Powerful gas explosion levels Mass. buildings; at least 18 hurt

SPRINGFIELD, Mass. (AP) — A natural gas explosion in one of New England's biggest cities on Friday destroyed two buildings, including one housing a strip club, and damaged others beyond repair but didn't kill anyone, authorities said.

Firefighters, police officers and gas company workers in the area because of an earlier gas leak and odor report were among more than a dozen people injured, authorities said.

"This is a miracle on Worthington Street that no one was killed," Lt. Gov. Tim Murray said at a press conference.

The explosion in a downtown area of Springfield, 90 miles west of Boston, blew out all windows in a three-block radius, leaving three more buildings irreparably damaged and prompting emergency workers to evacuate a six-story apartment building that was buckling.

Police Sgt. John Delaney marveled at the destruction at the blast's epicenter, where a multistory building was leveled.

"It looks like there was a missile strike here," he said.

Officials at two nearby hospitals said at least 18 victims were transported there with injuries but none was critical.

Firefighters responded to the scene at 4:20 p.m. and were investigating the gas leak when the blast happened shortly after 5 p.m. The cause of the explosion hadn't been identified but was under investigation, they said.

Springfield, which has about 150,000 residents, is the largest city in western Massachusetts. It's known as the home of the Basketball Hall of Fame, which is not in the vicinity of the blast.

The explosion, in an area of downtown Springfield with commercial properties and residences, destroyed a building that housed a Scores Gentlemen's Club.

Area resident Wayne Davis said he felt his apartment building shake a block away.

"I was laying down in bed, and I started feeling the building shaking and creaking," he said.

The Navy veteran said the boom from the explosion was louder than anything he'd ever heard, including the sound of a jet landing on an aircraft carrier.

The blast was so loud it was heard for miles around. Video from WWLP-TV showed the moment of the explosion, with smoke billowing into the air above the neighborhood.

Mayor Domenic Sarno said it was through "God's mercy" that nobody had been reported killed in the explosion.

"My thoughts and prayers are with the individuals that have been injured and the people who have been displaced," he said, adding that emergency shelter was being set up for those unable to go home.

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Associated Press writers Bridget Murphy and Bob Salsberg in Boston contributed to this story.

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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.

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Philippines, Vietnam protest map in China passport

MANILA, Philippines (AP) — A map that China has incorporated into its passports has drawn diplomatic fury because it appears to claim the entire South China Sea, ignoring competing claims from the Philippines, Vietnam and other countries.

Philippine Foreign Secretary Albert del Rosario told reporters in Manila that he sent a note to the Chinese Embassy that his country "strongly protests" Beijing's inclusion of an image showing China's claimed maritime borders in its new passport.

Del Rosario says 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.

"The outline map of China on the passport is not directed against any particular country," Foreign Ministry spokeswoman Hua Chunying said Thursday.

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 potentially oil- and gas-rich South China Sea islands and waters also are claimed by the Philippines, Vietnam, Taiwan, Brunei and Malaysia.

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.

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Associated Press writers Chris Brummitt in Hanoi, Vietnam, and Zhao Liang in Beijing contributed to this report.

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Amazon Kindle Fire HD 8.9 is Good, But No iPad Killer [REVIEW]

Unboxing the Kindle Fire HD 8.9

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[More from Mashable: Apple Now Owns the iMessage Name]

Amazon expands its tablet sights with the bigger, more powerful Kindle Fire HD 8.9. Can it compete against Apple‘s iPad?

If there’s one company that deserves credit for reigniting the iPad competitor market, it’s Amazon. Despite some bugs and an overall blah design, its 7-inch Kindle Fire was the first Android tablet that made sense to consumers who gobbled it up to help the Fire grab 50% of the Android tablet market in just 6 months.

[More from Mashable: 9 Black Friday Deals For iPhone Owners]

That tablet essentially opened the flood gates for a new set of ever-more-powerful 7-inchers from, notably, Barnes & Noble and Google. All three companies have already updated their 7-inch offerings to more powerful components and higher-resolutions screens. They’re all still running Android, though Amazon and Barnes & Noble choose to hide the Google OS behind smarter and much more consumer-friendly interfaces.

All this led Apple to finally enter the mid-sized tablet space with the iPad Mini. It’s easily the best-looking tablet of the bunch, but also $ 120 more expensive than its nearest competitor.

The more interesting development, though, is Amazon‘s (and Barnes & Noble‘s) decision to go toe-to-toe with Apple’s full-size iPad and launch the Amazon Kindle Fire HD 8.9 (in 4G LTE and WiFi-only). The move is akin to a middle weight boxer putting on the pounds to take on the Heavyweight world champion. Amazon’s Kindle Fire HD is slightly smaller (the iPad is 9.7-inches), lighter (567g vs. 625g), cheaper ($ 369 for 32 GB model vs. $ 599 for the iPad 4th Gen — Amazon subsidizes with sleep-state ads, that I do not mind) and overall somewhat less powerful. In order to win the battle, the 8.9-inch Kindle Fire HD better be pretty nimble on its feet, while able to throw that all important knockout punch.

Short version of this story: the Kindle Fire HD 8.9 does some serious damage, but the iPad 4th Gen gets the decision and retains the tablet leader title.

The Kindle Fire HD 8.9 is by no means a failure. In many ways, it’s as good as the smaller Kindle Fire HD, but throughout my tests I noticed odd bugs and glitches (which should all be fixable by software) and a somewhat disturbing lack of power that’s especially obvious when you put the Fire HD 8.9 next to the iPad 4th Gen

What It Is

If you’ve never seen an iPad and someone handed you the Kindle Fire HD .9, you’d likely say its jet-black, soft-to-the-touch plastic body felt good in your hands and was more than effective at all the core tasks (reading, game playing, e-mail, web browsing).

Design-wise, the 8.9 device looks exactly like the 7-inch model, complete with the too-hard to find volume and power buttons. There are no other physical buttons on this device, but Amazon chooses to hide the few it has by making them the exact same color as the chassis and flush with the body. Every time I use the tablet I do the “where’s the damn button” dance, rotating the Kindle Fire HD round and round until I feel the buttons (since I can barely see them).

I have applauded Barnes & Noble for putting the physical “N” home button right on the face of their Nook HD. Bravo for having the guts to do this. Amazon apparently looks at Apple’s iPad home button and thinks to have anything similar would be seen as “copying” the Cupertino hardware giant, when instead they should realize that it works, consumers like it and tablets without it are at a distinct disadvantage.

Amazon’s interface has you make do with a virtual, slide-out home button that is always available. Problem is, I found times when it wasn’t available. When I played Spider-Man and Asphalt 7, the tiny little left-had bar would disappear and I couldn’t exit the game unless I hit the sleep/power button.

The rest of the Kindle Fire HD 8.9′s body is solid and unremarkable (if you read my Kindle fire HD 7 review, then you know exactly what to expect.). Like the iPad 4th Gen, the Kindle Fire HD 8.9 has a front-facing 720p-capable camera. It’s useful for capturing video, snapping 1 Megapixel images and, probably most important, Skype video chats. Skype has built a fairly sharp-looing Kindle Fire app, though the design doesn’t fully fit the larger 8.9-inch screen. Skype just updated its Android app for better tablet viewing and hopefully, we’ll see this update hit the Kindle Fire HD 8.9 as well.

The iPad also has an HD rear-facing camera. The Kindle fire HD 8.9 does not (Barnes & Noble leave out cameras altogether)

Not Packing a Punch

As a large-screen high-resolution tablet (though iPad’s 2048×1536 retina display beats it), the Kindle Fire HD 8.9 offers plenty of attractive screen real estate for web browsing, book and magazine reading and games. But the results can be mixed. Silk, Amazon‘s custom web browser, was occasionally less than responsive and games, though, they ran well, never looked half as good as they do on the considerably more expensive iPad 4.

Granted, you can’t always find the same high-quality immersive action games on both Android and iOS, but Asphalt 7 Heat is a notable exception and it throws the performance differences between the two tablets into stark contrast. Game play is equally responsive on both platforms: the Kindle Fire HD 8.9’s accelerometer reads my moves just as well as the iPad.

The graphics on the Kindle Fire HD, however, are reduced to blobs and blocks (palm trees without distinct leaves, buildings without discernible windows) . The iPad’s quad-core graphics simply overmatch the Kindle Fire. I have never, for example, seen an iPad draw the game as I was playing, as I did when I tried out The Amazing Spider-Man.

Additionally, I experienced more than my share of crashes with games and even magazine apps like Vanity Fair.

The Good

Not everyone, however, will compare the Kindle Fire HD 8.9 to the iPad. Some will see the $ 299 entry-level price point (for the 16 GB model) and appreciate the power, flexibility and utility of this device. Like all Fire’s before it, the Kindle Fire HD 8.9 makes it easy to consume mass quantities of content. Nearly every menu option: Games, Apps, Books, Music, Videos, Newsstand, puts you just one click away from shopping for fresh content. If you have an Amazon account (and who doesn’t) your desired book, music or movie is just a click away. Plus, you can still easily store any of it locally, and worry about running out of storage space, or in the cloud, and never worry about space or accessibility—you can get to that purchased Kindle content from any Kindle app or registered Amazon device.

Watching movies on the tablet is a pleasure. I streamed a couple through Amazon Prime; they looked good on the 1920 x 1200 screen and the Dolby Stereo speakers produced sharp, loud, almost room-filling sound—an impressive feat not even the iPad can match.

The Kindle Fire HD 8.9 also includes a mini-HDMI-out port, which prompted me to connect the tablet to my 47-inch LED HDTV so we could watch Disney’s Brave. Yes, I had to get up and tap on the Kindle screen each time I wanted to pause and restart the move, but otherwise, I was pretty impressed with how the Kindle handled the task.

Obviously I yearn for an Apple Airplay-like feature on Android tablets (rumor has it one is coming), but this is the next, best thing.

There isn’t a lot to say about the Kindle Fire HD 8.9-inch interface that I did not say in the Kindle Fire HD 7 review. I will note, however, that the increased real estate makes the trademark task carousel seem almost too big. Icons for everything from your recently played Spider-Man game to magazine apps, books and Web sites all sit side-by-side-by side. Some, like book covers, look gorgeous.

Others like a broken web-page link look stupid. Worse yet, none of them have labels, which can occasionally make it hard to identify which app or task you’re looking at. I’m just not sure this interface metaphor is sustainable.

Personally I prefer either the clean consistent look of iOS, or the uber-user friendly, family-oriented Nook HD profile-based one. Amazon may want to take a hard look at those and start over.

Staying Connected

The Kindle Fire HD 8.9 is also Amazon’s first cellular-based tablet. That fact puts it even more squarely in competition with the iPad (which obviously has always had 3G models and now offers blazing fast 4G LTE ones as well on all major carriers).

Amazon’s mobile broadband plans are a little more conservative, with just the AT&T 4G LTE option (the 32 GB 4G model that I tested lists for $ 499, which is still $ 224 less than a comparable iPad 4th Gen).

In my experience, the connectivity is superfast and fairly ubiquitous. Amazon‘s $ 49 (a year) flat fee plan is attractive, but with a cap of 250MB per month of data, it’s unlikely it will satisfy the most data-hungry users. If you do need more data, users can also get 3GB and 5GB data plans directly from AT&T on the device.

At press time, Amazon had not enabled streaming video over LTE. Having it sounds nice, but even with the most generous data plans, streaming video would eat it up faster than you can say, “I’m streaming Back to the Future in HD over 4G LTE on my Kindle fire HD!”

The reality for most users is that WiFi is plentiful and you’ll be hard pressed to find a spot where you can’t connect for free or a small one-off fee. It’s the reason Barnes & Noble’s line of HD Nooks do not include a cellular option.

Review continues after FreeTime Gallery

FreeTime

Kindle HD FreeTime Start

Click here to view this gallery.

Perhaps the best new addition to the Kindle Fire family is not a piece of hardware or new component, but the new FreeTime app. Amazon put a lot of loving care into this parental control interface, but almost mucks the whole thing up by hiding the tool under an app that you have to scroll down to (or search) to find. By contrast profiles and age and content controls are baked into the Barnes & Noble Nook HD in a way that makes them impossible to ignore.

Even so, once you do access FreeTime, I think you’ll be pleased with the level of control it gives you. I added test profiles for my two children and then hand-picked every app and piece of content they could access. I was also able to block broadband mobile and even set time limits for access to content and overall screen viewing time (on a per profile basis). The set-up is a bit wonky and it bizarrely switches between landscape and profile screens, but I still applaud the effort. It would make sense for Amazon to move FreeTime into a device set-up screen. If the user has no additional family members or kids using the device, they can easily skip it.

To Buy or Not to Buy

Amazon’s expansive content and shopping ecosystem has always been a strong draw and it’s just as good in this large screen tablet as it was in the very first Kindle Fire. Still, you have to compare it with the equally strong iOS ecosystem, which is no slouch in the content shopping department. Apple doesn’t connect you as seamlessly to physical products, but there’s nothing difficult about shopping on Amazon.com via your iPad. It’s also notable that tablet competitor Barnes & Noble has added movie and TV viewing, rental and purchase.

Ultimately, all of these tablets are offering more and more of the same content options, apps, and features. The decision will likely come down to price, app selection, interface and overall ease of use. The Amazon Kindle fire HD 8.9 scores well on all of these, but does not always lead.

For the price, it’s a great value, but I want Amazon to focus on hardware and interface design for the next big update. Then, they may get my full endorsement.

This story originally published on Mashable here.

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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:

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Thanksgiving Day parade offers respite for storm victims

GENEVA (Reuters) - Kris Kristofferson -- Oxford scholar, athlete, U.S. Army helicopter pilot, country music composer, one-time roustabout, film actor, singer, lover of women, three times a husband and father of eight -- seems ready to meet his maker. At least, that was the clear impression he left with an audience of middle-aged-and-upwards fans at a concert in Geneva this week, a message underscored by his 28th and latest album, "Feeling Mortal" and its coffin-dark cover. ...

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Australian author Bryce Courtenay dies of cancer

CANBERRA, Australia (AP) — Australian best-selling author Bryce Courtenay has died of stomach cancer. He was 79.

His publisher Penguin Group said Friday that the South African-born writer died at his family home in the Australian capital Canberra late Thursday surrounded by his family and pets.

Courtenay had a successful career in advertising before writing his first novel, "The Power of One," which was published in 1989 when he was 56. The story became a movie starring Morgan Freeman.

His 21st novel, "Jack of Diamonds," was published this month.

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India secretly hangs lone surviving Mumbai gunman

MUMBAI, India (AP) — India secretly executed the lone surviving gunmen from the 2008 Mumbai terror attack, four years after Pakistani gunmen blazed through India's financial capital, killing 166 people and shattering relations between the nuclear-armed neighbors.

Mohammed Ajmal Kasab, a Pakistani citizen, was hanged early Wednesday at a jail in Pune, a city near Mumbai, after Indian President Pranab Mukherjee rejected his plea for clemency.

News of the execution was widely cheered in India, with political parties organizing public celebrations and some people setting off firecrackers. But for those more deeply touched by the events of 26/11, as the attack is known here, the hanging offered only a partial catharsis.

"This is an incomplete justice as the masterminds and main handlers of 26/11 are still absconding," said Kavita Karkare, the widow of Hemant Karkare, the chief of Mumbai's anti-terrorism squad who was killed while pursuing Kasab. "They should also be hanged."

Indian officials accuse Pakistan's intelligence agency of working with the militant group Lashkar-e-Taiba to plan the attack — an allegation Islamabad denies. India and Pakistan, which have fought three wars since they were carved out of British India in 1947, suspended peace talks after the Mumbai attack.

Since 2011, the two countries have rekindled the peace talks, taken steps to bolster trade and signed a visa agreement to make cross-border travel easier, but New Delhi's frustration with Pakistan's failure to bring those responsible for the attack to justice has complicated efforts to mend relations.

The attacks were also a major embarrassment for India's security establishment, which failed to stop 10 gunmen who entered Mumbai on a dinghy from running roughshod over the police and elite security forces for three days.

Indian authorities faced public pressure to execute Kasab quickly, and the government fast-tracked the appeal and execution process, which often can take years or even decades.

Union Home Minister Sushil Kumar Shinde said the ministry sent Kasab's mercy plea to Mukherjee on Oct. 16 and he rejected it on Nov. 5.

Indian Foreign Minister Salman Khurshid said the government had attempted to inform Pakistani officials of the impending execution, but a fax sent to Pakistan's foreign office went unanswered. He said the government had also informed Kasab's next of kin.

Indian officials said Kasab was buried at Yerwada Central Jail, where he was executed. Some of India's most famous freedom fighters including Mohandas Gandhi served time there.

News of the execution provoked little immediate comment in Pakistan. Pakistan foreign office spokesman Moazzam Ali Khan said Kasab's family had not approached authorities about bringing his body home.

"We will look into this matter if the family of Ajmal Kasab contacts us to bring his body back, but so far they have not contacted us," he said.

Kasab and nine other gunmen entered Mumbai by boat on Nov. 26, 2008. Carrying cellphones, grenades and automatic weapons, they fanned out across the city, targeting two luxury hotels, a Jewish center, a tourist restaurant and a crowded train station. The three-day attack was broadcast live on television, transfixing the nation and the world.

A photo of Kasab striding through Mumbai's main train station, an assault rifle in hand, quickly became the iconic image of the siege.

All of the other attackers were killed during the siege. After Kasab was captured, an Indian judge sentenced Kasab to death in May 2010 for waging war against India, murder and terrorism, among other charges. Kasab cried as he heard the sentence.

In his confession, Kasab said he was recruited by Lashkar-e-Taiba after he left a low-paying job as a shop assistant in search of greater fortune as a bandit. The attackers were in regular phone contact with handlers in Pakistan during the siege.

Some in India felt Kasab should have been executed publicly. Others complained that the government had spent too much money on the care and feeding of a vilified criminal and said that for justice to be done, the attack's masterminds — not just their foot soldier — must be punished.

Mukesh Agarwal, who was shot in his right arm during the attack, called Kasab's execution "the best possible gift" from the Indian government. But he said "instead of secretly hanging him, they government should have hanged him publicly."

"I am sad and happy both," said Sonu, an office clerk in New Delhi who uses one name. "Sad because I wonder what forced him do such things and happy because this will be a good example to all the terrorists in the future."

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Associated Press writers Aijaz Ansari in Mumbai, Chon Ngashangva and Muneeza Naqvi in New Delhi, and Munir Ahmed in Islamabad, Pakistan, contributed to this report.

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Exclusive: TV networks start seven-day ratings push with advertisers

LOS ANGELES (Reuters) – U.S. television broadcast networks are taking the first steps to persuade advertisers to pay for commercial viewership that occurs up to seven days after a program airs, a shift that would provide a new revenue stream to help combat ratings erosion.

The networks argue that the rising popularity of digital video recorders is pushing a sizeable number of viewers to delay watching their favorite programs beyond the first three days, the time period most often used for calculating ad payments.

Some advertisers are ready to make the move to a seven-day metric. One of the big four networks, Walt Disney Co’s ABC, earlier this year reached deals with some sponsors that bring in payments for eyeballs counted between days four and seven.

The other broadcasters have begun talks with advertisers and hope to convince them to switch to the longer window in time for the “upfront” selling season that starts early next year, when billions of dollars in ad commitments will be made, according to people familiar with the discussions.

Since 2007, most TV ad time has been bought and sold based on “C3,” a ratings measurement based of the average number of commercial minutes watched during a program either live or within three days of its airing.

TV networks want advertisers to shift to “C7,” which captures commercials watched within seven days.

Advertisers hesitate to pay for the added days, particularly for time-sensitive ads pitching a department store’s one-day sale or the opening of a summer movie blockbuster. Media buyers are pushing for precise measurements of each commercial viewed, rather than an average for an entire program, as well as a tabulation of how many people are watching on mobile devices.

The debate intensified after Nielsen data showed a sharp decline in three-day viewing at the start of the fall TV season compared with last year.

The drop is partly due to “the greater penetration of DVRs and the greater usage of DVRs, which clearly have shifted the rating in the direction of C3, and ultimately, hopefully, C7,” Disney CEO Bob Iger told analysts on a November 8 conference call.

Most viewing of network prime time shows still takes place within three days. But the post-three day viewers are growing and can be significant. Ratings for ABC comedy hit “Modern Family” increased by 5 percent, to 6.5 million viewers age 18 to 49 viewers, when counted by the C7 measurement instead of C3.

The later viewers also are among the most-coveted by advertisers, according to ABC research, which showed people who watched a show after three days were more highly educated and had higher incomes. For days four through seven, “the people who are doing the viewing are some of the most desirable available from an advertiser’s perspective,” said Charles Kennedy, senior vice president of research for ABC and the ABC Family cable network.

Earlier this year, ABC made deals with some sponsors to pay for ad time based on C7 numbers, ABC spokesman Kevin Brockman said. “We expect to do more of them if they make sense for us and our clients,” Brockman said.

At CBS, the flagship network of CBS Corp, CEO Leslie Moonves has been outspoken in pressing for a C7 metric and said it “represents a significant opportunity for us that is still in the very early stages.”

“As we move forward, we will make it a priority to get paid for all of the viewing that is going on across our shows, including DVR viewing beyond C3,” Moonves told analysts on a November 7 conference call.

Advertisers are not ready to commit to the switch and will be looking for something in return if they agree to a longer window. Timing is a big concern for many brands that want to get a message out to large numbers of consumers during a specific time period. Some commercials lose their value for sponsors over a few days.

“In moving to C7, you’ve got to be careful because you are taking away some of the advantage of why clients buy television,” said Sam Armando, director of strategic intelligence for SMGx, a division of media buying agency Starcom MediaVest Group.

Advertisers believe simply adding more days to the current metric fails to adequately capture viewership. Brands are lobbying for a more precise measurement that tracks viewership of each commercial, rather than an average for a program over a time period, they say. They also want information on how many people see their ads on programs watched on computers or Internet-connected mobile devices like phones and tablets.

“If the industry is going to make a move, we need to consider it all before we just make a little baby step to C7,” Armando said.

(Reporting By Lisa Richwine; Edited by Ronald Grover and Andrew Hay)

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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.

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Online:

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

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

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

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