The official word from NIH is at pages in Medlineplus Drug information.
These sites clearly note that tamoxifen increases the risk of uterine cancer. For very detailed research in this, you can search PubMed for free on the web. You can try searches like: tamoxifen and "increased risk" and uterine(70 hits), tamoxifen and "increased risk" and carcinogen*(242 hits), or even: astrazeneca and tamoxifen(26 hits). Pubmed has extremely technical information, and very few articles are free online, but the many free abstracts could help you get a better impression of what the risks are.
For less technical and more policy related information, the best bet would be something like FirstGov with searches like: astrazeneca tamoxifen risk* (60 hits), astrazeneca tamoxifen uterine* (33 hits), or even using phrases: astrazeneca tamoxifen "uterine sarcoma" (10 hits). If you are near an academic library, a large general database like Academic Search Premier or Lexis Academic would be well worthwhile. Academic Search gets 5 hits for the search: tamoxifen and astrazeneca and risk*; Lexis Academic gets 8 hits in past 10 years for the search (in general news / Major papers): astrazeneca and tamoxifen and risk.
If you are only near a public library (or if you have remote access via a library card number login), you can very probably get much useful information in their general magazine databases. Many have Infotrac, and perhaps even more have Masterfile Premier (like Academic Search, Masterfile is an Ebsco database). Masterfile Premier gets 31 hits, including 26 with full text online, for the search: tamoxifen and uter*, for example.
One more possiblity, on the "Cancer treatment centers" part of the question is the Edgar database at www.sec.gov. Edgar Archives search: astrazeneca gets many hits, including their 2004 Annual Report in the 02/25/2005 6-K report Page 34 notes under Salick Health Care..."SHC manages full-service outpatient comprehensive cancer centres in affiliation with major teaching and community hospitals in California, Florida and New York and is affiliated with a large network of over 160 physicians, working in specialised areas such as haematology and medical, radiation and surgical oncology."
There are 86 total entries in that search result in Edgar Archives, many of which have su-files once you click on the main one. There are many details such as director names, etc., for the persistent researcher to dig through. You can also search the "Latest Filings."
But when you get what looks like 1 hit, click again under the center column hot link "Astrazeneca PLC (0000901832) (Filer)" and get 76 hits that include newer filings.
Thanks,
Jim Miller, U of MD College Park
Addendum by Michele McGinnis
Chemical and Agrochemical Legacy
AstraZeneca PLC was incorporated in England and Wales on 17 June 1992 under the Companies Act 1985. It is a public limited company domiciled in the UK. From February 1993 until April 1999, the Company was called Zeneca Group PLC. On 6 April 1999, the Company changed its name to AstraZeneca PLC. The Company was formed when the pharmaceutical, agrochemical and specialty chemical businesses of Imperial Chemical Industries PLC were demerged in 1993. In 1999, the Company sold the specialty chemical business. Also in 1999, the Company merged with Astra AB of Sweden. In 2000, it demerged the agrochemical business and merged it with the similar agribusiness of Novartis AG to form a new company called Syngenta AG.
Zeneca Agrochemicals (was) one of the world's leading suppliers of crop protection chemicals. Its broad range of products, designed to improve crop yields and food quality, controls major weeds, diseases and pests in all principal crops. Leading products include the herbicides Gramoxone, Touchdown, Reglone, Surpass, Fusilade, Flex, and Achieve; the insecticides Karate and Force and the fungicides Amistar and Bravo. The international scale and breadth of Agrochemicals' operations enable(d) it to develop products cost-effectively and quickly bring them to the market.
Environmental Legacy
In addition to expenditure for meeting current and foreseen environmental protection requirements, the Group incurs substantial costs in investigating and cleaning up land and groundwater contamination. In particular, AstraZeneca and/or its affiliates have environmental liabilities at some currently or formerly owned, leased and third party sites. In the US, the AstraZeneca affiliate, Zeneca Inc., and/or its indemnitees, have been named as potentially responsible parties (PRPs) or defendants at approximately 13 sites where Zeneca Inc. is likely to incur future investigation, remediation or operation and maintenance costs under federal or state, statutory or common law environmental liability allocations schemes. Similarly, the AstraZeneca affiliate, Stauffer Management Company LLC (SMC), which was established in 1987 to own and manage certain assets of Stauffer Chemical Company acquired that year, and/or its indemnitees, have been named as PRPs or defendants at approximately 29 sites where SMC is likely to incur future investigation, remediation or operation and maintenance costs under federal or state, statutory or common law environmental liability allocations schemes. In Europe and other parts of the world outside the US, AstraZeneca is likely to incur costs at three currently owned sites and has given indemnities to third parties in respect of approximately 45 other sites. These environmental liabilities arise almost entirely from legacy operations that are not part of our current pharmaceuticals business and, at most of these sites, remediation, where required, is either completed or nearing completion. In the aggregate, however, significant expenditure on clean up and monitoring is likely to be required. AstraZeneca has made provisions for the estimated costs of future environmental investigation, remediation and operation and maintenance.
Sources:
Astra Zeneca 2004 Annual Report
Astran Zeneca 1999 Annual Report
Breast Cancer Awareness Month
AstraZeneca HealthCare Foundation is one of the founders and has been the sole funder of the National Breast Cancer Awareness Month (NBCAM) program, now in its 17th year. The primary objective of the NBCAM program is to educate women about breast cancer by stressing the importance of detecting the disease in its earliest stages through screening mammography. The program works through a nationwide educational campaign aimed at the general public, state and federal governments, health care professionals, employers, and women of all ages and ethnic groups. The program is supported by 17 not-for-profit organizations and government agencies that comprise the NBCAM Board of Sponsors.
Source: Astra Zeneca
The AstraZeneca HealthCare Foundation was established in 1993 as the Zeneca HealthCare Foundation. It is a tax-exempt; nonoperating private foundation organized under section 501(c) (3) of the Internal Revenue Code.
AstraZeneca HealthCare Foundation
P.O. Box 15437
Wilmington, DE 19850-5437
Phone:
(302) 886-3769
Fax:
(302) 886-3119
Contact:
Kathryn McKenzie
Email:
kathryn.mckenzie2@astrazeneca.com
Source: National Breast Cancer Awareness Month
Tumor Risk
It has previously been known that NOLVADEX (Tamoxifen) has been associated with an increased risk of uterine cancer. Most uterine cancers that NOLVADEX has been associated with are endometrial cancers (cancer of the lining of the uterus), but it is now known that some rare uterine sarcomas (cancer of the body of the uterus) have also been reported. Uterine sarcoma is generally diagnosed at a more advanced stage. Women diagnosed with uterine sarcoma usually have a poorer outcome and shorter survival. This information has been added to the NOLVADEX Prescribing Information.
Source: Astra Zeneca
Treatment Centers
Salick Health Care Salick Health Care (SHC) is a leading provider of outpatient oncology management and consulting services. Ownership of SHC provides AstraZeneca with a unique window on the provider sector of the US oncology market and access to many opinion leaders in the field of oncology. SHC manages full-service outpatient comprehensive cancer centres in affiliation with major teaching and community hospitals in California, Florida and New York and is affiliated with a large network of over 160 physicians, working in specialised areas such as haematology and medical, radiation and surgical oncology. In 2004, SHC continued to perform well in its cancer centre management business with positive profit and cash contributions. We implemented a long term management agreement with NYU Hospitals Center with the opening of a new 85,000 square foot cancer centre in Manhattan in July 2004. Focused on growth, SHC is actively pursuing consulting and management relationships in new markets in the US as well as exploring opportunities to bring its unique model of cancer care to the UK. SHC also continued the development of its innovative clinical research network to improve patient care and cancer treatment. The SHC Research Network is conducting a growing number of centrally co-ordinated phase 2 and 3 clinical trials.
Salick Health Care, Inc. In April 2004, Comprehensive Cancer Centers, Inc. (CCC), a subsidiary of Salick Health Care, Inc. received a subpoena from the US Department of Justice seeking, among other items, medical records and related documentation for services provided to patients at the Comprehensive Cancer Center at Desert Regional Medical Center in Palm Springs, California. The Center is managed by CCC, which is co-operating fully with the document request.
Source: Astra Zeneca 2004 Annual Report
