David Bowie Makes Triumphant Comeback with New Album: PEOPLE's Critic















03/01/2013 at 08:40 PM EST



Ten years after his last album, David Bowie is back – and so is his swagger.

Forget the moody musings of "Where Are We Now?" – the reflective comeback single that he dropped, seemingly out of nowhere, on his birthday last month (Jan. 8). The Next Day – which, though not released until March 12, began streaming in its entirety on iTunes on Friday – represents much more of an emphatic, energetic return from the 66-year-old Rock and Roll Hall of Famer.

"We'll never be rid of these stars/ But I hope they live forever," sings Bowie, sounding like the immortal rock god he is over the glittering guitar-pop bounce of "The Stars (Are Out Tonight)."

It's one of many driving, guitar-charged tracks on The Next Day: You can just imagine Ziggy Stardust getting his groove on to the bouncy beat of "Dancing Out in Space," while "(You Will) Set the World on Fire" is a rocking, fist-pumping anthem for today's young Americans.

Elsewhere, "Dirty Boys" is a sleazy grinder that, with its saxed-up funkiness, harks back to his soulful periods like 1975's Young Americans. In another nod to Bowie's past, The Next Day was produced by Tony Visconti, who also worked on the star's Berlin Trilogy albums from 1977 to 1979.

On one of the standouts, the melodic, midtempo "I'd Rather Be High," the album takes a political turn with Bowie's anti-war message: "I'd rather be dead or out of my head/ Then training these guns on those men in the sand."

It's moments like these that make The Next Day a triumphant comeback from a much-missed icon.

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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.


___


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


__


Online:


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


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American Idol Reveals Its Top 20















02/28/2013 at 11:20 PM EST







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


Michael Becker/FOX


American Idol has been on the air for 12 seasons. From the early days of Kelly Clarkson, the judges continually hounded the contestants on song choice. Simon Cowell (remember him?) would criticize contestants for being "cabaret," "old-fashioned" and, worst of all, "boring." Some of this season's contestants have been watching Idol since they were in elementary school, which makes it all the more inexplicable that they still choose to sing songs like Peggy Lee's "Fever," which is 57 years old.

The show began with the 10 contestants rising from the floor, Hunger Games-style. Five of them will continue, while five of them met their end. Find out who made it through to the next round …
Spoiler Alert! The final picks for the Top 20 follow:

Cortez Shaw: His ballad arrangement of David Guetta's "Titanium" was excellent – and it was a nice change to hear a song that was current and relevant. "Your range surprised me today," judge Randy Jackson said. "When you hit those big notes, I was shocked."

Burnell Taylor: He's lost 40 lbs. since auditioning, and singing John Legend's "This Time," he brought down the house – despite oddly exaggerated hand movements. "I would pay to hear you sing," said Nicki Minaj, sharing the best compliment of the night. Mariah Carey was also pleased, simply saying, "This was fantastic."

Lazaro Arbos: After delivering an emotional performance of Keith Urban's "Tonight I Want to Cry," the 21-year-old singer from Naples, Fla., was unanimously sent through to the next round. The Cuban-born Arbos has arguably the season's most poignant backstory, with a severe stutter that vanishes when he sings. Minaj remains a big fan, telling him: "You feel it. You stay in it. Don't change nothing."

Nick Boddington: The New York City bartender performed "Say Something Now" by James Morrison and did a passable – if unremarkable – job. "I kept waiting for the feeling of being connected to you as a person," said Urban. Carey agreed, saying, "I needed to feel you more connected to the song."

Vincent Powell: Singing Lenny Williams's "'Cause I Love You," he effortlessly broke into a falsetto that elicited cheers from the audience. After calling him a "sexy old-fashioned" singer, Minaj added, "I could envision a whole bunch of 50-year-olds throwing their panties at you." Powell, who works his day job as a church worship leader, laughed nervously.

And yes, it was guys' night, but finalist Zoanette Johnson made a cameo when she stood up and cheered Powell's performance, prompting host Ryan Seacrest to run over with a microphone. (For a brief moment, It felt like a '90s-era episode of Ricki Lake, which is actually a very good thing.) "Get it, Papa Smurf," Johnson screamed. "You go get it."

Leave it to Zoanette to steal the show on guy's night.

Tonight's finalists will join Charlie Askew, Curtis Finch Jr., Paul Jolley, Elijah Liu and Devin Velez – and 10 female finalists – to sing for America's votes next week.

Who are you rooting for?

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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.


___


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


__


Online:


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


Read More..

American Idol Reveals Its Top 10 Women






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.

Read More..

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.


___


On the Web:


The OIG report: http://1.usa.gov/VaztQm


The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1


___


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


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World powers and Iran set new talks in nuclear dispute


ALMATY (Reuters) - Six world powers ended two days of talks with Iran on its nuclear program without a breakthrough on Wednesday, but agreed to meet in Istanbul next month and resume negotiations in Kazakhstan on April 5.


The six powers - France, Germany, the United States, China Russia and Britain - offered at the talks to lift some sanctions if Iran scaled back nuclear activity that the West fears could be used to build a bomb.


Tehran, which denies seeking nuclear weapons, did not agree to do so and the sides did not appear any closer to an agreement to resolve a decade-old dispute that could lead to another war in the Middle East if diplomacy fails.


But Iran said the talks were a positive step in which the six powers tried to "get closer to our viewpoint", and Western diplomats had set their sights low, making clear that an agreement to meet again soon would be deemed a success.


In particular, they are aware that the closeness of Iran's presidential election in June is raising political tensions in Tehran and makes significant concessions unlikely.


"I hope the Iranian side is looking positively on the proposal we put forward," said European Union foreign policy chief Catherine Ashton, who led the talks on behalf of the six powers. "We have to see what happens next."


Israel, assumed to be the only country in the Middle East with nuclear weapons, has hinted strongly that it could attack Iran's nuclear sites if diplomacy and sanctions do not stop its enrichment of uranium to near weapons-grade.


MORE MEETINGS SCHEDULED


One diplomat in Almaty said the Iranians appeared to be suggesting at the talks that they were opening new avenues, but that it was not clear if this was really the case.


Both sides said experts would meet for talks in the Turkish city of Istanbul on March 18 and that political negotiators would return to Almaty on April 5-6.


The meeting in the Kazakh city was the first between the world powers and Iran in eight months.


Russian negotiator Sergei Ryabkov confirmed that the six powers had offered to ease sanctions on Iran if it stops enriching uranium to 20 percent fissile purity - a short technical step from weapons grade - at an underground site where it carries out its most controversial uranium enrichment work.


Western officials said the offer of sanctions relief included a resumption of trade in gold and precious metals and lifting an embargo on imports of petrochemical products if Iran responded. But a U.S. official said the world powers had not offered to suspend oil or financial sanctions.


The sanctions are hurting Iran's economy and its chief nuclear negotiator, Saeed Jalili, suggested Iran could discuss its production of nuclear fuel, although he appeared to rule out closing the underground enrichment plant at Fordow.


In comments in Persian translated into English, Jalili told a news conference Fordow was under the supervision of the U.N. nuclear watchdog and there was no justification for closing it.


"RIGHT TO ENRICHMENT"


Asked about the production of 20-percent enriched fuel, he reiterated Iran's position that it needed this for a research reactor and had a right to produce it.


Iran says its enrichment program is aimed solely at producing nuclear energy so that it can export more oil, and that Israel's assumed nuclear arsenal is the main threat to peace in the region.


But Jalili did indicate that Iran might be prepared to discuss the issue, saying: "This can be discussed in the negotiations ... in view of confidence building."


Iran has also previously suggested that 20-percent enrichment was up for negotiation if it received the fuel from abroad instead. It also wants sanctions lifted.


"While an agreement to meet again may not impress skeptics of diplomacy, an important development did occur," said Trita Parsi, an expert on Iran. "The parties began searching for a solution by offering positive measures in order to secure concessions from the other side.


"In past meetings, the approach centered on coercion - the main motivator for concessions was the threat of new sanctions and other escalatory steps."


Ali Vaez of the International Crisis group said the powers had broken a taboo by discussing sanctions relief.


Another expert, Dina Esfandiary of the International Institute for Strategic Studies, said: "I note that the mood is more optimistic and that's great, but a deal still hasn't been reached and in my view its unlikely to be reached before the Iranian elections have come and gone."


(Additional reporting by Yeganeh Torbati in Almaty, Zahra Hosseinian in Zurich, Gabriela Baczynska in Moscow, Dan Williams in Jerusalem and Marcus George in Dubai; Writing by Timothy Heritage and Fredrik Dahl; Editing by Kevin Liffey)



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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."


____


Online:


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


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


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Stock index futures signal mixed open

LONDON (Reuters) - Stock index futures pointed to a mixed Wall Street open on Wednesday, with futures for the S&P 500 and Nasdaq 100 indexes slipping 0.1 percent, while futures for the Dow Jones rose 0.1 percent by 0933 GMT.


U.S. durables goods and homes data due out at 1330 and 1500 GMT respectively should provide further clues on the health of the world's largest economy.


The Pentagon program chief for the F-35 warplane slammed its commercial partners Lockheed Martin and Pratt & Whitney on Wednesday, accusing them of trying to "squeeze every nickel" out of the U.S. government and failing to see the long-term benefits of the project.


Pratt & Whitney is 99 percent sure the fan blade problem that grounded the Pentagon's 51 new F-35 fighter jets was not caused by high-cycle fatigue, which could force a costly design change, according to two sources familiar with an investigation by the enginemaker.


Airbus parent EADS predicted higher profit this year on the heels of stronger than expected 2012 earnings and a clampdown on costs, with the development of its A350 jet remaining the biggest wild card in its bid to match rival Boeing .


Partner Communications , Israel's second-largest mobile phone operator, reported weaker-than-expected quarterly profit and said it could have weak earnings throughout 2013 due to fierce competition that has slashed calling rates.


The pan-European FTSEurofirst 300 index <.fteu3> was up 0.1 percent at 1,151.69 points by 1010 GMT on Wednesday while the euro zone's Euro STOXX 50 index <.stoxx50e> also advanced 0.1 percent, although concerns over Italy's political stalemate were likely to cap gains.


The Dow Jones industrial average <.dji> gained 115.96 points, or 0.84 percent, to 13,900.13 at the close on Tuesday. The Standard & Poor's 500 Index <.spx> rose 9.09 points, or 0.61 percent, to 1,496.94. The Nasdaq Composite Index <.ixic> advanced 13.40 points, or 0.43 percent, to close at 3,129.65.


(Reporting by Sudip Kar-Gupta; Editing by Susan Fenton)



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