Funding the Construction of New Coast Guard Heavy Polar Security Cutters (Icebreakers) Enables the Agency's Mission Execution, Secures American Interests, and Supports Scientific Research

The United States Coast Guard cannot properly accomplish more than 80% of its missions due to its waning polar icebreaking capabilities. Its only operational heavy icebreaker, the forty-three-year old Polar Star, continues to break down on its annual Operation Deep Freeze mission. The Coast Guard’s icebreaking fleet only contains one other vessel, a medium icebreaker with limited Polar Region support capabilities. Despite its best efforts since 2012, the Coast Guard has yet to secure enough funding for new ship construction from Congress. This proposal analyzes how funding for the construction of three new heavy Polar Security Cutters (icebreakers) enables the Coast Guard’s mission, secures American interests in the Polar Regions, and supports scientific research. Ultimately, its positive recommendation to introduce an appropriations bill to secure this funding best addresses this problem

Breast self examination and breast cancer stage at diagnosis.

The relationship between breast self examination (BSE) and breast cancer stage at diagnosis was examined in 616 women aged 15-59 years. Differences in tumour characteristics between those not practising BSE and those practising but not taught were small and inconstant. However, women who had both practised and had been taught BSE had more favourable tumours than the non-practising group. The difference was most marked in terms of tumour size and the involvement of axillary nodes. The proportions of women in the non-BSE and taught-BSE groups with each characteristic were respectively: size less than or equal to 2 cm 33% and 45%, T1 clinical stage 27% and 42%, and N0 pathological stage 37% and 50%. This advantage to taught-BSE women persisted after adjustment for the identified confounding factors of age, social class and oral contraceptive use. The likely impact on breast cancer mortality is difficult to assess, although the potential benefit of the lead time gained must not be ignored when assessing the costs and benefits of BSE

Oral contraceptives and cervical cancer--further findings from the Oxford Family Planning Association contraceptive study.

In 1983, we reported results from the Oxford Family Planning Association contraceptive study regarding the association between oral contraceptives (OCs) and cervical neoplasia, after a 10 year follow-up of a cohort of 17,000 women. Further findings from this study are reported here after an additional 12 years of follow-up. A nested case--control design was used in which cases were all women diagnosed under 45 years of age with invasive carcinoma (n = 33), carcinoma in situ (n = 121) or dysplasia (n = 159). Controls were randomly selected from among cohort members and matched to cases on exact year of birth and clinic attended at recruitment to study. Conditional logistic regression analysis was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) associated with various aspects of OC use relative to never users adjusted for social class, smoking, age at first birth and ever use of diaphragm or condom. Ever users of OCs had a slightly elevated OR for all types of cervical neoplasia combined (OR = 1.40, 95% CI 1.00-1.96). Odds ratios were highest for invasive carcinoma (OR = 4.44, 95% CI 1.04-31.6), intermediate for carcinoma in situ (OR = 1.73, 95% CI 1.00-3.00) and lowest for dysplasia (OR = 1.07, 95% CI 0.69-1.66). The elevated risk associated with OC use appeared to be largely confined to current or recent (last use in the past 2 years) long-term users of OCs. Among current or recent users, ORs for all types of cervical neoplasia combined were 3.34 (95% CI 1.96-5.67) for 49-72 months of use, 1.69 (95% CI 0.97-2.95) for 73-96 months and 2.04 (95% CI 1.34-3.11) for 97 or more months. These results suggest a possible effect of OC use on later stages of cervical carcinogenesis, although residual confounding due to sexual factors or human papillomavirus (HPV) infection cannot be ruled out

Fertility in relation to the risk of breast cancer.

All studies reported here, like our own, support the view that the higher risk of breast cancer in women having a late first birth is attributable to early pregnancy itself having a direct protective effect against the disease, a benefit which they have not experienced. One study, however, has directly examined breast cancer risk in two groups of infertile women - those presumed to have 'progesterone deficiency' and those presumed to have infertility of non hormonal origin. The results suggested that breast cancer risk was increased in premenopausal women (but not in postmenopausal women) with 'progesterone deficiency'. The number of cases of premenopausal breast cancer included in the analysis (11) was, however, very small. In our view, the findings in this study do not weigh heavily against our results and those of others