New research suggests that mammography, the low dose x-ray procedure that helps doctors diagnose small tumors in the breast, might frequently pick up tumors that will go away on their own. Scientists in Norway tracked two populations of over 100,000 women between the ages of 50 and 64. One group received mammograms every two years while those in the other group had a single mammogram at the end of the six-year study. The incidence of invasive breast cancer (the type of cancer that has spread beyond the milk ducts and into the surrounding tissue) was 22% higher in the frequent screening group. This finding led researchers to speculate that mammograms had detected cancers that would have regressed if the women had received no treatment. Otherwise they would expect the two groups, which had parallel risk factors, to have similar breast cancer incidence.

Without further research, it is unclear how often mammograms detect cancers that spontaneously regress. But if it happens as often as this study suggests, then doctors will have to spend more time thinking about how one can distinguish between a cancer that is likely to regress on its own and one that could progress and threaten a woman’s life. Should women endure surgeries, radiation and chemotherapy for cancers that could potentially disappear with no treatment at all?

If some 20% of cancers picked up in mammograms actually do regress within six years, it seems risky to assume they would disappear forever. Perhaps, in a decade or two, some of these tumors could return more aggressive than ever. Or if these cancers do vanish indefinitely, understanding what prevents them from mustering a full-fledged assault on the body might help scientists develop new treatment strategies.

Undoubtedly, this article raises a host of interesting research questions. But where does the scientist begin? I think we need longer term studies comparing groups of women receiving frequent and infrequent mammograms in order to determine if the incidence rates remain disparate beyond six years. What do you think should be on the agenda for future studies?

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A study presented at this month’s conference of the European Research Organization on Genital Infection and Neoplasia provided evidence that a widely-marketed cervical cancer vaccine might also stave off genital warts in young men. Gardasil, which immunizes women against the cancer-causing human papillomavirus (HPV), is also 90% effective in shielding young men from developing genital lesions caused by the four HPV strains it targets, scientists reported. The study was funded by the vaccine’s maker, Merck.

Health agencies in Australia and other countries have already approved Gardasil use for both males and females, but the US government has only cleared the vaccine for use in females. Merck is now seeking US Food and Drug Administration (FDA) approval for Gardasil’s use in preventing genital lesions among males ages 9 to 26.

Thwarting genital warts is an obvious boon—and there are other compelling arguments for extending Gardasil’s use to young men. HPV plays a role in oral, neck and other types of cancers affecting males. Furthermore, vaccinating boys might potentially curb the spread of the virus to young women, thereby reducing the burden of cervical cancer—the fifth deadliest cancer among women worldwide. And isn’t it only fair to vaccinate men and women for a disease both are responsible for spreading?

The idea may sound appealing, but concerns remain about Gardasil’s value—even for girls. And some reports have suggested that the vaccine might, in very rare circumstances, trigger serious illness among certain people. Additionally, exactly how long the immunity conferred by the vaccine lasts is unknown. Experts point out that the average follow-up time for patients in Gardasil’s clinical trials was about 15 months. There is also the argument that the vaccine, which costs about $375, may not be cost-effective for all of its target age groups.

Given the unresolved questions about Gardasil use in women, I think we should think twice about broadening its application to men at this time. What do you think?

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When will I hit menopause? How many more years will I be able to get pregnant? Many women ask themselves these questions, especially if they are planning to combine a family life with a professional career.

Scientists are trying to help women find answers. MaryFran Sowers and her colleagues from the University of Michigan in Ann Arbor are using a range of variables, including age and hormone levels, to predict the time window in which a woman is likely to hit menopause. The method they have developed has been published but is far from being packaged into a commercial test. Meanwhile, at least one European company is already selling a mail-order fertility kit: the PlanAhead Fertility Test, which according to the company can estimate the number of eggs remaining in the ovaries based on hormone concentrations.

This idea of precisely predicting menopause is appealing, but a one-size-fits-all test may not work for every woman, cautions Sowers. Factors such as obesity, diabetes and smoking might affect a woman’s fertility and the age she reaches menopause. Sowers is now beginning to study these special subpopulations.

There are clear benefits to knowing when menopause is coming. A woman who knows she is likely to soon lose the cardiovascular and bone benefits of reproductive hormones might be motivated to cut saturated fats and cholesterol from her diet, for example. But there may be instances in which knowing the future could lead to risky decisions. Suppose a woman takes a menopause predictor test and learns that she isn’t likely to reach menopause until age 55. She may delay childbearing until age 40, when her chances of developing gestational diabetes and placental problems are significantly higher. Research also shows that women over 40 are about 40% more likely than younger women to deliver early, and premature babies face a higher risk of developing chronic lung disease and other health problems. Will menopause tests lead to more high risk pregnancies?

For more of the latest news on fertility and reproduction, please see Nature Medicine’s November special on reproductive medicine.

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