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’ 

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

 

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 

What factors affect quality of life in older patients with cancer?

A new study provides insights on the factors that affect health-related quality of life in older adults with cancer. The findings support the importance of addressing persistent symptoms, managing comorbidities, promoting leisure-time physical activity, and addressing financial challenges. | Cancer  | Story via ScienceDaily

Abstract

As the population of older adults with cancer continues to grow, the most important factors contributing to their health-related quality of life (HRQOL) remain unclear.

Methods

A total of 1457 older adults (aged ≥65 years) with cancer participated in a telephone survey. Outcomes were measured using the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the 12-Item Short Form Survey from the Medical Outcomes Study. Statistical techniques used to identify factors in 4 domains (physical, psychological, social, and spiritual) most strongly associated with HRQOL included linear models, recursive partitioning, and random forests. Models were developed in a training data set (920 respondents) and performance was assessed in a validation data set (537 respondents).

Results

Respondents were a median of 19 months from diagnosis, and 28.1% were receiving active treatment. The most relevant factors found to be associated with PCS were symptom severity, comorbidity scores, leisure-time physical activity, and having physical support needs. The most relevant factors for MCS were having emotional support needs, symptom severity score, and the number of financial hardship events. Results were consistent across modeling techniques. Symptoms found to be strongly associated with PCS included fatigue, pain, disturbed sleep, and drowsiness.

Symptoms found to be strongly associated with MCS included fatigue, problems remembering things, disturbed sleep, and lack of appetite.

Conclusions

The findings of the current study support the importance of addressing persistent symptoms, managing comorbidities, promoting leisure-time physical activity, and addressing financial challenges. A long-term comprehensive approach is needed to ensure the well-being of older adults with cancer.

 

Full reference: Maria Pisu et al. | Most impactful factors on the health-related quality of life of a geriatric population with cancer |Cancer |  First publishd 18 December 2017

NHS takes 40 days to diagnose patients with cancer, study finds

The average time for a patient in England to be diagnosed with cancer is 40 days, a new study suggests | British Journal of General Practice | story via The Independent

Research published in the British Journal of General Practice has found that in 2014 the median number of days from first relevant presentation to the date of diagnosis was 40 days. This ranged from 15 days to 86 days.

The findings identify avenues for quality improvement activity and provide a baseline for future audit of the impact of 2015 National Institute for Health and Care Excellence guidance on management and referral of suspected cancer.

Health officials have set a target for all cancer patients to be diagnosed within 28 days by 2020.

Full reference: Swann, R. et al. | Diagnosing cancer in primary care: results from the National Cancer Diagnosis Audit | British Journal of General Practice | 18 December 2017

Prevention of bowel cancer

Bowel Cancer UK has published Finding the Key to the Cures: a plan to end bowel cancer by 2050.

Bowel cancer is the UK’s second biggest cancer killer with 16,000 people dying from the disease, and the fourth most common cancer with over 41,200 people diagnosed each year. The key to reducing the numbers of people dying from this condition is early diagnosis. This report examines ways and methods of increasing earlier detection methods which could transform survival rates and ultimately benefit thousands of people in the future.