Pap Test May Prove Useful at Detecting More Types of Cancer, Study Suggests

The Pap test, which has prevented countless deaths from cervical cancer, may eventually help to detect cancers of the uterus and ovaries as well, a new study suggests.

For the first time, researchers have found genetic material from uterine or ovarian cancers in Pap smears, meaning that it may become possible to detect three diseases with just one routine test.

But the research is early, years away from being used in medical practice, and there are caveats. The women studied were already known to have cancer, and while the Pap test found 100 percent of the uterine cancers, it detected only 41 percent of the ovarian cancers. And the approach has not yet been tried in women who appear healthy, to determine whether it can find early signs of uterine or ovarian cancer.

On the other hand, even a 41 percent detection rate would be better than the status quo in ovarian cancer, particularly if the detection extends to early stages. The disease is usually advanced by the time it is found, and survival rates are poor. About 22,280 new cases were expected in the United States in 2012, and 15,500 deaths. Improved tests are urgently needed.

Uterine cancer has a better prognosis, but still kills around 8,000 women a year in the United States.

These innovative applications of the Pap test are part of a new era in which advances in genetics are being applied to the detection of a wide variety of cancers or precancerous conditions. Scientists are learning to find minute bits of mutant DNA in tissue samples or bodily fluids that may signal the presence of hidden or incipient cancers.

Ideally, the new techniques would find the abnormalities early enough to cure the disease or even prevent it entirely. But it is too soon to tell.

“Is this the harbinger of things to come? I would answer yes,” said Dr. Bert Vogelstein, director of the Ludwig Center for Cancer Genetics and Therapeutics at Johns Hopkins University, and a senior author of a report on the Pap test study published on Wednesday in the journal Science Translational Medicine. He said the genomes of more than 50 types of tumors had been sequenced, and researchers were trying to take advantage of the information.

Similar studies are under way or are being considered to look for mutant DNA in blood, stool, urine and sputum, both to detect cancer and also to monitor the response to treatment in people known to have the disease.

But researchers warn that such tests, used for screening, can be a double-edged sword if they give false positive results that send patients down a rabbit hole of invasive tests and needless treatments. Even a test that finds only real cancers may be unable to tell aggressive, dangerous ones apart from indolent ones that might never do any harm, leaving patients to decide whether to watch and wait or to go through surgery, chemotherapy and radiation with all the associated risks and side effects.

“Will they start recovering mutations that are not cancer-related?” asked Dr. Christopher P. Crum, a professor at Harvard Medical School who was not involved in the research.

But he also called the study a “great proof of principle,” and said, “Any whisper of hope to women who suffer from endometrial or ovarian cancer would be most welcome.”

DNA testing is already performed on samples from Pap tests, to look for the human papillomavirus, or HPV, which causes cervical cancer. Dr. Vogelstein and his team decided to try DNA testing for cancer. They theorized that cells or DNA shed from cancers of the ovaries and the uterine lining, or endometrium, might reach the cervix and turn up in Pap smears.

The team picked common mutations found in these cancers, and looked for them in tumor samples from 24 women with endometrial cancer and 22 with ovarian cancer. All the cancers had one or more of the common mutations.

Then, the researchers performed Pap tests on the same women, and looked for the same DNA mutations in the Pap specimens. They found the mutations in 100 percent of the women with endometrial cancer, but in only 9 of the 22 with ovarian cancer. The test identified two of the four ovarian cancers that had been diagnosed at an early stage.

Finally, the team developed a test that would look simultaneously for cancer-associated mutations in 12 different genes in Pap samples. Used in a control sample of 14 healthy women, the test found no mutations — meaning no false-positive results.

Dr. Luis A. Diaz, the other senior author of the report and an associate professor of oncology at Johns Hopkins, called the research a step toward a screening test that at first blush appears very effective at detecting endometrial cancer, though obviously less so at finding ovarian cancer.

“Probably one of the most exciting features of this approach,” Dr. Diaz said, “is that we wanted a test that would seamlessly integrate with routine medical practice that could be utilized with the same test that women get every day all over the world, the Pap smear.”

But, he added: “We can’t say it’s ready for prime time. Like all good science, it needs to be validated.”

He and other members of the team said it might be possible to improve the detection rate for ovarian cancer by looking for more mutations and by changing the technique of performing Pap tests to increase the likelihood of capturing cells from the ovary. The change might involve timing the test to a certain point in a woman’s monthly cycle, using a longer brush to collect cells from deeper within the cervix or prescribing a drug that would raise the odds of cells being shed from the ovary.

The technique also needs to be tested in much larger groups of women, including healthy ones, to find out whether it works, particularly at finding cancers early enough to improve survival. And studies must also find out whether it generates false positive results, or identifies cancers that might not actually need to be treated.

Michael H. Melner, a program director in molecular genetics and biochemistry for the American Cancer Society, called the research “very promising,” in part because it is based on finding mutations.

“It tells you not just that cancer is there, but which mutation is there,” Dr. Melner said. “As we learn more and more about which mutations are associated with more or less severe forms of cancer, it’s more information, and possibly more diagnostic.”

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Shares Rise as Companies Report Earnings

Stocks rose on Wall Street on Wednesday after corporate earnings reports got off to a good start.

The Dow Jones industrial average climbed 61.66 points to 13,390.51. The Standard & Poor’s 500-stock index gained 3.87 points to 1,461.02, and the Nasdaq composite rose 14 to 3,105.81.

Stocks are facing their first big challenge of the year as companies start to report earnings for the fourth quarter of 2012. Throughout last year, analysts cut their outlook for earnings growth in the period and now expect them to rise by 3.21 percent, according to data from S&P Capital IQ.

“Maybe earnings expectations were a little too low,” Ryan Detrick, a strategist at Schaeffer’s Investment Research, said. “You don’t need to have great earnings, you just need to beat those expectations” for stocks to rally, he said.

Early indications were decent. The aluminum maker Alcoa reported late Tuesday that it swung to a profit for the fourth quarter, with earnings that met Wall Street’s expectations. The company brought in more revenue than analysts had expected, and the company predicted rising demand for aluminum this year as the aerospace industry gains strength. Alcoa is usually the first Dow component to report earnings every quarter.

Despite the better revenue number, Alcoa’s stock performance Wednesday was lackluster. It traded higher for part of the day, then ended down 2 cents at $9.08 a share.

Other companies fared better after reporting earnings. Helen of Troy, which sells personal care products under brands like Dr. Scholl’s and Vidal Sassoon, rose 2.7 percent, up 90 cents to $34.43 after reporting a 15 percent increase in quarterly net income.

Boeing was the biggest gainer of the 30 stocks in the Dow. It jumped 3.5 percent, up $2.63 to $76.76, after two days of sharp declines set off by new problems for its 787 Dreamliner. Boeing said it had “extreme confidence” in the plane even as federal investigators tried to determine the cause of a fire on Monday aboard an empty Japan Airlines plane in Boston and a fuel leak in another Japan Airlines 787 on Tuesday.

The wireless network operator Clearwire rose 7.2 percent, or 21 cents, to $3.13, after Dish network made an unsolicited offer to buy the company, which has already agreed to sell itself to Sprint. Dish rose 88 cents to $36.85, and Sprint fell 9 cents to $5.88.

The online education company Apollo Group fell 7.8 percent after reporting a sharp decline in fall term student sign-ups at the University of Phoenix, which it operates. The stock fell $1.62, to $19.32 a share.

Interest rates were steady. The Treasury’s benchmark 10-year note rose 1/32, to 97 29/32, and the yield was unchanged at 1.86 percent.

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Communists and Liberals Face Off in China Censorship

GUANGZHOU, China — Protests over censorship at one of China’s most liberal newspapers descended into ideological confrontation in this southeastern provincial capital on Tuesday, pitting advocates of free speech against supporters of Communist Party control, who wielded red flags and portraits of Mao Zedong.

The face-off between liberals and leftists outside the headquarters of the company that publishes the weekly newspaper, Southern Weekend, came after disgruntled editors and reporters at the paper last week deplored what they said was crude meddling by the top propaganda official in Guangdong Province, which has long had a reputation as a bastion of a relatively free press.

With a number of celebrities and business leaders rallying online to the liberal cause, senior propaganda officials in Beijing began this week to roll out a national strategy of demonizing the rebel journalists and their supporters. The Central Propaganda Department issued a directive to news organizations saying that the defiant outburst at Southern Weekend, also known as Southern Weekly, had involved “hostile foreign forces.”

The order, translated by China Digital Times, a research group at the University of California, Berkeley, that studies Chinese news media, said that Chinese journalists must drop their support for Southern Weekend and insisted that “party control of the media is an unwavering basic principle.”

An editor at a party news organization said the term “hostile forces” had been used in an internal discussion with a senior editor about the Southern Weekend conflict. Several Chinese journalists outside Guangdong said Tuesday that a positive outcome for the frustrated Southern Weekend reporters and editors appeared uncertain, and that their call for the dismissal of Tuo Zhen, the top provincial propaganda official, who took up his post in May, was probably too radical for higher authorities to accept.

The protesting journalists at Southern Weekend blame Mr. Tuo, a former journalist himself, for ordering a drastic change in a New Year’s editorial that had originally called for greater respect for constitutional rights. The revised editorial instead praised party policies. Mr. Tuo has not commented.

A former editor at the Nanfang Media Group, which includes Southern Weekend, said negotiations continued on Tuesday between provincial propaganda officials and representatives of the disgruntled journalists and editors.

The former editor, who asked that his name not be used for fear it could jeopardize his current job, said the talks focused on the protesting journalists’ demands for an inquiry into the New Year’s episode and for the newspaper’s managers to rescind a statement that absolved Mr. Tuo of responsibility for the editorial.

“They want that statement to be removed, and they also want assurances about relaxing controls on journalists — not removing party oversight, but making it more reasonable, allowing reporters to challenge officials,” he said. “The other main demand is for an impartial explanation of what happened, an accounting so it won’t happen again.”

The former editor said a continued standoff into Wednesday could jeopardize the newspaper’s usual publication on Thursday. “In effect, it’s a strike,” he said. “It looks unclear whether it can come out on Thursday.”

So far, senior Chinese officials have not commented publicly on the censorship dispute at the paper, which could test how far the recently appointed Communist Party leader, Xi Jinping, will go in support of more open economic and political policies. “I don’t believe that Xi is totally hypocritical when he talks about reform,” said Chen Min, a prominent former opinion writer for Southern Weekend who was forced out of the newspaper in 2011 during a party-led crackdown on potential dissent.

Defenders of Communist orthodoxy turned up at the newspaper headquarters on Tuesday to make the case for firm party control of the media.

“We support the Communist Party, shut down the traitor newspaper,” said a cardboard sign held up by one of 10 or so conservative demonstrators.

“Southern Weekend has an American dream,” another sign said. “We don’t want the American dream, we want the Chinese dream.”

Most of the party supporters refused to give their names. One who did, Yang Xingfa, 50, from Hunan Province, said: “Southern Weekend belongs to the people. However, the paper always ignores the achievements of the Chinese Communist Party and asks why China isn’t more like the United States. Outrageous!”

Some of the participants held portraits of Mao; others waved the red flags of China and of the Communist Party. They said they had come on their own initiative and not at the behest of officials.

The dueling protests outside the newspaper headquarters reflected the political passions and tensions raised by the quarrel over censorship. Internet chatter about the conflict has become widespread, and finding a resolution to the standoff poses a challenge both to the central authorities and to Hu Chunhua, the new party chief of Guangdong and a potential candidate to succeed Mr. Xi in a decade.

Hundreds of bystanders watched and took photos on cellphones as the leftists shouted at the 20 or more protesters who had gathered to denounce censorship, and shoving matches broke out between the demonstrators. The 70 or so police officers and security guards mostly watched, stepping in on occasion to separate the two sides.

At one point, leftists were showered with 50-cent renminbi currency notes, which are worth about 8 United States cents. The Fifty-Cent Party has become a popular term used to disparage pro-party leftists, who are accused by critics of taking 50 cents as payment for each pro-party message they post on the Internet.

One defender of the Southern Weekend journalists was Liang Taiping, 28, a poet who wore a mask popularized by the Hollywood movie and British comic book “V for Vendetta.” Mr. Liang said he had bought the mask after watching the movie recently on state-run China Central Television, which had surprised many Chinese with its willingness to show the film uncut, since the film advocates the overthrow of a one-party dictatorship.

“It’s the only newspaper in China that’s willing to tell the truth,” said Mr. Liang, who added that he had traveled by train about 350 miles from the southern city of Changsha to show his support. “What’s the point of living if you can’t even speak freely?”

Edward Wong reported from Guangzhou, and Chris Buckley from Hong Kong. Jonah M. Kessel contributed reporting from Guangzhou, and Jonathan Ansfield from Beijing. Mia Li contributed research from Guangzhou.

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Baseball Dumping Dugout-to-Bullpen Landlines

The reserve clause is dead. And so are wool uniforms. There are no longer eight teams in each league. And the Houston Astros have departed the National League.

 Major League Baseball is now about to disconnect the landlines that link dugouts to bullpens. Long after the rest of society embraced cellphones, managers and coaches will soon be able to discuss pitching changes on Samsung Galaxy S III phones.

The 21st century 4G dugout-to-bullpen connection that is being created by T-Mobile USA as part of its wireless sponsorship with Major League Baseball was announced Tuesday at the International Consumer Electronics Show in Las Vegas.

 “This is baseball’s continued push into the digital age,” said Tim Brosnan, Major League Baseball’s executive vice president for business. “It’s also about a very aggressive wireless provider that sought us out to create this unique communications platform.”

Baseball had not thought of a dugout-to-bullpen phone system in its talks with various wireless providers about a national sponsorship over the past decade, Brosnan said.

The wireless system will be tested at the World Baseball Classic in Arizona in March; after assessing how it worked, and fixing any problems, it will be rolled out in the major leagues. Whether each stadium will have it in 2013 has not been determined.

T-Mobile’s sponsorship plans also include enhancing network connectivity for fans at all ballparks and helping MLB Advanced Media create content for smartphones and tablets.

To create the dugout-to-bullpen communications system, each ballpark will get the equivalent of a small cellular system with a miniature cell tower.

But while wireless companies like T-Mobile are continuously trying to broaden their national coverage territory, the dugout-to-bullpen system will have limits enforced by a technology called geo-fencing. So, managers and pitching coaches will not be able to chat with the bullpen coach from the pitcher’s mound. And bullpen coaches cannot ask, “Can you hear me now?” once they leave the bullpen’s environs.

“The guidance we’ve been given is that we shouldn’t fundamentally change what makes baseball baseball,” said Mark McDiarmid, T-Mobile’s vice president for engineering. “There is reason to be cautious about how far the coach could move away from the dugout before the umpires might think it’s inappropriate.”

Baseball is not shifting to cellphones because of an incident during the eighth inning of Game 5 of the 2011 World Series when the noise at Rangers Ballpark in Arlington caused Derek Lilliquist, the Cardinals’ bullpen coach, to misunderstand Manager Tony La Russa’s instructions about which relievers should start warming up.

Twice, La Russa asked that Jason Motte get up. Lilliquist apparently did not hear the first request. When La Russa called again to get Motte ready, Lilliquist thought he was asking for Lance Lynn. The miscommunication led to La Russa’s surprise when he summoned a right-hander and Lynn arrived at the mound, not Motte. Lynn stayed in long enough to issue an intentional walk; Motte quickly got ready and replaced him.

Lilliquist might well have heard La Russa’s instructions if they had used the cellphone system, with multiple microphones, noise mitigation and the ability to raise audio levels.

 Given T-Mobile’s investment over the next three years, it is not surprising that each dugout’s branded cellphone docking station — about the size of a personal computer tower — will be about as visible to TV cameras as the Gatorade vessel is.

But, Brosnan said, baseball has not ordained the obvious commercial tie-in: that each call to the bullpen on Fox, ESPN and TBS’s national telecasts be sponsored by T-Mobile.

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Gaps Seen in Therapy for Suicidal Teenagers

Most adolescents who plan or attempt suicide have already received at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled youths, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, in the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems like attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and that about a third of those who had suicidal thoughts had made an attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.

The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said. According to the Centers for Disease Control and Prevention, 1,386 people between the ages of 13 and 18 committed suicide in 2010, the latest year for which numbers are available.

“I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”

The report said nothing about whether the therapies given were state of the art or carefully done, said Matt Nock, a professor of psychology at Harvard and the lead author, and it is possible that some of the treatments prevented suicide attempts. “But it’s telling us we’ve got a long way to go to do this right,” Dr. Nock said. His co-authors included Ronald C. Kessler of Harvard and researchers from Boston University and Children’s Hospital Boston.

Margaret McConnell, a consultant in Alexandria, Va., said her daughter Alice, who killed herself in 2006 at the age of 17, was getting treatment at the time. “I think there might have been some carelessness in the way the treatment was done,” Ms. McConnell said, “and I was trusting a 17-year-old to manage her own medication. We found out after we lost her that she wasn’t taking it regularly.”

In the study, researchers surveyed 6,483 adolescents from the ages of 13 to 18 and found that 9 percent of male teenagers and 15 percent of female teenagers experienced some stretch of having persistent suicidal thoughts. Among girls, 5 percent made suicide plans and 6 percent made at least one attempt (some were unplanned).

Among boys, 3 percent made plans and 2 percent carried out attempts, which tended to be more lethal than girls’ attempts.

(Suicidal thinking or behavior was virtually unheard-of before age 10.)

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias or generalized anxiety disorder. Those with an added behavior problem — attention-deficit disorder, substance abuse, explosive anger — were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases they can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and suicide attempts in, among others, people with borderline personality disorder, who are highly prone to self-harm.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments — talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use — was more effective than regular therapies.

“But that’s just one study, and it’s small,” said Dr. Brent of the University of Pittsburgh. “We can treat components of the overall problem, but that’s about all.”

Ms. McConnell said that her daughter’s depression had seemed mild and that there was no warning that she would take her life. “I think therapy does help a lot of people, if it’s handled right,” she said.

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Gaps Seen in Therapy for Suicidal Teenagers

Most adolescents who plan or attempt suicide have already received at least some mental health treatment, raising questions about the effectiveness of current approaches to helping troubled youths, according to the largest in-depth analysis to date of suicidal behaviors in American teenagers.

The study, in the journal JAMA Psychiatry, found that 55 percent of suicidal teenagers had received some therapy before they thought about suicide, planned it or tried to kill themselves, contradicting the widely held belief that suicide is due in part to a lack of access to treatment.

The findings, based on interviews with a nationwide sample of more than 6,000 teenagers and at least one parent of each, linked suicidal behavior to complex combinations of mood disorders like depression and behavior problems like attention-deficit and eating disorders, as well as alcohol and drug abuse.

The study found that about one in eight teenagers had persistent suicidal thoughts at some point, and that about a third of those who had suicidal thoughts had made an attempt, usually within a year of having the idea.

Previous studies have had similar findings, based on smaller, regional samples. But the new study is the first to suggest, in a large nationwide sample, that access to treatment does not make a big difference.

The study suggests that effective treatment for severely suicidal teenagers must address not just mood disorders, but also behavior problems that can lead to impulsive acts, experts said. According to the Centers for Disease Control and Prevention, 1,386 people between the ages of 13 and 18 committed suicide in 2010, the latest year for which numbers are available.

“I think one of the take-aways here is that treatment for depression may be necessary but not sufficient to prevent kids from attempting suicide,” said Dr. David Brent, a professor of psychiatry at the University of Pittsburgh, who was not involved in the study. “We simply do not have empirically validated treatments for recurrent suicidal behavior.”

The report said nothing about whether the therapies given were state of the art or carefully done, said Matt Nock, a professor of psychology at Harvard and the lead author, and it is possible that some of the treatments prevented suicide attempts. “But it’s telling us we’ve got a long way to go to do this right,” Dr. Nock said. His co-authors included Ronald C. Kessler of Harvard and researchers from Boston University and Children’s Hospital Boston.

Margaret McConnell, a consultant in Alexandria, Va., said her daughter Alice, who killed herself in 2006 at the age of 17, was getting treatment at the time. “I think there might have been some carelessness in the way the treatment was done,” Ms. McConnell said, “and I was trusting a 17-year-old to manage her own medication. We found out after we lost her that she wasn’t taking it regularly.”

In the study, researchers surveyed 6,483 adolescents from the ages of 13 to 18 and found that 9 percent of male teenagers and 15 percent of female teenagers experienced some stretch of having persistent suicidal thoughts. Among girls, 5 percent made suicide plans and 6 percent made at least one attempt (some were unplanned).

Among boys, 3 percent made plans and 2 percent carried out attempts, which tended to be more lethal than girls’ attempts.

(Suicidal thinking or behavior was virtually unheard-of before age 10.)

Over all, about one-third of teenagers with persistent suicidal thoughts went on to make an attempt to take their own lives.

Almost all of the suicidal adolescents in the study qualified for some psychiatric diagnosis, whether depression, phobias or generalized anxiety disorder. Those with an added behavior problem — attention-deficit disorder, substance abuse, explosive anger — were more likely to act on thoughts of self-harm, the study found.

Doctors have tested a range of therapies to prevent or reduce recurrent suicidal behaviors, with mixed success. Medications can ease depression, but in some cases they can increase suicidal thinking. Talk therapy can contain some behavior problems, but not all.

One approach, called dialectical behavior therapy, has proved effective in reducing hospitalizations and suicide attempts in, among others, people with borderline personality disorder, who are highly prone to self-harm.

But suicidal teenagers who have a mixture of mood and behavior issues are difficult to reach. In one 2011 study, researchers at George Mason University reduced suicide attempts, hospitalizations, drinking and drug use among suicidal adolescent substance abusers. The study found that a combination of intensive treatments — talk therapy for mood problems, family-based therapy for behavior issues and patient-led reduction in drug use — was more effective than regular therapies.

“But that’s just one study, and it’s small,” said Dr. Brent of the University of Pittsburgh. “We can treat components of the overall problem, but that’s about all.”

Ms. McConnell said that her daughter’s depression had seemed mild and that there was no warning that she would take her life. “I think therapy does help a lot of people, if it’s handled right,” she said.

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A Financial Service for People Fed Up With Banks

Steve Dykes for The New York Times

Shamir Karkal, left,

Like many people, Josh Reich got fed up with his bank after it charged him overdraft fees and he endured painful customer service calls to fight them. But unlike most people, Mr. Reich, a software engineer from Australia, decided to come up with a better way to bank.

Mr. Reich and a co-founder, Shamir Karkal, created Simple, an online banking start-up company based in Portland, Ore., that offers its customers free checking accounts and data-rich analysis of their transactions and spending habits.

Few entrepreneurs dare to set their sights on industries as large and entrenched as banking and expect to flourish. But Mr. Reich, 34, a professed data nerd who has built computers and tinkered with the innards of sophisticated cameras, holds a master’s degree in business and has a robust background in financial data analysis. He is confident that Simple’s minimalist approach — it promises not to charge any fees for any services — will draw fans and customers.

“Banks make money by keeping customers confused,” Mr. Reich said. “There’s no incentives to make the experience better.”

Of course, inviting people to trust a start-up with their money is a lot to ask. The company, which began signing up customers late last year in a deliberately slow fashion, now has 20,000 and has processed transactions worth more than $200 million.

It also has the backing of prominent venture capital firms including Shasta Ventures, SV Angel and IA Ventures and has raised more than $13 million. Simple has few, if any, direct competitors, although some services like SmartyPig and Mint offer analysis of bank accounts and financial transactions.

Simple is actually not a bank. It has deals with CBW Bank and Bancorp, federally insured banks, to hold its customers’ money.

And it has built slick apps for the Web and mobile devices to give customers an overview of their accounts and transactions. But it encourages customers to treat it as a bank, closing their more traditional accounts and only using Simple.

The company’s biggest challenge, banking analysts say, will be to persuade people to give it a try.

“It is extremely difficult to get consumers to change and leave their banks,” said Jacob Jegher, an analyst at Celent, a research and consulting firm. “Plus, although they are not a bank, they still operate like a financial institution, and they will face challenges that big banks have decades of experience with.”

After the financial crisis, smaller community banks and credit unions gained customers eager for alternatives to larger corporate banks. Experts say Simple could attract those customers as well.

Early adopters are warming to the service; during a speech last fall at a conference aimed at technology enthusiasts, designers and creative people, Mr. Reich asked how many in attendance were Simple customers. A majority of the crowd raised hands.

Mr. Reich said Simple was keeping its first group of customers small to allow it to work out any kinks. (Already there have been some flaws, like one that briefly locked several users out of their accounts in November.) At this stage, those who want a Simple account have to request an invitation on its site, though these are handed out fairly liberally to those who meet the minimal qualifications of Simple and its bank partners.

Customers receive a plain white card that can be used like a debit card. The company offers most traditional banking features, like direct deposit and money transfers. But there is plenty it does not offer, like joint or business checking accounts, or paper checkbooks, which may be a deal killer for some.

The start-up does not have physical bank branches or automated teller machines, nor does it plan to build any. As a result, Simple customers cannot make cash deposits and must rely on the Internet and phone for service.

Simple tries to make up for what it does not have with modern software design and data analysis.

Each Simple transaction is tagged with detailed information that allows customers to search their accounts with plain English commands like “Show me how much I spent on meals over $30 last month,” or “Show me how much money I spent on gifts in December.”

Customers can see transactions plotted on a map or search for all transactions in a particular state or country, something that would be difficult with a traditional bank account.

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Iran’s Oil Exports and Sales Down 40 Percent, Official Admits

Iran’s oil minister acknowledged for the first time on Monday that petroleum exports and sales had fallen by at least 40 percent over the past year, contradicting his previous denials and providing an unusual public admission that the cumulative impact of Western economic sanctions has grown more severe.

The acknowledgment by the oil minister, Rostam Qasemi, came as new restrictions from the sanctions are threatening to further choke Iran’s ability to sell oil, its most important export. Under provisions of an American law that takes effect in February, importers of Iranian oil that have been exempted from the sanctions cannot send the money used to buy it to Iran without risking penalties in the United States. The result could impound billions of dollars’ worth of Iran’s expected oil revenue in the banks of those importing countries.

Additional punitive measures, which President Obama signed into law last week, broaden the list of blacklisted Iranian industries to include all energy, shipping and shipbuilding enterprises and seek to restrict barter transactions that Iran has been using to circumvent earlier sanctions. Some critics of the new steps say they nearly amount to a trade embargo.

In another consequence of the sanctions’ impact, the Oil Ministry on Monday stopped the sale of jet fuel to Iran’s heavily indebted domestic airlines unless they pay cash. The semiofficial Mehr news agency reported that most commercial airline flights inside the country had been canceled as a result.

Mr. Qasemi, a former Revolutionary Guards commander who was appointed oil minister more than a year ago, had consistently asserted that Iran had no problem selling its oil. In September, in an address to the Parliament, he said that oil exports were rising, despite outside data that showed a sharp drop. At other times, he has threatened to halt all oil exports in retaliation for the sanctions, apparently in a vain effort to raise oil prices by frightening global oil traders.

Both the Organization of the Petroleum Exporting Countries, of which Iran is a major member, and the International Energy Agency, a group of mostly Western oil-importing countries, have reported that Iran’s crude exports fell to roughly a million barrels a day by the end of 2012, compared with 2.4 million a year earlier.

Other Iranian officials have said it is clear that the country’s oil exports have suffered.

Economists knowledgeable about Iran’s sanctions problems said Mr. Qasemi’s acknowledgment of the export decline, made at a parliamentary meeting on finances, was inevitable because the government must find a way to fill a large gap in the budget — a gap that revenue from oil exports had been expected to fill.

The Iranian Students’ News Agency quoted the minister as telling lawmakers that “there has been a 40 percent decrease in oil sales and a 45 percent decrease in repatriating oil money.” The agency also quoted him as forecasting further decreases without specifying how much.

“It’s common knowledge in Iran that oil exports have fallen,” said Djavad Salehi-Isfahani, an economics professor at Virginia Tech, who visited his native Iran last month. “I don’t know if the oil minister had been in denial.”

Dr. Salehi-Isfahani suggested that President Mahmoud Ahmadinejad’s government might have to resolve the budget deficit problem with an accounting maneuver that would recalculate the value of Iran’s oil sales at half the official foreign-exchange rate — 25,000 rials per dollar instead of the central bank’s artificial rate of 12,260 rials per dollar.

That change would be much closer to the rial’s actual value and essentially double the amount — in rials — gained from Iranian oil exports. But such a move would also concede the sanctions’ severe inflationary impact, which has caused a steep fall in the value of the Iranian currency this past year.

Many Iranians have suffered from the rial’s decline, which has essentially made them poorer by raising the price of imported goods. Iran’s inflation also has left many Iranian businesses unable to pay wages or bills. The problem surfaced in a new way on Monday with the abrupt cancellation of domestic flights by Iranian airlines, which had been buying fuel on credit.

The head of the Airlines Association, Seyyed Abdol Reza Musavi, told Mehr that flights in Tehran, Kish, Mashhad and other airports had been halted because the carriers failed to repay their debts, and that fuel would now be provided “on a cash-only basis.” It was unclear how long the flight suspensions would last.

The sanctions on Iran have been intensifying for the past few years because of its disputed nuclear program, which Iran says is for peaceful use but which Western countries and Israel suspect is meant to develop the ability to make nuclear weapons.

Thomas Erdbrink contributed reporting from Tehran.

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American Delegation Arrives in North Korea on Controversial Private Trip

David Guttenfelder/Associated Press

Eric Schmidt, Google's executive chairman, arrived in Pyongyang on Monday.

SEOUL, South Korea — Bill Richardson, the former governor of New Mexico, led a private delegation including Eric Schmidt, Google’s executive chairman, to North Korea on Monday, a controversial trip to a country that is among the most hostile to the Internet.

Kim Kwang Hyon/Associated Press

Bill Richardson with journalists on Monday after arriving in Pyongyang, North Korea. Mr. Richardson, who has visited the North several times, called his trip a private humanitarian mission.

Mr. Richardson, who has visited North Korea several times, called his four-day trip a private humanitarian mission and said he would try to meet with Kenneth Bae, a 44-year-old South Korean-born American citizen who was arrested on charges of “hostile acts” against North Korea after entering the country as a tourist in early November.

“I heard from his son who lives in Washington State, who asked me to bring him back,” Mr. Richardson said in Beijing before boarding a plane bound for Pyongyang. “I doubt we can do it on this trip.”

In a one-sentence dispatch, the North’s state-run Korean Central News Agency confirmed the American group’s arrival in Pyongyang, calling it “a Google delegation.”

Mr. Richardson said his delegation planned to meet with North Korean political, economic and military leaders, and to visit universities.

Mr. Schmidt and Google have kept quiet about why Mr. Schmidt joined the trip, which the State Department advised against, calling the visit unhelpful. Mr. Richardson said Monday that Mr. Schmidt was “interested in some of the economic issues there, the social media aspect,” but did not elaborate. Mr. Schmidt is a staunch proponent of Internet connectivity and openness.

Except for a tiny portion of its elite, North Korea’s population is blocked from the Internet. Under its new leader, Kim Jong-un, the country has emphasized science and technology but has also vowed to intensify its war against the infiltration of outside information in the isolated country, which it sees as a potential threat to its totalitarian grip on power.

Although it is engaged in a standoff with the United States over its nuclear weapons and missile programs and habitually criticizes American foreign policy as “imperial,” North Korea welcomes high-profile American visits to Pyongyang, billing them as signs of respect for its leadership. It runs a special museum for gifts that foreign dignitaries have brought for its leaders.

Washington has never established diplomatic ties with North Korea, and the two countries remain technically at war after the 1950-53 Korean War ended in a truce.

But Mr. Richardson’s trip comes at a particularly delicate time for Washington. In the past weeks, it has been trying to muster international support to penalize North Korea for its launching last month of a long-range rocket, which the United States condemned as a violation of United Nations Security Council resolutions banning the country from testing intercontinental ballistic missile technology.

North Korea has often required visits by high-profile Americans, including former Presidents Jimmy Carter and Bill Clinton, before releasing American citizens held there on criminal charges. Mr. Richardson, who is also a former ambassador to the United Nations, traveled to Pyongyang in 1996 to negotiate the release of Evan Hunziker, who was held for three months on charges of spying after swimming across the river border between China and North Korea.

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Oil Sand Industry in Canada Tied to Higher Carcinogen Level

Todd Korol/Reuters

An oil sands mine Fort McMurray, Alberta.

OTTAWA — The development of Alberta’s oil sands has increased levels of cancer-causing compounds in surrounding lakes well beyond natural levels, Canadian researchers reported in a study released on Monday. And they said the contamination covered a wider area than had previously been believed.

For the study, financed by the Canadian government, the researchers set out to develop a historical record of the contamination, analyzing sediment dating back about 50 years from six small and shallow lakes north of Fort McMurray, Alberta, the center of the oil sands industry. Layers of the sediment were tested for deposits of polycyclic aromatic hydrocarbons, or PAHs, groups of chemicals associated with oil that in many cases have been found to cause cancer in humans after long-term exposure.

“One of the biggest challenges is that we lacked long-term data,” said John P. Smol, the paper’s lead author and a professor of biology at Queen’s University in Kingston, Ontario. “So some in industry have been saying that the pollution in the tar sands is natural, it’s always been there.”

The researchers found that to the contrary, the levels of those deposits have been steadily rising since large-scale oil sands production began in 1978.

Samples from one test site, the paper said, now show 2.5 to 23 times more PAHs in current sediment than in layers dating back to around 1960.

“We’re not saying these are poisonous ponds,” Professor Smol said. “But it’s going to get worse. It’s not too late but the trend is not looking good.” He said that the wilderness lakes studied by the group were now contaminated as much as lakes in urban centers.

The study is likely to provide further ammunition to critics of the industry, who already contend that oil extracted from Canada’s oil sands poses environmental hazards like toxic sludge ponds, greenhouse gas emissions and the destruction of boreal forests.

Battles are also under way over the proposed construction of the Keystone XL pipeline, which would move the oil down through the western United States and down to refineries along the Gulf Coast, or an alternative pipeline that would transport the oil from landlocked Alberta to British Columbia for export to Asia.

The researchers, who included scientists at Environment Canada’s aquatic contaminants research division, chose to test for PAHs because they had been the subject of earlier studies, including one published in 2009 that analyzed the distribution of the chemicals in snowfall north of Fort McMurray. That research drew criticism from the government of Alberta and others for failing to provide a historical baseline.

“Now we have the smoking gun,” Professor Smol said.

He said he was not surprised that the analysis found a rise in PAH deposits after the industrial development of the oil sands, “but we needed the data.” He said he had not entirely expected, however, to observe the effect at the most remote test site, a lake that is about 50 miles to the north.

Asked about the study, Adam Sweet, a spokesman for Peter Kent, Canada’s environment minister, emphasized in an e-mail that with the exception of one lake very close to the oil sands, the levels of contaminants measured by the researchers “did not exceed Canadian guidelines and were low compared to urban areas.”

He added that an environmental monitoring program for the region announced last February 2012 was put into effect “to address the very concerns raised by such studies” and to “provide an improved understanding of the long-term cumulative effects of oil sands development.”

Earlier research has suggested several different ways that the chemicals could spread. Most oil sand production involve large-scale open-bit mining. The chemicals may become wind-borne when giant excavators dig them up and then deposit them into 400-ton dump trucks.

Upgraders at some oil sands projects that separate the oil bitumen from its surrounding sand are believed to emit PAHs. And some scientists believe that vast ponds holding wastewater from that upgrading and from other oil sand processes may be leaking PAHs and other chemicals into downstream bodies of water.

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