receive far too little research money and in some cases, hardly any at all.

But now, that is changing.

On Friday, Dr. Bernadine Healy, the new director of the National Institutes of Health (NIH), said the government would launch the most far-reaching study ever of the major causes of sickness and death in women: cancer, heart disease, osteoporosis and stroke.

Her announcement of the $500 million effort comes amid a risingchorus of demands by health groups, members of Congress and researchers that women be given more scientific scrutiny.

Dr. Healy told Congress that there has been "an important awakening to a simple fact -- namely, women have unique medical problems that need greater attention."

A report last year by the General Accounting Office helped politicize women. It found that women were being excluded from federally financed research projects -- the aspirin study was offered as a case in point -- despite an official policy requiring that they be represented.

In particular, women have rallied around the need for more research on breast cancer, a disease that now affects 1 in 9 women and kills 45,000 Americans each year.

"Women are angry. . . . They have mobilized their troops," said Sharon Green, executive director of Y-ME, a Chicago-based national advocacy organization for breast cancer patients.

"We decided we have to scream louder," said Elaine Grobman, (( director of the Philadelphia Breast Health Institute, one of a number of new groups around the country calling for more breast cancer research.

Ms. Grobman said she was struck by how few federal research dollars were spent on breast cancer compared to AIDS -- $81 million in fiscal 1990 against $1.5 billion for AIDS.

In Washington, Cindy Pearson, program director for the NationalWomen's Health Network, said: "What breast cancer activists are learning from the AIDS activists is that . . . new money does exist when society is held accountable."

Ms. Pearson said she hoped the pressure will help make breast (( cancer a major focus of medical science -- the way heart disease in men has held center stage for three decades.

Already, following the GAO report, the NIH has set up a new division, the Office of Research on Women's Health. The office is charged with making sure women are appropriately represented federally funded studies. It also will be coordinating, the study announced Friday.

The Congressional Caucus for Women's Issues, made up of men and women, has asked the GAO to undertake a second investigation -- this time looking at the Food and Drug Administration's policy of forbidding women of childbearing age to participate in early testing of new drugs.

Meanwhile, the National Cancer Institute's proposed budget for breast cancer research next year is $102 million -- up 50 percent fromfiscal 1990.

So sensitive is the women's issue that you "cannot write a research grant in 1991 unless you include women," said Dr. John R. Crouse III, a cholesterol expert at Bowman Gray Medical School in North Carolina.

Among the medical questions that women's health groups and researchers hope to resolve are:

* Does a high-fat diet put women at risk for breast cancer? While the rate of breast cancer tends to be higher in countries where diets contain a lot of fat, there is no scientific evidence to prove that a high-fat diet can cause breast cancer in humans. The National Cancer Institute is laying the groundwork for a major study of this.

* Does estrogen-replacement therapy protect older women from heart disease? While past studies show that it does some good, no large-scale, clinically controlled trial has been conducted to measure clearly its effect on preventing heart disease in women past menopause.

* Is the low-fat diet universally prescribed for both sexes to lower cholesterol actually of value for many women? Some researchers worry that a cholesterol-lowering diet could do women more harm than good because they normally have higher levels of the "good" cholesterol, known as HDL. But the diet could lower it along with the "bad" cholesterol, known as LDL.

Some doctors say a cholesterol reading of 220 -- considered risky for a man -- might not be bad for a woman if she had a high level of HDL.

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