Retooling Pap test to spot more kinds of cancer

WASHINGTON (AP) — For years, doctors have lamented that there's no Pap test for deadly ovarian cancer. Wednesday, scientists reported encouraging signs that one day, there might be.

Researchers are trying to retool the Pap, a test for cervical cancer that millions of women get, so that it could spot early signs of other gynecologic cancers, too.

How? It turns out that cells can flake off of tumors in the ovaries or the lining of the uterus, and float down to rest in the cervix, where Pap tests are performed. These cells are too rare to recognize under the microscope. But researchers from Johns Hopkins University used some sophisticated DNA testing on the Pap samples to uncover the evidence — gene mutations that show cancer is present.

In a pilot study, they analyzed Pap smears from 46 women who already were diagnosed with either ovarian or endometrial cancer. The new technique found all the endometrial cancers and 41 percent of the ovarian tumors, the team reported Wednesday in the journal Science Translational Medicine.

This is very early-stage research, and women shouldn't expect any change in their routine Paps. It will take years of additional testing to prove if the so-called PapGene technique really could work as a screening tool, used to spot cancer in women who thought they were healthy.

"Now the hard work begins," said Hopkins oncologist Dr. Luis Diaz, whose team is collecting hundreds of additional Pap samples for more study and is exploring ways to enhance the detection of ovarian cancer.

But if it ultimately pans out, "the neat part about this is, the patient won't feel anything different," and the Pap wouldn't be performed differently, Diaz added. The extra work would come in a lab.

The gene-based technique marks a new approach toward cancer screening, and specialists are watching closely.

"This is very encouraging, and it shows great potential," said American Cancer Society genetics expert Michael Melner.

"We are a long way from being able to see any impact on our patients," cautioned Dr. Shannon Westin of the University of Texas MD Anderson Cancer Center. She reviewed the research in an accompanying editorial, and said the ovarian cancer detection would need improvement if the test is to work.

But she noted that ovarian cancer has poor survival rates because it's rarely caught early. "If this screening test could identify ovarian cancer at an early stage, there would be a profound impact on patient outcomes and mortality," Westin said.

More than 22,000 U.S. women are diagnosed with ovarian cancer each year, and more than 15,000 die. Symptoms such as pain and bloating seldom are obvious until the cancer is more advanced, and numerous attempts at screening tests have failed.

Endometrial cancer affects about 47,000 women a year, and kills about 8,000. There is no screening test for it either, but most women are diagnosed early because of postmenopausal bleeding.

The Hopkins research piggybacks on one of the most successful cancer screening tools, the Pap, and a newer technology used along with it. With a standard Pap, a little brush scrapes off cells from the cervix, which are stored in a vial to examine for signs of cervical cancer. Today, many women's Paps undergo an additional DNA-based test to see if they harbor the HPV virus, which can spur cervical cancer.

So the Hopkins team, funded largely by cancer advocacy groups, decided to look for DNA evidence of other gynecologic tumors. It developed a method to rapidly screen the Pap samples for those mutations using standard genetics equipment that Diaz said wouldn't add much to the cost of a Pap-plus-HPV test. He said the technique could detect both early-stage and more advanced tumors. Importantly, tests of Paps from 14 healthy women turned up no false alarms.

The endometrial cancers may have been easier to find because cells from those tumors don't have as far to travel as ovarian cancer cells, Diaz said. Researchers will study whether inserting the Pap brush deeper, testing during different times of the menstrual cycle, or other factors might improve detection of ovarian cancer.

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Biden, NRA to Meet During Day 2 of Gun Talks

Vice President Joe Biden will start day two of this week's meetings on gun violence Thursday, and the participants in the latest round of talks will include two powerhouses in the gun industry -- the National Rifle Association and Wal-Mart, one of the largest sellers of firearms in the country.

Spokesmen for the NRA and Wal-Mart confirmed representatives from their organizations will be included in the meetings Thursday. Advocates for sportsmen, women's groups, wildlife groups and gun owners will also be there. The vice president is slated to meet with members of the entertainment industry in the evening.

James J. Baker, the NRA's top lobbyist, will attend the meeting on behalf of the organization. The NRA called for armed officers to be placed in every school after the massacre at Sandy Hook Elementary School in Newtown, Conn. in December.

"We are sending a representative to hear what they have to say," Andrew Arulanandam, a spokesman for the NRA, said.

Wal-Mart initially turned down an invitation to participate in the talks but reversed its decision after it "underestimated the expectation to attend the meeting on Thursday in person," a spokesman said.

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"We take this issue very seriously and are committed staying engaged in this discussion as the administration and Congress work toward a consensus on the right path forward," David Tovar, vice president of corporate communications for Wal-Mart, said.

The latest meetings come one day after Biden held a first round of talks this week with gun safety advocate groups and victims and survivors of gun violence. Speaking to reporters before the meeting, the vice president expressed the administration's commitment to develop effective gun policy by considering all ideas. He suggested the administration would be ready to take executive action on the issue, which would not require help from Congress.

"We're here today to deal with a problem that requires our immediate action, urgent action. And the president and I are determined to take action," Biden told reporters before a meeting in his ceremonial office in the Eisenhower Executive Office Building. "I want to make it clear that we are not going to get caught up in the notion [that] unless we can do everything, we're going to do nothing."

"There are executive orders, executive action that can be taken. We haven't decided what that is yet, but we're compiling it all with the help the attorney general and all the rest of the cabinet members, as well as legislative action, we believe, is required," Biden said.

Colin Goddard, a survivor of the shooting at Virginia Tech University in 2007, participated in the meeting at the White House Wednesday and said the talks gave the groups "encouragement from the highest office in the country."

"I was really encouraged by seeing how focused and determined the administration is in seeing comprehensive changes to the gun violence in America," Goddard, who is now the assistant director for federal legislation at the Brady Campaign to Prevent Gun Violence, told ABC News. "It was really great to see even the Vice President of the United States of America supporting us. He wants to see this done to the end and bringing us all to the table to share our personal stories, share our ideas about what our proposals could be."

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Exhausted Egyptians count cost of political turmoil

ZAGAZIG, Egypt (Reuters) - These days, craftsmen, shopkeepers and other inhabitants of the Egyptian Delta town of Zagazig are often too busy making ends meet to ponder why life seems to be getting harder every day.

But when, exhausted, they finally come home and sit down to their evening meal, conversations inevitably turn to growing hardship and the frightening prospect of cuts in food subsidies as the economy slides further into crisis.

With their patience already stretched after years of upheaval, Egyptians - from the capital Cairo to smaller towns like Zagazig - appear to be nearing the point where discontent could explode into a new wave of unrest.

"There is no security. There is nothing," said Soheir Abdel Moneim, a retired school teacher, as she hurried through an open-air market in Zagazig in search of vegetables she could afford.

"The pound is falling. Everything is more expensive. Is there anything that has not become more expensive?" she asked with a shrug, as traders on bicycles loaded with their wares dodged through the chaos of the market.

Nearby, a torn poster of President Mohamed Mursi beams from the wall of a crumbling brick house, with the words "Liars! Liars!" scrawled over his face.

The mood of growing nervousness is bad news for Mursi, who faces a parliamentary election in coming months, and a new round of political feuding that could pitch Egypt back into civil strife.

Egypt's economy, once strong and popular among investors, has been in tatters since the revolt of 2011 that ousted Hosni Mubarak and shook the country to its foundations.

Disagreements over a new national constitution late last year triggered violent protests, dealing another blow to the economy and eroding trust in Mursi's government.

A country where cuts in food subsidies have caused riots in the past now faces the risk of further upheaval as Mursi prepares to impose austerity measures in order to obtain a desperately needed $4.8 billion loan from the International Monetary Fund.

In Zagazig, people worry about the future.

Farouk Sarhan, the 74-year-old manager of a shop selling women's clothes, said sales were already down by almost 50 percent from just a few weeks ago.

"No one is selling or buying. I had more activity last year," he said, stubbing out a cigarette with a deep sigh in his tiny store lined with mannequins of veiled women.

"Customers are not buying as much as before because of the economic situation."

The price of fresh food often goes up in winter but shoppers in the Zagazig market said recent increases had been steep, with tomatoes and cauliflower about 50 percent dearer than at the start of the year.

WHAT NEXT?

Egypt has been on the ropes since investors and tourists fled after the revolt, when people rose up to demand their freedom and also an end to economic policies they said simply lined the pockets of the rich.

On the economic front, the picture remains grim, although Qatar's decision to lend Egypt another $2 billion has offered some respite.

Foreign reserves are dwindling and the pound has been hitting new lows daily. Food and raw materials from abroad have become more expensive, hurting businesses and families in a desert nation which relies on imports to feed itself.

As in other parts of Egypt, people in Zagazig see complex economic trends in terms of the daily hardships they must endure, and it is Mursi's government and his Muslim Brotherhood allies who get the blame.

"Mursi doesn't feel our grievances," said Emad, a man in his late 30s who sells traditional Egyptian clothes by the side of a dusty street. He said he had been forced to raise prices to cover rising costs, upsetting his customers.

Pointing to one of the black embroidered gowns, Emad said: "We used to sell this for 35 pounds ($5.40). Now it's 45 pounds. We didn't raise the prices. Traders did.

"Very few people are buying. I used to sell 50 pieces a day, and now I sell 15 or 20. Today I still haven't sold anything."

Reliable opinion polls are unavailable in Egypt and it is hard to gauge how widespread people's views are. But in Zagazig, most of those interviewed by Reuters echoed Emad's feelings.

Economists worry that continued turmoil could prompt people and businesses to convert their savings into dollars en masse - a risky process known as dollarisation which has caused trouble in many emerging market crises before.

But in Zagazig, people laughed at the idea, saying only the rich could afford to buy foreign currency. "Dollars?" asked Nabil, a local trader, as others burst into laughter. "Give me some dollars! Of course we don't have any!"

SUPPORT FOR MURSI

But some were prepared to give Mursi a chance.

In the nearby village of al-Adwa, where the future president grew up in the family of a local farmer, brick walls and fences were plastered with posters of Mursi.

A crowd of farmers standing by the side of a dirt track cutting through the village shook their fists and shouted "Mursi! Mursi!" when asked about their political views.

But even in Adwa, where Mursi appeared to enjoy rock-solid support, locals said sudden increase in taxes or abrupt cuts to fuel or food subsidies would cost him dearly.

"If that happens that would be the worst thing. What am I going to do as a farmer?" said Said Youssef, his hands black from working the land. "Where are we going to get the money?"

Another man, Aly Saber, 65, said fertilizer prices had gone up by 50 Egyptian pounds in the past year alone, making his business less profitable.

"Things are tough here in the rural areas," he said as others nodded in agreement. "Everything is becoming more expensive."

Mohamed Gamal, the 42-year-old owner of a tiny shop selling kitchen appliances, said business was so bad that he would sometimes go for days without a single customer.

"I import goods all the time. Prices have gone up by 10-40 percent since the revolution. It's gone up even more in recent weeks," said Gamal, who, Like Mursi, grew up in Adwa.

He said his neighbors were suspicious about why he had to keep raising his prices.

"People just don't believe me," he said, hunched over his desk, cigarette smoke swirling above stacks of unsold trays, cups and ironing boards. "They are not convinced why things are getting more expensive. I buy them, and they stack up."

($1 = 6.4809 Egyptian pounds)

(Writing by Maria Golovnina; Editing by Giles Elgood)

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Japan's foreign minister on two-day visit to Singapore

SINGAPORE: Japan's Minister for Foreign Affairs Fumio Kishida will visit Singapore from Thursday till Friday.

This will be Mr Kishida's first official visit to Singapore in his current capacity.

During his visit, Mr Kishida will call on Prime Minister Lee Hsien Loong at the Istana, and meet with Minister for Foreign Affairs and Law K Shanmugam.

Mr Shanmugam will also host Mr Kishida to lunch.

- CNA/de

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Enough proof of Pak army's involvement in Indian jawans' killing: Antony

NEW DELHI/KOLKATA: Outraged by the brutal killing of two of its soldiers by intruding Pakistani troops, India on Wednesday strongly protested to Pakistan, warning that the "unacceptable" incident will have adverse impact on the ties.

As strong reactions by the government and political parties came, Pakistan high commissioner Salman Bashir was summoned by foreign secretary Ranjan Mathai, who conveyed India's "deepest concern and protest" over yesterday's attack in which two Indian soldiers were killed and their bodies subjected to "barbaric and inhuman mutilation".

Pakistan was also asked to immediately investigate these actions that are in contravention of all norms of international conduct and ensure that these do not recur.

India's Director General of Military Operations (DGMO) Lt Gen Vinod Bhatia spoke to his Pakistani counterpart Maj Gen Ashfaq Nadeem to complain about the attack. A Pakistani military official said in Islamabad that Gen Nadeem rejected Indian Army's contention of cross-Line of Control(LoC) firing by Pakistani troops and killing of any Indian soldier.

Referring to last month's Indo-Pak discussions on conventional CBMs, wherein maintaining the sanctity of the LoC, one of the most important CBMs between the two countries, was emphasised, Khurshid said,"therefore violation of (ceasefire) that itself is something which is a matter of great concern. And that would obviously, if not immediately, contained will have adverse impact on what we have been trying to do for such a long time."

In a gruesome attack, Pakistan regular soldiers crossed into Indian territory in Poonch sector of Jammu and Kashmir on Tuesday and ambushed an Indian patrol killing two soldiers, one of whom was decapitated.

Khurshid also stressed the need "to make sure that whatever happened should not be escalated. We cannot and must not allow escalation of this very unwholesome event that has taken place."

Enough proof of Pak army's involvement in Indian jawans killing: Antony

Defence minister A K Antony said on Wednesday that there is ample evidence to prove that Pakistani troops were involved in the killing of two Indian Army jawans along the Line of Control in Jammu and Kashmir. According to Antony, the act was inhuman.

"I already condemned the incident before leaving Delhi. There is ample evidence of how they treated the two Indian Army soldiers. The act was inhuman and we have already taken up the matter with the Pakistani government. The government of India is taking up the issue with all stakeholders. The Director General (Military Operations) is keeping close watch on the developments and has also taken up the issue with his counterpart in Pakistan," the defence minister said in Kolkata before leaving for Delhi.

Antony was in Kolkata for the 47th Convocation of the Indian Statistical Institute (ISI). The defence minister is the chairman of the ISI Council. In his brief address, Antony pointed out how research carried out at the institute has applications in the security sector as well.

"Make use of your skills but ensure that values don't suffer. Society has high hopes from you. Do contribute to society. I would have wanted to spend more time here but I have several important meetings in Delhi and have to rush back. The situation is such that my coming to Kolkata became uncertain at one point of time," Antony said before leaving, midway through the programme.

(With inputs from PTI)

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Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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Dead Lotto Winner's Wife Seeks 'Truth'

The wife of a $1 million Chicago lottery winner who died of cyanide poisoning told ABC News that she was shocked to learn the true cause of his death and is cooperating with an ongoing homicide investigation.

"I want the truth to come out in the investigation, the sooner the better," said Shabana Ansari, 32, the wife of Urooj Khan, 46. "Who could be that person who hurt him?

"It has been incredibly hard time," she added. "We went from being the happiest the day we got the check. It was the best sleep I've had. And then the next day, everything was gone."

Ansari, Khan's second wife, told the Chicago Sun-Times that she prepared what would be her husband's last meal the night before Khan died unexpectedly on July 20. It was a traditional beef-curry dinner attended by the married couple and their family, including Khan's 17-year-old daughter from a prior marriage, Jasmeen, and Ansari's father. Not feeling well, Khan retired early, Ansari told the paper, falling asleep in a chair, waking up in agony, then collapsing in the middle of the night. She called 911.

Khan, an immigrant from India who owned three dry-cleaning businesses in Chicago, won $1 million in a scratch-off Illinois Lottery game in June and said he planned to use the money to pay off his bills and mortgage, and make a contribution to St. Jude Children's Research Center.

"Him winning the lottery was just his luck," Ansari told ABC News. "He had already worked hard to be a millionaire before it."

Illinois Lottery/AP Photo

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Jimmy Goreel, who worked at the 7-Eleven store where Khan bought the winning ticket, described him to The Associated Press as a "regular customer ... very friendly, good sense of humor, working type of guy."

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Khan's unexpected death the month after his lottery win raised the suspicions of the Cook County medical examiner. There were no signs of foul play or trauma so the death initially was attributed to arteriosclerotic cardiovascular disease, which covers heart attacks, stroke or ruptured aneurysms. The medical examiner based the conclusion on an external exam -- not an autopsy -- and toxicology reports that indicated no presence of drugs or carbon monoxide.

Khan was buried at Rosehill Cemetery in Chicago.

However, several days after a death certificate was issued, a family member requested that the medical examiner's office look further into Khan's death, Cook County Medical Examiner Stephen Cina said. The office did so by retesting fluid samples that had been taken from Khan's body, including tests for cyanide and strychnine.

When the final toxicology results came back in late November, they showed a lethal level of cyanide, which led to the homicide investigation, Cina said. His office planned to exhume Khan's body within the next two weeks as part of the investigation.

Melissa Stratton, a spokeswoman for the Chicago Police Department, confirmed it has been working closely with the medical examiner's office. The police have not said whether or not they believe Khan's lottery winnings played a part in the homicide.

Khan had elected to receive the lump sum payout of $425,000, but had not yet received it when he died, Ansari told the AP, adding that the winnings now are tied up as a probate matter.

"I am cooperating with the investigation," Ansari told ABC News. "I want the truth to come out."

Authorities also have not revealed the identity of the relative who suggested the deeper look into Khan's death. Ansari said it was not her, though she told the AP she has subsequently spoken with investigators.

"This is been a shock for me," she told ABC News. "This has been an utter shock for me, and my husband was such a goodhearted person who would do anything for anyone. Who would do something like this to him?

"We were married 12 years [and] he treated me like a princess," she said. "He showered his love on me and now it's gone."

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Afghan peace efforts show flickers of life

WASHINGTON/ISLAMABAD (Reuters) - President Barack Obama and Afghan President Hamid Karzai will discuss matters of war, including future U.S. troop levels and Afghanistan's army, when they meet on Friday, but matters of peace may be the most delicate item on their long agenda.

After nearly 10 months in limbo, tentative reconciliation efforts involving Taliban insurgents, the Karzai government and other major Afghan factions have shown new signs of life, resurrecting tantalizing hopes for a negotiated end to decades of war.

Pakistan, which U.S. and Afghan officials have long accused of backing the insurgents and meddling in Afghanistan, has recently signaled an apparent policy shift toward promoting its neighbor's stability as most U.S. combat troops prepare to depart, top Pakistani and Afghan officials said.

In another potentially significant development, Taliban representatives met outside Paris last month with members of the Afghan High Peace Council - although not directly with members of the Karzai government, which they have long shunned.

U.S. officials, speaking on condition of anonymity, said the developments are promising - but that major challenges remain to opening negotiations, let alone reaching an agreement on the war-ravaged country's political future.

Hopes for Afghan peace talks have been raised before, only to be dashed. Last March, the Taliban suspended months of quiet discussions with Washington aimed at getting the insurgents and the Karzai government to the peace table.

Obama is expected to press the Afghan president to bless the formal opening of a Taliban political office in the Gulf state of Qatar as a way to jump-start inter-Afghan talks.

Karzai has been lukewarm to the idea, apparently fearing his government would be sidelined in any negotiations.

TRIP AT A TURNING POINT

Karzai's meeting with Obama, at the end of a three-day visit to Washington, is shaping up to be one of the most critical encounters between the two leaders, as the White House weighs how rapidly to remove most of the roughly 66,000 U.S. troops in Afghanistan and how large a residual force to leave after 2014.

Obama, about to begin his second term in office, appears determined to wrap up U.S. military engagement in Afghanistan. On Monday, he announced as his nominee for Pentagon chief former Nebraska Senator Chuck Hagel, who appears likely to favor a sizeable U.S. troop drawdown.

Other issues on the agenda have plenty of potential for causing friction: the future size and focus of the Afghan military; a festering dispute over control of the country's largest detention center; and the future of international aid after 2014.

Karzai's trip "is one of the most important ones because the discussions we are going to have with our counterparts will define the relations between (the) United States and Afghanistan," Afghan Foreign Minister Zalmay Rassoul told the lower house of parliament this month.

No final announcement on post-2014 U.S. troop levels is expected during Karzai's visit, and the issue is further complicated by Washington's insistence on legal immunity for American troops that remain.

General John Allen, the top U.S. and NATO commander in Afghanistan, recommended keeping between roughly 6,000 and 15,000 U.S. troops in Afghanistan after 2014, but the White House is considering possibly leaving as few as 3,000 troops.

A U.S. official, speaking on condition of anonymity, said the White House had asked for options to be developed for keeping between 3,000 and 9,000 troops in the country.

PAST PEACE HOPES DASHED

Last year, the Obama administration hoped to kick-start peace talks with a deal that would have seen Washington transfer five Taliban prisoners from Guantanamo Bay prison. In return, the Taliban would renounce international terrorism and state a willingness to enter talks with Karzai's representatives.

That deal never came off, and the question now is whether it, or an alternative peace process, can get under way as the U.S. military presence rapidly winds down.

Looking at developments in the last few months, "you could see that there are things happening," said one U.S. official, who was not authorized to speak for the record.

At the end of 2012, Pakistan released four Afghan Taliban prisoners who were close to the movement's reclusive leader, Mullah Mohammed Omar. It appeared to be a step toward meeting Afghanistan's long-standing insistence that Islamabad free those who could help promote reconciliation. A senior Afghan official welcomed the release.

A member of Pakistan's parliament closely involved in Afghan policy-making said there are signs of a shift in the thinking of Pakistan's powerful military. Some in the military, which has long regarded Afghanistan as a battleground in its existential conflict with rival India, are now saying that the graver threat comes from Pakistan's own militants.

"Yes, there is skepticism. The hawks are there. But the fact is that previously there were absolutely no voices in the army with this kind of positive thinking," the parliamentarian said.

"Pakistan has also realized that there won't be a complete withdrawal of the U.S. from Afghanistan," the lawmaker said. "The security establishment realizes it has to compromise somewhere. Hence the Taliban releases. ... Hence the statements from even the most skeptical Afghan officials that there is a change in Pakistani thinking."

Ghairat Baheer, who represented the Hezb-e-Islami faction at last month's peace talks in the Paris suburb of Chantilly, rejected a continued U.S. military presence in Afghanistan, but praised the Pakistan prisoner release as a sign of its good intentions.

WAITING FOR THE TALIBAN

After more than a year of frustration, Obama administration officials are skeptical about luring the Taliban to peace talks, citing what appears to be a deep fissure within the movement between moderates who favor entering the political process and hard-liners committed to ousting both NATO troops and Karzai.

The Taliban's lead negotiator, Tayeb Agha, whom the Obama administration regards as a reliable interlocutor, offered to resign last month in apparent frustration, the Daily Beast website reported.

Taliban envoys have yet to meet officially with Karzai's government, and the insurgents demand a rewriting of the Afghan constitution.

"I don't think anyone knows where (reconciliation) stands. And I mean that because there are a lot of reconciliation talks and a lot of games that are being played in a lot of places," said Fred Kagan, a military analyst at the conservative American Enterprise Institute.

"The likelihood of getting an acceptable deal that actually secures our interests is vanishingly small," he said. "But the probability that you could get the deal and have it implemented in time to make this drawdown timeline make sense is nonsense."

(Additional reporting by Phil Stewart and David Alexander in Washington, and Hamid Shalizi in Kabul. Editing by Christopher Wilson)

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Karzai on US visit as Obama mulls Afghan troop plan

WASHINGTON: President Hamid Karzai will begin a four-day US visit on Tuesday as President Barack Obama weighs how fast to withdraw troops from Afghanistan and whether to leave a "residual force" behind after 2014.

Foreign combat soldiers are due to exit Afghanistan by the end of next year, more than a decade after a US-led invasion brought down the Taliban regime in 2001, but the country remains wracked by Islamist violence.

US officials have reportedly prepared plans for between 3,000 and 9,000 troops to remain to prevent Al-Qaeda militants from re-establishing themselves and to ensure Taliban fighters cannot take the capital Kabul.

But pressure is growing on Obama to end the war rapidly due to deep war weariness in the United States, tightening military budgets and anger over "insider attacks" by Afghan troops on the NATO-led soldiers.

"If Mr. Obama cannot find a way to go to zero troops, he should approve only the minimum number needed," The New York Times said in an editorial this week that called Karzai's government "profoundly corrupt".

Obama will host talks with Karzai at the White House on Friday, the day after the Afghan president meets Secretary of State Hillary Clinton.

US officials have said a decision could be made during Karzai's visit on how many troops stay on in Afghanistan after 2014 - a figure that could determine whether the country tips into a widely-feared civil war.

The talks will also include equipping and strengthening Afghan forces, efforts to negotiate peace with Taliban-led insurgents and a long-term security agreement with the United States, Karzai's office said.

The number of foreign soldiers battling the insurgency in Afghanistan has already fallen to 100,000 from about 150,000. Of those, 66,000 are US troops, down from a maximum of about 100,000.

Afghan army and police are due to take over complete security responsibility from NATO troops by the end of 2014, but there are major concerns they will not be able to face down the country's many warring factions.

More than 60 foreign soldiers were killed in 2012 in "insider attacks" that have bred bitter mistrust and threatened to derail the training of Afghan security forces.

Karzai has expressed support for keeping some US troops in Afghanistan after 2014 but sensitive details - including immunity for American soldiers and the transfer of detainees into Afghan custody - are still under negotiation.

Washington scrapped plans for some troops to remain in Iraq after Baghdad refused to grant US soldiers immunity from prosecution.

Karzai's relationship with Washington has been troubled in recent years and there are fears that attention on his country, heavily dependent on international aid, could plummet after the NATO withdrawal.

A White House statement ahead of the visit said that Obama envisioned "an enduring partnership between the United States and Afghanistan".

Outgoing Defense Secretary Leon Panetta has stressed that any residual force would focus on Al-Qaeda, which was sheltered by the Taliban government that was ousted after the 9/11 attacks.

Friday's talks will come just days after Obama put the finishing touches to his security team, having named his picks to head up the State Department, Pentagon and CIA.

Karzai is expected to visit Asadullah Khalid, his spy chief who was wounded in an attack in Kabul last month, at an American hospital on Tuesday.

- AFP/de

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Report: Death rates from cancer still inching down

WASHINGTON (AP) — Death rates from cancer are continuing to inch down, researchers reported Monday.

Now the question is how to hold onto those gains, and do even better, even as the population gets older and fatter, both risks for developing cancer.

"There has been clear progress," said Dr. Otis Brawley of the American Cancer Society, which compiled the annual cancer report with government and cancer advocacy groups.

But bad diets, lack of physical activity and obesity together wield "incredible forces against this decline in mortality," Brawley said. He warned that over the next decade, that trio could surpass tobacco as the leading cause of cancer in the U.S.

Overall, deaths from cancer began slowly dropping in the 1990s, and Monday's report shows the trend holding. Among men, cancer death rates dropped by 1.8 percent a year between 2000 and 2009, and by 1.4 percent a year among women. The drops are thanks mostly to gains against some of the leading types — lung, colorectal, breast and prostate cancers — because of treatment advances and better screening.

The news isn't all good. Deaths still are rising for certain cancer types including liver, pancreatic and, among men, melanoma, the most serious kind of skin cancer.

Preventing cancer is better than treating it, but when it comes to new cases of cancer, the picture is more complicated.

Cancer incidence is dropping slightly among men, by just over half a percent a year, said the report published by the Journal of the National Cancer Institute. Prostate, lung and colorectal cancers all saw declines.

But for women, earlier drops have leveled off, the report found. That may be due in part to breast cancer. There were decreases in new breast cancer cases about a decade ago, as many women quit using hormone therapy after menopause. Since then, overall breast cancer incidence has plateaued, and rates have increased among black women.

Another problem area: Oral and anal cancers caused by HPV, the sexually transmitted human papillomavirus, are on the rise among both genders. HPV is better known for causing cervical cancer, and a protective vaccine is available. Government figures show just 32 percent of teen girls have received all three doses, fewer than in Canada, Britain and Australia. The vaccine was recommended for U.S. boys about a year ago.

Among children, overall cancer death rates are dropping by 1.8 percent a year, but incidence is continuing to increase by just over half a percent a year. Brawley said it's not clear why.

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