Cancer Strategy

This Thursday there will be a General Debate on the Cancer Strategy in the Commons chamber.

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Following on from the Coalition Government’s 2011 cancer strategy, Improving Outcomes: A Strategy for Cancer, in January 2015 NHS England announced a new independent cancer taskforce to develop a  five-year action plan for cancer services, led by Sir Harpal Kumar, Chief Executive of Cancer Research UK. The plan would build on NHS England’s vision for improving cancer outcomes as set out in the NHS
Five Year Forward View. The independent cancer taskforce’s five-year strategy for cancer, Achieving World-Class Cancer Outcomes: A Strategy for England 2015- 2020 was published in July 2015.

This debate pack outlines the progress so far in implementing this cancer strategy and provides statistics on survival rates and the NHS cancer workforce. Finally, this paper pulls together commentary and analysis from official, parliamentary and third sector organisations.

Further information is available at parliament.uk

The full report can be viewed here

Full reference:

Bate, A. et al |Cancer Strategy |19 February 2018 |Retrieved from parliament.uk |

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Consumption of ultra-processed foods linked to higher cancer risk

A new study published in the BMJ, has reported an association between comsuming a diet high in utlra-processed foods and a higher overall cancer risk.  The ultra- processed foods, sugary breakfast cereals, pizza, cakes and pre-sliced bread, may increase the risk of cancer.  The results demonstrated that if consumption of ultra-processed foods increased by 10%, was associated with a greater than 10% risk in overall and breast cancer.
During the study:

  • On average, 18% of people’s diet was ultra-processed
  • On average, there were 79 cancers per 10,000 people each year
  • Upping the proportion of processed food by 10% would lead to nine extra cancers per 10,000 people per year

The researchers concluded: “These results suggest that the rapidly increasing consumption of ultra-processed foods may drive an increasing burden of cancer in the next decades.”

You can listen to the podcast below

The full article is also available to read at the BMJ

Abstract

Objective To assess the prospective associations between consumption of ultra-processed food and risk of cancer.

Design Population based cohort study.

 

Setting and participants
104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort. Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification.

Main outcome measures Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors.

 

Results Ultra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis).

 

Conclusions In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations.

Full reference: BMJ 2018; k322
The following news stories may also be of interest:

The Independent Processed food, sugary cereals and sliced bread may contribute to cancer risk, study claims

BBC News Ultra-processed foods ‘linked to cancer’ 

Gene on the X-chromosome may contribute to a woman’s risk of developing ovarian cancer according to US researchers

Currently, women with a strong family history of cancer can be tested for the BRCA gene, which greatly increases a woman’s chance of developing breast cancer and ovarian cancer. Yet experts believe there may be other cases of sporadic ovarian caner that are inherited via the X chromosome females receive from their father.  Full story at BBC News 
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US researchers have used the largest familial study of ovarian cancer to argue that there exists an ovarian cancer susceptibility gene on the X-chromosome acting independently of BRCA1 and BRCA2. This observation implies that there may be many cases of seemingly sporadicovarian cancer that are actually inherited; for example, only daughters who inherit risk from their fathers. This X-linked pattern implies novel ways to prioritize families for screening even without additional testing-sisters must both be carriers or neither; fathers of women with potentially inherited ovarian cancer may receive new attention.
In addition, the scientists found evidence that other cancers affect fathers and sons in these families. Using sequencing technology, we isolated a candidate gene, MAGEC3, that may be associated with earlier onset of ovarian cancer. The further study of this gene and the X-linked pattern will require additional study.  (Author summary from PLOS Genetics)

Full reference: Eng, K. H. 2018||Paternal lineage early onset hereditary ovarian cancers: A Familial Ovarian Cancer Registry study|PLOS Genetics| https://doi.org/10.1371/journal.pgen.1007194

The article can be downloaded from PLOS here 

Related content:  Daily Telegraph  Ovarian cancer can be passed on via fathers – and it strikes younger

 

Impact of chronic diseases on cancer risk

Several common chronic diseases together account for more than a fifth of new cancer cases and more than a third of cancer deaths| BMJ | via ScienceDaily

Findings from research published in the BMJ show that the cancer risks from common chronic diseases, such as heart disease and diabetes, are as important as those from five major lifestyle factors combined.

A team of researchers  investigated the combined effect of eight common chronic diseases or disease markers on cancer risk compared with lifestyle factors. Among the conditions evaluated were cardiovascular disease, diabetes, chronic kidney disease, pulmonary disease, and gouty arthritis.

The researchers found that cardiovascular disease markers, diabetes, chronic kidney disease markers, pulmonary disease, and gouty arthritis marker were individually associated with risk of developing cancer or cancer death.

Together, these chronic diseases and markers accounted for more than one fifth of all new cancers and more than one third of all cancer deaths in this study population, which was similar to the contribution of five major lifestyle risk factors combined — smoking, insufficient physical activity, insufficient fruit and vegetable intake, alcohol consumption, and obesity.

The researchers also found that physical activity was associated with a nearly 40% reduction in the excess risks of cancer and cancer death associated with chronic diseases and markers.

However, the authors point out that chronic diseases are not targeted in current cancer prevention strategies — and say their findings have important implications for developing new strategies that target chronic diseases.

Full detail at ScienceDaily

Full reference: Huakang Tu et al. |  Cancer risk associated with chronic diseases and disease markers: prospective cohort study | BMJ 2018

Can artificial UV radiation cause malignant melanoma in humans?

A new study published in the Anticancer Research journal, refutes reports from the World Health Organization (WHO) and the EU.

The international team of researchers has conducted a thorough search of the scientific databases MEDLINE and ISI Web of Science for relevant studies and subjected the results to a systematic meta-analysis.

 

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Although the team found an association of a slightly increased melanoma risk when comparing ‘ever’ versus ‘never’ sunbed users, they identified significant shortcomings in the scientific studies they included in their meta-analysis. Many of the earlier published results were based on observational studies with poor quality data that fail to support causation.

Full story at  Science Daily 

 

Full reference: Burgard et al. Solarium Use and Risk for Malignant Melanoma: Meta-analysis and Evidence-based Medicine Systematic Review | Anticancer Research| 2018 DOI: 10.21873/anticanres.12339

 

A related publication  critically appraises reports recently published by the WHO and the EU regarding sun bed use.  The authors are  deeply concerned that these assessments appear to be based on an incomplete, unbalanced and non-critical evaluation of the literature.

Professor Reichrath, one of the researchers,  cautions that “the current state of scientific knowledge in the field does not allow one to conclude that moderate solarium use results in an increased risk of malignant melanoma.”

Full reference: Reichrath et al. A Critical Appraisal of the Recent Reports on Sunbeds from the European Commission’s Scientific Committee on Health, Environmental and Emerging Risks and from the Word Health Organization. Anticancer Research, 2018 DOI: 10.21873/anticanres.12330

 

New Cancer Drugs Fund benefiting thousands of patients and releasing £140million for the NHS

Since the Cancer Drugs Fund (CDF) opened in July 2016,  nearly 15,700 patients have benefited from 52 drugs treating 81 different types of cancer. Of these patients, around 5,000 have received treatment sooner than they would have under the previous system.

AS NHS England has also secured discounts on on eight of the treatments previously funded via the old CDF this is expected to generate savings for the NHS of around £140m over the next five years.

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The new system means the National Institute for Health and Care Excellence (NICE) appraisal process now starts much earlier for newly referred drugs, with the aim of publishing draft guidance before drugs receive their licence, and then final guidance to be issued within 90 days of that.

Patients also benefit from new cancer drugs at least four months earlier under the reformed CDF than was previously the case.  All cancer treatments recommended by NICE, whether for routine commissioning or the CDF are now available to patients as soon as positive draft guidance is published by NICE.

 

Further information can be found at  NHS England

Cancer diagnoses and incidence rates in England in 2016

The Office for National Statistics and Public Health England  have released statistics for Cancer diagnoses in England for 2016.

The main points are:

  • The number of new cases of cancer in England continues to rise and, in 2016, there were 303,135 cancers registered (excluding non-melanoma skin cancers); this is an increase of 3,212 from 2015 and is equivalent to 828 new cases being diagnosed each day during 2016.
  • More cancers were registered in males (155,019) than females (148,116) and across the majority of cancer sites, more males were diagnosed with cancer than females; this is a persistent feature of the data, as reported in previous cancer registration years.
  • The age-standardised incidence rates for newly diagnosed cancers were 663.4 per 100,000 males and 541.1 per 100,000 females; age-standardised rates for newly registered cases of cancer (incidence) were higher in males than females, which is a repeating trend of the data, as outlined in previous cancer registration statistics.
  • Breast (15.2%), prostate (13.4%), lung (12.7%) and colorectal (11.5%) cancers continue to account for over half of the cancer registrations in England for all ages combined.

The bulletin can be downloaded here 

The dataset for 2016 (and previous years)  can be found here