The report, which was compiled by the California Environmental Protection Agency, estimates that each year in the United States, there are between 35,000 and 62,000 deaths from coronary heart disease related to secondhand smoke. The report includes 18 epidemiologic studies that link secondhand smoke to coronary heart disease. The report is also being made available to each state health department by the Centers for Disease Control and Prevention. While gains have been made in the diagnosis and treatment of breast cancer, there has been little success in its prevention. Recently, the Breast Cancer Prevention Trial, which began in 1992, found that the use of tamoxifen in women at high risk of developing breast cancer was associated with a 49 percent reduction in the occurrence of primary disease.
Tamoxifen arrests the growth of breast cancer tumor cells.
For 25 years, tamoxifen has been used to treat women with advanced breast cancer. The usefulness of tamoxifen in the possible prevention of breast cancer was suggested by several studies. Tamoxifen has several side effects, including increased risk of endometrial cancer, pulmonary embolism, deep venous thrombosis and cataracts. Also, little is known about long-term effects of treatment with tamoxifen. According to the ACOG committee, the decision to use tamoxifen should be made on an individual basis after considering patients' medical histories, risk assessments and preferences, and informing patients of the risks and possible side effects of the drug.