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Trial: Less Frequent Mammograms Pose No Greater Risk After Breast Cancer
Globally, the frequency of mammograms for women who have undergone breast cancer treatment varies after they're recurrencefree. Although annual surveillance is widely practiced in the Us, less regular mammography poses no greater risk, according to a randomized clinical trial published in The Lancet.
The trial was carried out in UK hospitals among women who were diagnosed with breast cancer at age 50 years or older and who had been recurrence-free for 3 years following curative surgery. The approximately 5200 participants were randomly assigned to receive mammograms either every year or less often: every 2 years if they'd had a lumpectomy and every 3 years if they'd had a mastectomy.
At 5 years, the breast cancer-specific survival rate was 9 8 % for both groups, and the overall survival rate was 9 5 %
The similarity of the results between the 2 groups demonstrates that more regular mammograms don't seem to lead to better health outcomes, the authors noted. They added that the findings could lessen the burden of annual mammography on health care systems and patients seeking to avoid increased radiation exposure, anxiety, and out-of-pocket costs.
Published Online: March 7, 2025
doi:10.1001/jama.2025.1346
Sudan Virus Disease Outbreak in Uganda Spurs First-Ever Ebola Vaccine Trial
The World Health Organization (WHO) reported an outbreak of Sudan virus disease (SVD) in Uganda following confirmation in late January that an adult male nurse had contracted the illness. The health care worker presented with fever-like symptoms and died from multiorgan failure about a week later. As of February 20, 9 confirmed cases of SVD have been reported in the current outbreak.
The viral hemorrhagic fever disease, which belongs to the same family as the Ebola virus disease, has had a high case fatality rate between 4 1 % and 70 % SVD is characterized by acute onset of fever and nonspecific symptoms, with severe illness including unexplained bleeding, brain dysfunction, hypotension, and organ failure. In the absence of licensed vaccines and therapeutics for prevention and treatment, the risk of serious public health impact is high. WHO warned.
Within 4 days of the first confirmed case, the Ministry of Healthof Uganda, WHO, and other partners launched the first-ever clinical efficacy trial for a vaccine against Ebola disease due to Sudan virus. Distribution of the recombinant vesicular stomatitis candidate vaccine will begin with close contacts of the reported case, following a ring vaccination strategy of prevention.
As a precaution, the US Centers for Disease Control and Prevention has issued a level 2 travel advisory for Uganda, encouraging visitors to exercise enhanced precautions and monitor themselves for SVDsymptoms while in the country and for up to 3 weeks after departure.
Published Online: March 7, 2025. doi:10.1001/jama.2025.1347
Headaches Correlated With Increased Suicide Risk, Study Finds
Headaches, a common malady for many adults, can cause such excruciating pain and impaired daily functioning that they may increase the odds of attempting suicide, a study has found.
The population-based cohort study of about 717 000 Danish citizens conducted from 1995 to 2020 found that those who were diagnosed with headaches were more likely than their matched counterparts to attempt or complete suicide. Over 15 years, the absolute risk of attempted suicide was 0 . 7 8 % in those who experienced headaches compared with 0 . 3 3 % in those who did not.
The study, published inJAMA Neurology. matched individuals aged 15 years or older who were diagnosed with headaches to those without a headache diagnosis by sex and birth year in a 5:1 ratio. Elevated risk of suicide was consistent across headache types, including migraine, tension headaches, posttraumaticheadache disorder, and trigeminal autonomic cephalalgia.
The seriousness of the findings and the high prevalence of headache disorders highlight the importance of early detection, effective headache treatment, and behavioral health interventions for affected patients, the authors stated.
Published Online: March 7,2025. doi:10.1001/jama.2025.1348
PAHO Warns of Dengue Outbreak Risk as DENV-3 Spreads in the Americas
In 2024, cases of the mosquito-borne viral disease dengue hit historic highs throughout the Americas. The virus remains a threat in 2025, with more than 477 000 suspected cases already reported in the region as of February 20. The Pan American Health Organization (PAHO) also has issued an epidemiological alert based on growing circulation of 1 of dengue's 4 distinct serotypes, DENV-3, in the region.
Argentina, Brazil, Mexico, and Peru are among the nations currently reporting DENV-3 circulation. According to the alert, such a reappearance of a serotype that has not been in circulation over the past decade increases the probability of severe cases.
Although the TAK-003 vaccine is meant to protect against all dengue serotypes, research has shown that it is less effective against DENV-3. In the absence of a US Food and Drug Administration-approved treatment for the virus, the National Institutes of Health has launched a clinical trial to test the efficacy of the investigational monoclonal antibody AV-1 on symptom mitigation.
In the meantime, PAHO has urged coun tries in the southern hemisphere of the Americas "to strengthen their surveillance, early diagnosis, and clinical management" as they prepare for a possiblerise in cases. Most people with dengue don't develop symptoms, but those who do may experience body aches, severe headaches, nausea, fever, and rash, with severe illness progressing to shock, internal bleeding, and death.
Published Online: March 7,2025. doi:10.1001/jama.2025.1349
Salt Substitute Cuts Risk of Recurrent Stroke, Death
Lowering dietary sodium is shown to help reduce blood pressure and prevent stroke. But for people who crave the taste of salt, new research suggests that replacing it with a 2 5 % potassium chloride substitute might provide these benefits to individuals with a history of stroke.
In a randomized clinical trial, the cumulative recurrencerate of stroke was 1 7 % over an average follow-up of about 5 years for those who used the salt substitute vs 1 9 % for those consuming regular salt, a relative reduction of 14 % . Cutting sodium and supplementing potassium lowers blood pressure without increasing hyperkalemia risk, the authors stated.
The trial, published in JAMA Cardiology. involved about 15 200 patients with a historyof strokethroughout northern China. In addition to a lower incidence of stroke, the salt substitute was also associated with a 12 % relativereduction inall-cause mortality (with the death rate at 20 % for those using a salt substitute vs 2 2 % for those ingesting regular salt), with the most pronounced reduction in absolute risk for deaths from vascular causes.
The researchers noted that salt substitutes are only slightly more expensive than conventional salt and have only minor flavor differences, presenting a low-cost intervention with potentially large health gains.
Published Online: March 7, 2025
doi:10.1001/jama.2025.1350
Study Finds Modest Link Between Semaglutide and a Type of Vision Impairment
As glucagon-like peptide-1 (GLP-1) receptor agonists continue to rise in popularity as a treatment option for individuals with type 2 diabetes (T2D), their potential connectionto vision problems has raised concern. A study published in JAMA Ophthalmology suggests that there is an increased risk of nonarteritic anterior ischemic optic neuropathy (NAION) with semaglutide use in people with T2D.
Individuals with NAION experience sudden vision loss in 1 eye due to a lack of blood flow to the optic nerve, with vision loss rarely improving after the initial event. (Semaglutide treatment results in a rapid correction of hyperglycemia, which could be associated with NAION and other eye problems, the authors of a separate study in JAMA Ophthalmology proposed.)
In the retrospective study of more than 37 million individuals with T2D, the risk of NAION for people taking semaglutide was considered modest, higher only compared with patients taking empagliflozin, a nonGLP-1 medication.
Still, the risk is smaller than previously reported, the authors noted. They wrote that this warrants further investigation into how the association between semaglutide use and NAION in people with T2D extends to other GLP-1 drugs. - Samantha Anderer
Published Online: March 7, 2025. doi:10.1001/jama.2025.1351
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