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10 Jul 2014
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Exclusive: EU warns Ireland it could expand tax probe beyond Apple - source

By Foo Yun Chee

BRUSSELS Fri Jun 20, 2014 10:37am EDT

The Apple logo is pictured at a retail store in the Marina neighborhood in San Francisco, California April 23, 2014. REUTERS/Robert Galbraith

The Apple logo is pictured at a retail store in the Marina neighborhood in San Francisco, California April 23, 2014.

Credit: Reuters/Robert Galbraith

BRUSSELS (Reuters) - The European Commission has told Ireland it may investigate more companies as part of a probe into the country's tax practices, after announcing a formal probe into Apple Inc's (AAPL.O) Irish subsidiaries, a person familiar with the matter said on Friday.

The EU is investigating whether Ireland, Luxembourg and the Netherlands have attracted investment and jobs by helping big companies avoid tax in other countries, including EU members.

Corporate profit-shifting has come under the international spotlight in recent years following reports of how companies such as Apple and Google Inc (GOOGL.O) use complex structures to slash their tax bills.

The Commission suspects Ireland was too lenient in rulings it gave to Apple and which helped the company shield tens of billions of dollars in profit from tax and has asked Dublin for information on the rulings it gave the iPhone maker.

Commission officials said they believed other companies had also benefited from generous treatment and want Ireland to change its approach so companies cannot shift so much profit through Ireland into tax havens.

"The Commission has told Ireland it may go after other companies if it does not fix the problem," the source said, without naming the companies concerned.

Apple has denied receiving selective treatment from the Irish authorities.

To see the original post together with other supplementary pictures or online video, visit the link aboveIreland, the Netherlands and Luxembourg said any tax rulings they give are in line with international practices.

Pushed by France and Germany, Brussels is keen to clamp down on what it sees as unfair tax competition across the bloc.

"Member states' tax incentives should never be used to lure profits away from where they should rightfully be taxed," EU tax commissioner Algirdas Semetas told a meeting of EU finance ministers in Luxembourg on Friday, according to the text of his speech published by the EU. "We must verify that the principles of fair play are not being undermined."

If the Commission can prove Ireland agreed tax treatments which diverge from international rules, it could deem any corporate tax savings to be a form of subsidy which must be halted or even repaid.

Asked about the EU watchdog's warning to Ireland, Commission spokesman for competition policy Antoine Colombani said: "What the European Commission told Irish authorities is that it has serious doubts about the compliance with the EU's state aid rules of individual tax rulings concerning Apple."

An Irish finance ministry spokesman said the ministry had no knowledge of the EU threat.

"We have provided information to the Commission for the information-gathering exercise and in relation to any case, it regards one company and one company only and we haven't been informed of anything in addition to that," he said.

(Writing by Tom Bergin in London Additional reporting by Padraic Halpin in Dublin; Editing by David Holmes)

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20 Jun 2014
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Could ignorance of illness be better for mental health?

By Shereen Lehman

NEW YORK Tue Jun 17, 2014 1:36pm EDT

NEW YORK (Reuters Health) - People who don't know they have health problems rate their own health as good, according to a new study, but their self-image worsens when they're aware of their diagnosis.

Based on a large population survey in Norway, the authors say that increased use of screenings, more sensitive tests and widening diagnostic criteria may cause unexpected harm because poor self-rated health is tied to a greater risk of death.

Although early detection of disease can be important for treatment, the authors write in the journal BMJ Open, "disease-labeling" may cause problems by altering a person's perception of their own wellbeing.

"We know ever more people are being labeled, owing to more screening, lower diagnostic thresholds, commercial - and non-commercial - health campaigns and so on," Pal Jorgensen said. "Self-rated health is shown, several times, to be inversely associated with mortality."

Jorgensen, who led the new study, is a public health researcher at the Norwegian University of Science and Technology in Trondheim.

"It is also an important aspect in the increasing attention and discussion of overdiagnosis; people being labeled with disease, but where treatment does not lower mortality," Jorgensen told Reuters Health in an email.

Overdiagnosis generally refers to diagnosing and treating early or minor conditions that may never have progressed to cause a problem. This can include the controversial practice of diagnosing "pre-disease" states, such as slightly elevated blood sugar that falls short of diabetes (see Reuters Health story of May 6, 2011, here:

To gauge the effect of being diagnosed with disease on a person's perception of their own health, Jorgensen and his colleagues analyzed data on 33,734 adults between the ages of 40 and 70 who were surveyed and medically tested in the mid-1990s in Norway.

The researchers were interested in connections between how the participants answered the simple question "How is your health at the moment?" and whether or not they were aware of having specific health conditions, including diabetes, thyroid disease and high blood pressure.

The researchers used the medical testing data to determine if people actually had any of those three conditions, and found that people with diagnosed illness were less likely to say they were in good health.

But people with undiagnosed illnesses were more likely to say their health was good than people without those illnesses.

For instance, women who knew they had hypothyroidism were less likely to report good health than women without thyroid disease, but women who didn't know they had thyroid problems were 84 percent more likely to believe they were healthy than women who didn't have thyroid disease.

Similarly, people with undiagnosed severe hypertension were more likely to report good health compared to participants with normal blood pressure readings.

And, in general, participants who didn't know they had diabetes or mild to moderate hypertension were just as likely as people without the disorders to believe they were in good health.

"We were surprised that many persons with disease, without knowledge about this fact, reported their self-rated health as good, sometimes even more often than healthy people," Jorgensen said. "The fact that persons with acknowledged disease report their health as poor was not unexpected."

It's important to note that the study relied on self-reported information, which may not be completely accurate, and that studies like this can't prove that knowing about a health condition actually causes a person to feel they're in poor health, the authors caution.

It's possible that people who don't know about their conditions are more optimistic and worry less in general so they're just less likely to go to the doctor for check-ups or when they have vague symptoms, Jorgensen and his colleagues write.

Jorgensen said that people should be concerned and ask critical questions, like whether health screening will do them any good or improve their chances to live longer.

"The main effects of check-ups are more people defined as sick, more people undergoing treatment, without lowered mortality," he added.


To see the original version together with other other pictures or videos, browse the link previously mentionedOtis Brawley, chief medical officer of the American Cancer Society and author of "How We Do Harm: A Doctor Breaks Ranks About Being Sick in America," told Reuters Health the researchers are right on target.

"We've got data to show that depression and suicide increases in men who are known to have an elevated PSA, not men who have prostate cancer but men who have an elevated PSA that merits an evaluation for prostate cancer," he said.

People think early detection can only be good and they don't know that giving someone a diagnosis or label can be harmful, he said.

"So I think we need to think about these things, but we also need to have a more positive attitude about the early detection of some of these diseases," he said.

Neither expert suggested that genuine illness should go untreated.

Brawley said he would prefer that a patient and doctor know about any health problems so they could work through them.

"If I've got someone who's got mild diabetes or metabolic syndrome I might actually be able to work with that patient and actually get them to a near-normal state," he said.

SOURCE: BMJ Open, online May 28, 2014.

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20 Jun 2014
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15 Jun 2014
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New approach to treating prostate cancer may boost survival

Adding the chemotherapy drug docetaxel to standard hormone-depleting therapy may extend the lives of men with advanced prostate cancer, a new study finds.

The study was to be presented Sunday in Chicago at the annual meeting of the American Society of Clinical Oncology (ASCO).

"Hormone therapy has been a standard treatment for prostate cancer since the 1950s," lead author Christopher Sweeney, a medical oncologist at the Dana-Farber Cancer Institute in Boston, explained in an ASCO news release.

"This is the first study to identify a strategy that prolongs survival in newly diagnosed metastatic prostate cancer," he added. "The benefit is substantial and warrants this being a new standard treatment for men who have [extensive] disease and are fit for chemotherapy."

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One expert not connected to the new trial agreed.

"These data are practice-changing and help us further improve the care we give to patients with prostate cancer," said Dr. Arjun Balar, co-leader of the Genitourinary Cancers Program at the Perlmutter Cancer Center at NYU Langone Medical Center in New York City.

He believes the study will "also help us better understand the biology of the most aggressive and lethal prostate cancers so we can design new clinical trials to further improve the outcomes of men with this devastating disease."

Prostate cancer is often spurred on by hormones such as testosterone, so hormone-depleting therapy is the standard initial treatment for these "hormone-sensitive" tumors. The treatment is initially effective, but the disease eventually becomes resistant to the therapy in most patients.

Chemotherapy is typically started only after the disease progresses despite hormone therapy, experts note.

In this U.S. National Cancer Institute-led study, 790 men newly diagnosed with advanced hormone-sensitive prostate cancer were divided into two groups. One group received hormone therapy alone, while the other group got hormone therapy plus docetaxel for 18 weeks.

After a median follow-up of more than two years, there were 136 deaths in the hormone therapy-only group, and 101 deaths in the hormone therapy-plus-docetaxel group. Median survival was 44 months in the hormone therapy group and 57.6 months in the hormone therapy/docetaxel group, the researchers reported.

Among men whose prostate cancer had spread to major organs or bones, median survival was 32.2 months in the hormone therapy group and 49.2 months in the hormone therapy/docetaxel group.

The use of docetaxel also delayed cancer progression, the study found. Median time to progression after treatment was 19.8 months in the hormone therapy group and 32.7 months in the hormone therapy/docetaxel group.

"These results demonstrate how we can use 'old tools' in new, more powerful ways to improve and extend patients' lives," ASCO President Dr. Clifford Hudis said in the ASCO news release.

"This study is also a powerful testimony to the importance of National Cancer Institute-led research, as both of these drugs are available in generic form today and this research might have otherwise not been pursued," he added.

Experts caution that studies presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

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11 Jun 2014
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