'Dallas' star Larry Hagman dies in Texas

J.R. Ewing was a business cheat, faithless husband and bottomless well of corruption. Yet with his sparkling grin, Larry Hagman masterfully created the charmingly loathsome oil baron — and coaxed forth a Texas-size gusher of ratings — on television's long-running and hugely successful nighttime soap, "Dallas."

Although he first gained fame as nice guy Major Tony Nelson on the fluffy 1965-70 NBC comedy "I Dream of Jeannie," Hagman earned his greatest stardom with J.R. The CBS serial drama about the Ewing family and those in their orbit aired from April 1978 to May 1991, and broke viewing records with its "Who shot J.R.?" 1980 cliffhanger that left unclear if Hagman's character was dead.

The actor, who returned as J.R. in a new edition of "Dallas" this year, had a long history of health problems and died Friday due to complications from his battle with cancer, his family said.

"Larry was back in his beloved hometown of Dallas, re-enacting the iconic role he loved the most. Larry's family and closest friends had joined him in Dallas for the Thanksgiving holiday," the family said in a statement that was provided to The Associated Press by Warner Bros., producer of the show.

The 81-year-old actor was surrounded by friends and family before he passed peacefully, "just as he'd wished for," the statement said.

Linda Gray, his on-screen wife and later ex-wife in the original series and the sequel, was among those with Hagman in his final moments in a Dallas hospital, said her publicist, Jeffrey Lane.

"He brought joy to everyone he knew. He was creative, generous, funny, loving and talented, and I will miss him enormously. He was an original and lived life to the fullest," the actress said.

Years before "Dallas," Hagman had gained TV fame on "I Dream of Jeannie," in which he played an astronaut whose life is disrupted when he finds a comely genie, portrayed by Barbara Eden, and takes her home to live with him.

Eden recalled late Friday shooting the series' pilot "in the frigid cold" on a Malibu beach.

"From that day, for five more years, Larry was the center of so many fun, wild and sometimes crazy times. And in retrospect, memorable moments that will remain in my heart forever," Eden said.

Hagman also starred in two short-lived sitcoms, "The Good Life" (NBC, 1971-72) and "Here We Go Again" (ABC, 1973). His film work included well-regarded performances in "The Group," ''Harry and Tonto" and "Primary Colors."

But it was Hagman's masterful portrayal of J.R. that brought him the most fame. And the "Who shot J.R.?" story twist fueled international speculation and millions of dollars in betting-parlor wagers. It also helped give the series a place in ratings history.

When the answer was revealed in a November 1980 episode, an average 41 million U.S. viewers tuned in to make "Dallas" one of the most-watched entertainment shows of all time, trailing only the "MASH" finale in 1983 with 50 million viewers.

It was J.R.'s sister-in-law, Kristin (Mary Crosby) who plugged him — he had made her pregnant, then threatened to frame her as a prostitute unless she left town — but others had equal motivation.

Hagman played Ewing as a bottomless well of corruption with a charming grin: a business cheat and a faithless husband who tried to get his alcoholic wife, Sue Ellen (Gray), institutionalized.

"I know what I want on J.R.'s tombstone," Hagman said in 1988. "It should say: 'Here lies upright citizen J.R. Ewing. This is the only deal he ever lost.'"

On Friday night, Victoria Principal, who co-starred in the original series, recalled Hagman as "bigger than life, on-screen and off. He is unforgettable, and irreplaceable, to millions of fans around the world, and in the hearts of each of us, who was lucky enough to know and love him."

Ten episodes of the new edition of "Dallas" aired this past summer and proved a hit for TNT. Filming was in progress on the sixth episode of season two, which is set to begin airing Jan. 28, the network said.

There was no immediate comment from Warner or TNT on how the series would deal with Hagman's loss.

In 2006, he did a guest shot on FX's drama series "Nip/Tuck," playing a macho business mogul. He also got new exposure in recent years with the DVD releases of "I Dream of Jeannie" and "Dallas."

Dallas Mayor Mike Rawlings said Saturday morning in a statement that Hagman's role as J.R. helped the city gain "worldwide recognition."

"Larry is a North Texas jewel that was larger than life and he will be missed by many in Dallas and around the world," Rawlings said.

The Fort Worth, Texas, native was the son of singer-actress Mary Martin, who starred in such classics as "South Pacific" and "Peter Pan." Martin was still in her teens when he was born in 1931 during her marriage to attorney Ben Hagman.

As a youngster, Hagman gained a reputation for mischief-making as he was bumped from one private school to another. He made a stab at New York theater in the early 1950s, then served in the Air Force from 1952-56 in England.

While there, he met and married young Swedish designer Maj Axelsson. The couple had two children, Preston and Heidi, and were longtime residents of the Malibu beach colony that is home to many celebrities.

Hagman returned to acting and found work in the theater and in such TV series as "The U.S. Steel Hour," ''The Defenders" and "Sea Hunt." His first continuing role was as lawyer Ed Gibson on the daytime serial "The Edge of Night" (1961-63).

He called his 2001 memoir "Hello Darlin': Tall (and Absolutely True) Tales about My Life."

"I didn't put anything in that I thought was going to hurt someone or compromise them in any way," he told The Associated Press at the time.

Hagman was diagnosed in 1992 with cirrhosis of the liver and acknowledged that he had drank heavily for years. In 1995, a malignant tumor was discovered on his liver and he underwent a transplant.

After his transplant, he became an advocate for organ donation and volunteered at a hospital to help frightened patients.

"I counsel, encourage, meet them when they come in for their operations, and after," he said in 1996. "I try to offer some solace, like 'Don't be afraid, it will be a little uncomfortable for a brief time, but you'll be OK.' "

He also was an anti-smoking activist who took part in "Great American Smoke-Out" campaigns.

Funeral plans had not been announced as of Saturday morning.

"I can honestly say that we've lost not just a great actor, not just a television icon, but an element of pure Americana," Eden said in her statement Friday night. "Goodbye, Larry. There was no one like you before and there will never be anyone like you again."

___

Associated Press writers Erin Gartner in Chicago and Shaya Mohajer in Los Angeles, and AP Television Writer Frazier Moore in New York contributed to this report.

Read More..

AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

Read More..

Tourists visit Texas ranch to remember 'Dallas' star Larry Hagman

PARKER, Texas (AP) — Tourists and locals flocked to Southfork Ranch on Saturday, bringing flowers in memory of Larry Hagman, who played the infamous J.R. Ewing on the TV show "Dallas."

Hagman died in Dallas on Friday at age 81 due to complications from his battle with cancer.

Southfork, a ranch north of Dallas, was known to millions of viewers as the Ewing family home. Exterior shots of the house and pool were shown when the series aired from 1978 to 1991, although the show wasn't filmed there.

The ranch has been open for tours since the mid-1980s, and now sees more than 100,000 visitors each year. Each room of the house has a theme for each character.

On Saturday, J.R. Ewing's room had flowers and a card for tourists to sign.

"Today is about Larry Hagman and his family," said Janna Timm, a Southfork Ranch & Hotel spokeswoman. "He was such a wonderful person, and we will really miss him."

"Dallas" was recently revived on TNT this summer, and all of the scenes were filmed at Southfork or other places in the Dallas area. Hagman had revised his role as the scheming oilman who would even double-cross his own son.

Linda Sproule of Peterborough, Ontario, had been traveling through the U.S. the past couple of weeks and heard about Hagman's death Friday while in Dallas. She said she didn't know where Southfork was but wanted to come because she was a fan of the show in the 1980s.

"I remember on Friday nights we watched it, and J.R. was bigger than life in some ways," she said after taking the Southfork tour Saturday morning. "This ranch is beautiful. Being here is kind of emotional in a way."

Barbara Quinones and her husband were in town for their daughter's soccer tournament and had already planned to visit Southfork when they heard news of Hagman's death.

"We loved him because he was so ruthless," said Quinones, of Albuquerque, N.M. "This is a sad day, but I'm glad we're here."

Some of the show's stars, including Hagman, came to Southfork for the series' 25th anniversary. The Fort Worth-born actor also had visited several times before the show was revived.

"He was definitely a gentleman, a class act," said Jim Gomes, vice president of resorts at Southfork Ranch & Hotel. "He loved the fans as much as they loved him."

Read More..

Beijing's S. China Sea rivals protest passport map

TAIPEI, Taiwan (AP) — China has enraged several neighbors with a few dashes on a map, printed in its newly revised passports that show it staking its claim on the entire South China Sea and even Taiwan.

Inside the passports, an outline of China printed in the upper left corner includes Taiwan and the sea, hemmed in by the dashes. The change highlights China's longstanding claim on the South China Sea in its entirety, though parts of the waters also are claimed by the Philippines, Vietnam, Taiwan, Brunei and Malaysia.

China's official maps have long included Taiwan and the South China Sea as Chinese territory, but the act of including them in its passports could be seen as a provocation since it would require other nations to tacitly endorse those claims by affixing their official seals to the documents.

Ruling party and opposition lawmakers alike condemned the map in Taiwan, a self-governed island that split from China after a civil war in 1949. They said it could harm the warming ties the historic rivals have enjoyed since Ma Ying-jeou became president 4 1/2 years ago.

"This is total ignorance of reality and only provokes disputes," said Taiwan's Mainland Affairs Council, the Cabinet-level body responsible for ties with Beijing. The council said the government cannot accept the map.

Philippine Foreign Secretary Albert del Rosario told reporters in Manila that he sent a note to the Chinese Embassy that his country "strongly protests" the image. He said China's claims include an area that is "clearly part of the Philippines' territory and maritime domain."

The Vietnamese government said it had also sent a diplomatic note to the Chinese Embassy in Hanoi, demanding that Beijing remove the "erroneous content" printed in the passport.

In Beijing, the Foreign Ministry said the new passport was issued based on international standards. China began issuing new versions of its passports to include electronic chips on May 15, though criticism cropped up only this week.

"The design of this type of passports is not directed against any particular country," Chinese Foreign Ministry spokeswoman Hua Chunying said at a daily media briefing Friday. "We hope the relevant countries can calmly treat it with rationality and restraint so that the normal visits by the Chinese and foreigners will not be unnecessarily interfered with."

It's unclear whether China's South China Sea neighbors will respond in any way beyond protesting to Beijing. China, in a territorial dispute with India, once stapled visas into passports to avoid stamping them.

"Vietnam reserves the right to carry out necessary measures suitable to Vietnamese law, international law and practices toward such passports," Vietnamese foreign ministry spokesman Luong Thanh Nghi said.

Taiwan does not recognize China's passports in any case; Chinese visitors to the island have special travel documents.

China maintains it has ancient claims to all of the South China Sea, despite much of it being within the exclusive economic zones of Southeast Asian neighbors. The islands and waters are potentially rich in oil and gas.

There are concerns that the disputes could escalate into violence. China and the Philippines had a tense maritime standoff at a shoal west of the main Philippine island of Luzon early this year.

The United States, which has said it takes no sides in the territorial spats but that it considers ensuring safe maritime traffic in the waters to be in its national interest, has backed a call for a "code of conduct" to prevent clashes in the disputed territories. But it remains unclear if and when China will sit down with rival claimants to draft such a legally binding nonaggression pact.

The Philippines, Brunei, Malaysia and Vietnam are scheduled to meet Dec. 12 to discuss claims in the South China Sea and the role of China.

___

Associated Press writers Oliver Teves in Manila, Philippines, Chris Brummitt in Hanoi, Vietnam, and researcher Zhao Liang in Beijing contributed to this report.

Read More..

Marc Anthony comes to aid of Dominican orphanage

SANTO DOMINGO, Dominican Republic (AP) — Singer Marc Anthony is coming to the aid of an orphanage in the Dominican Republic.

A foundation run by Anthony with music and sports producer Henry Cardenas plans to build a new residence hall, classrooms and a baseball field for the Children of Christ orphanage in the eastern city of La Romana. Anthony attended the groundbreaking ceremony Friday with his model girlfriend Shannon de Lima.

Children of Christ Foundation Director Sonia Hane said Anthony visited the orphanage previously and decided to help. His Maestro Cares Foundation raised $200,000 for the expansion on land donated by a sugar company. The orphanage was founded in 1996 for children who were abused or abandoned or whose parents were unable to care for them.

Read More..

AP PHOTOS: Simple surgery heals blind Indonesians

PADANG SIDEMPUAN, Indonesia (AP) — They came from the remotest parts of Indonesia, taking crowded overnight ferries and riding for hours in cars or buses — all in the hope that a simple, and free, surgical procedure would restore their eyesight.

Many patients were elderly and needed help to reach two hospitals in Sumatra where mass eye camps were held earlier this month by Nepalese surgeon Dr. Sanduk Ruit. During eight days, more than 1,400 cataracts were removed.

The patients camped out, sleeping side-by-side on military cots, eating donated food while fire trucks supplied water for showers and toilets. Many who had given up hope of seeing again left smiling after their bandages were removed.

"I've been blind for three years, and it's really bad," said Arlita Tobing, 65, whose sight was restored after the surgery. "I worked on someone's farm, but I couldn't work anymore."

Indonesia has one of the highest rates of blindness in the world, making it a target country for Ruit who travels throughout the developing world holding free mass eye camps while training doctors to perform the simple, stitch-free procedure he pioneered. He often visits hard-to-reach remote areas where health care is scarce and patients are poor. He believes that by teaching doctors how to perform his method of cataract removal, the rate of blindness can be reduced worldwide.

Cataracts are the leading cause of blindness globally, affecting about 20 million people who mostly live in poor countries, according to the World Health Organization.

"We get only one life, and that life is very short. I am blessed by God to have this opportunity," said Ruit, who runs the Tilganga Eye Center in Katmandu, Nepal. "The most important of that is training, taking the idea to other people."

During the recent camps, Ruit trained six doctors from Indonesia, Thailand and Singapore.

Here, in images, are scenes from the mobile eye camps:

Read More..

Egypt president's moves worry Washington

WASHINGTON (Reuters) - The United States is concerned about Egyptian President Mohamed Mursi's decision to assume sweeping powers, the U.S. State Department said on Friday.

Mursi on Thursday issued a decree that puts his decisions above legal challenge until a new parliament is elected, causing angry protests by his opponents and violent clashes in central Cairo and other cities on Friday.

Mursi's aides said the decree was intended to speed up a protracted transition that has been hindered by legal obstacles, but rivals condemned Mursi as an autocratic "pharaoh" who wanted to impose his Islamist vision on Egypt.

U.S. Secretary of State Hillary Clinton met Mursi in Cairo on Wednesday and thanked him for his mediation efforts to establish a ceasefire between Israel and the Islamist Hamas movement ruling the Gaza Strip.

"The decisions and declarations announced on November 22 raise concerns for many Egyptians and for the international community," State Department spokeswoman Victoria Nuland said in a statement.

"The current constitutional vacuum in Egypt can only be resolved by the adoption of a constitution that includes checks and balances, and respects fundamental freedoms, individual rights, and the rule of law consistent with Egypt's international commitments.

"We call for calm and encourage all parties to work together and call for all Egyptians to resolve their differences over these important issues peacefully and through democratic dialogue."

Egyptian police on Friday fired teargas near Cairo's Tahrir Square, the heart of the 2011 uprising that toppled former President Hosni Mubarak. Thousands demanded Mursi quit and accused him of launching a "coup". There were also violent protests in Alexandria, Port Said and Suez.

Mubarak was an ally of the United States for decades. His downfall has thrown into doubt the United States' long-standing reliance on Egypt, the first Arab state to make peace with Israel, as a strategic partner in the region.

Clinton said on Wednesday: "Egypt's new government is assuming the responsibility and leadership that has long made this country a cornerstone for regional stability and peace."

(Reporting by Arshad Mohammed; Editing by Mohammad Zargham)

Read More..

US troops in Afghanistan celebrate Thanksgiving

KABUL, Afghanistan (AP) — It was Army Sgt. Keith Wells' first Thanksgiving Day away from his family and despite a cornucopia of food provided for the troops, his taste buds were craving his wife's macaroni and cheese back home.

"My wife's a foodie — you know the Food Network, cooking shows. Everything she makes is golden," Wells of Charlotte, N.C., said Thursday at a large international military base in the Afghan capital, Kabul.

The dining hall served up mac-and-cheese along with traditional Thanksgiving Day fixings. Wells was thankful for the good food, but he still missed his wife's home-cooking.

Huge hunks of beef greeted the estimated 2,500 diners as soldiers lined up in the dining hall. Red-white-and-blue decorations filled the room. Brochures titled "Learn about combat stress" served as table centerpieces.

There was roast turkey, sliced turkey, ham and rib-eye steaks. The troops were served steaming side dishes of dressing, corn, collard greens, yams and mashed potatoes and gravy that some lapped up with spoons. For dessert, there was a massive cake with a turkey etched in icing, pumpkin spice cookies and scores of pies.

A short walk from the dining hall, service members were playing a modified version of American football.

Parts of the scene could have come from a snapshot of any U.S. city: American guys in sweats tossing the pigskin, a scoreboard, a coin toss to start the game.

But on this military base, concrete barriers surrounded the field. The referees wore camouflaged shirts and the spectators carried rifles. The artificial turf was frayed and so dusty that when one player spiked the football, a puff of dirt rose from the field.

The players used a regulation football, but the game was a mix of football, soccer and rugby to fit the short field.

Some soldiers commented about the 11-year-old war that has claimed the lives of 2,029 American service members.

Army Chief Warrant Officer 4 Chuck Minton of Monroe, Ga., who has traveled extensively across Afghanistan, was optimistic. "It's been progressing here, getting better. The Afghans have taken over more missions," Minton said.

President Barack Obama pulled 10,000 troops out of Afghanistan in 2011 and 23,000 more this year, leaving about 66,000 American service members still deployed in the country. Nearly all international combat troops are to withdraw by the end of 2014 when Afghan forces will be fully in charge of securing the nation.

Army Maj. Rodney Gehrett of Colorado Springs, Colo., said he was surprised that the war was barely mentioned during the last U.S. presidential election — evidence that some Americans had tuned out the news from the front line a half a world away.

"The war in Afghanistan wasn't even brought up as a topic of conversation" during the election, Gehrett said. "It was a little surprising to me. Hopefully, that will change and people will realize that we still have troops here and they are fighting every day."

Army Sgt. Adam Draughn of Denver, Colo., said some people back home have the impression that the Afghan people don't want American troops in their country.

"Honestly, I think the biggest misconception in my opinion is that, you know, we actually are loved here," Draughn said. "The nationals do care about us. They do want us here to help them. We're not here uninvited."

Most of the holiday chatter, however, was focused on family.

Taking a break from the game, Army Capt. Robert Mikyska of North Aurora, Ill., pulled out a photocopied photo that was taken of he and his wife just before he deployed to Afghanistan nine months ago.

"Hi, honey!" Mikyska said, looking at the picture. "In a couple weeks, I'll be home. I can't wait to be back."

"My family's here," Army Spc. Ricky Clay, also of Monroe, Ga., said as he smiled and embraced his teammates on the sidelines of the football field.

Read More..

Lawsuit against Madonna dismissed in Russia

ST. PETERSBURG, Russia (AP) — A Russian court on Thursday dismissed a lawsuit that sought millions of dollars in damages from Madonna for allegedly traumatizing minors by speaking up for gay rights during a concert in St. Petersburg.

The ruling came after a one-day hearing that bordered on the farcical. During it, plaintiffs claimed that Madonna's so-called "propaganda of perversion" would negatively affect Russia's birthrate and erode the nation's defense capability by depriving the country of future soldiers. At one point, the judge threatened to expel journalists from the courtroom if they laughed too much.

In the end, the Moskovsky district court in St. Petersburg threw out the Trade Union of Russian Citizens' lawsuit and the 333 million rubles ($10.7 million) it sought from the singer for allegedly exposing youths to "homosexual propaganda."

Madonna did not attend the trial, and her publicist Liz Rosenberg said Thursday the star wouldn't comment about it.

Anti-gay sentiment is strong in Russia, particularly in St. Petersburg, where local legislators passed a law in February that made it illegal to promote homosexuality to minors. Six months later, Madonna criticized the law on Facebook, then stood up for gay rights during a concert in St. Petersburg that drew fans as young as 12.

"Who will children grow up to be if they hear about the equal rights of the lesbian lobby and manly love with traditional sexual relations?" one of the plaintiffs, Darya Dedova, testified Thursday. "The death rate prevails over the birth rate in the West; young guys are becoming gender neutral."

The plaintiffs submitted evidence about gay culture drawn from Wikipedia pages, claiming that a real encyclopedia could not have articles about homosexuality.

"We aren't against homosexual people, but we are against the propaganda of perversion among minors," Dedova told the court. "We want to defend the values of a traditional family, which are currently in crisis in this country. Madonna violated our laws and she should be punished."

Madonna, who performed in Moscow and St. Petersburg in August as part of her world tour, also angered Russian officials by supporting jailed members of the Russian punk band Pussy Riot. The American said during her Moscow concert that she would "pray for them," then turned around so the audience could see the words "Pussy Riot" written on her back. The singer also donned a ski mask similar to those worn by Pussy Riot.

Despite international outrage, three of that band's members were sentenced to two years in jail on hooliganism charges for performing a "punk prayer" at Moscow's main cathedral, during which they pleaded with the Virgin Mary to deliver Russia from President Vladimir Putin. One of the Pussy Riot members was later released from jail on appeal, but the other two were sent to prison camps to serve their sentences.

___

Seddon reported from Moscow.

Read More..

Study finds mammograms lead to unneeded treatment

Mammograms have done surprisingly little to catch deadly breast cancers before they spread, a big U.S. study finds. At the same time, more than a million women have been treated for cancers that never would have threatened their lives, researchers estimate.

Up to one-third of breast cancers, or 50,000 to 70,000 cases a year, don't need treatment, the study suggests.

It's the most detailed look yet at overtreatment of breast cancer, and it adds fresh evidence that screening is not as helpful as many women believe. Mammograms are still worthwhile, because they do catch some deadly cancers and save lives, doctors stress. And some of them disagree with conclusions the new study reached.

But it spotlights a reality that is tough for many Americans to accept: Some abnormalities that doctors call "cancer" are not a health threat or truly malignant. There is no good way to tell which ones are, so many women wind up getting treatments like surgery and chemotherapy that they don't really need.

Men have heard a similar message about PSA tests to screen for slow-growing prostate cancer, but it's relatively new to the debate over breast cancer screening.

"We're coming to learn that some cancers — many cancers, depending on the organ — weren't destined to cause death," said Dr. Barnett Kramer, a National Cancer Institute screening expert. However, "once a woman is diagnosed, it's hard to say treatment is not necessary."

He had no role in the study, which was led by Dr. H. Gilbert Welch of Dartmouth Medical School and Dr. Archie Bleyer of St. Charles Health System and Oregon Health & Science University. Results are in Thursday's New England Journal of Medicine.

Breast cancer is the leading type of cancer and cause of cancer deaths in women worldwide. Nearly 1.4 million new cases are diagnosed each year. Other countries screen less aggressively than the U.S. does. In Britain, for example, mammograms are usually offered only every three years and a recent review there found similar signs of overtreatment.

The dogma has been that screening finds cancer early, when it's most curable. But screening is only worthwhile if it finds cancers destined to cause death, and if treating them early improves survival versus treating when or if they cause symptoms.

Mammograms also are an imperfect screening tool — they often give false alarms, spurring biopsies and other tests that ultimately show no cancer was present. The new study looks at a different risk: Overdiagnosis, or finding cancer that is present but does not need treatment.

Researchers used federal surveys on mammography and cancer registry statistics from 1976 through 2008 to track how many cancers were found early, while still confined to the breast, versus later, when they had spread to lymph nodes or more widely.

The scientists assumed that the actual amount of disease — how many true cases exist — did not change or grew only a little during those three decades. Yet they found a big difference in the number and stage of cases discovered over time, as mammograms came into wide use.

Mammograms more than doubled the number of early-stage cancers detected — from 112 to 234 cases per 100,000 women. But late-stage cancers dropped just 8 percent, from 102 to 94 cases per 100,000 women.

The imbalance suggests a lot of overdiagnosis from mammograms, which now account for 60 percent of cases that are found, Bleyer said. If screening were working, there should be one less patient diagnosed with late-stage cancer for every additional patient whose cancer was found at an earlier stage, he explained.

"Instead, we're diagnosing a lot of something else — not cancer" in that early stage, Bleyer said. "And the worst cancer is still going on, just like it always was."

Researchers also looked at death rates for breast cancer, which declined 28 percent during that time in women 40 and older — the group targeted for screening. Mortality dropped even more — 41 percent — in women under 40, who presumably were not getting mammograms.

"We are left to conclude, as others have, that the good news in breast cancer — decreasing mortality — must largely be the result of improved treatment, not screening," the authors write.

The study was paid for by the study authors' universities.

"This study is important because what it really highlights is that the biology of the cancer is what we need to understand" in order to know which ones to treat and how, said Dr. Julia A. Smith, director of breast cancer screening at NYU Langone Medical Center in New York. Doctors already are debating whether DCIS, a type of early tumor confined to a milk duct, should even be called cancer, she said.

Another expert, Dr. Linda Vahdat, director of the breast cancer research program at Weill Cornell Medical College in New York, said the study's leaders made many assumptions to reach a conclusion about overdiagnosis that "may or may not be correct."

"I don't think it will change how we view screening mammography," she said.

A government-appointed task force that gives screening advice calls for mammograms every other year starting at age 50 and stopping at 75. The American Cancer Society recommends them every year starting at age 40.

Dr. Len Lichtenfeld, the cancer society's deputy chief medical officer, said the study should not be taken as "a referendum on mammography," and noted that other high-quality studies have affirmed its value. Still, he said overdiagnosis is a problem, and it's not possible to tell an individual woman whether her cancer needs treated.

"Our technology has brought us to the place where we can find a lot of cancer. Our science has to bring us to the point where we can define what treatment people really need," he said.

___

Online:

Study: http://www.nejm.org/doi/full/10.1056/NEJMoa1206809

Screening advice: http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrca.htm

___

Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

Read More..