NHS pushes forward with ambition to create world class cancer services
The NHS in England has set out its plans to deliver world class cancer services, which includes a fund to find new ways of speeding up diagnosis with the potential to save thousands more lives every year.
The National Cancer Transformation Board has published a wide ranging plan designed to increase prevention, speed up diagnosis, improve the experience of patients and help people living with and beyond cancer.
Fred Hutchinson Cancer Research Center. ScienceDaily. Published online: 18 April 2016.
In work presented at the American Association for Cancer Research’s annual meeting in New Orleans, Hsu and other researchers from Fred Hutch, the University of Michigan and other research groups debuted their latest progress in precision prevention — an in-the-works method to predict risk of colorectal cancer that integrates genetic, lifestyle and environmental risk factors.
This research is not yet ready to move into clinical practice, said Fred Hutch epidemiologist Dr. Ulrike “Riki” Peters, one of the study authors. But it’s the first attempt at combining so many different areas of colorectal cancer risk into one convenient risk predictor.
Is investment in research to develop new treatments the best approach to controlling cancer? Would emphasizing prevention bring about more return on investment? Should we channel what we are learning about precision medicine and the genome into cancer prevention, not treatment alone?
Many people believe that the time is right for another big push to defeat cancer, including President Obama, who called for a major cancer-fighting campaign in his final State of the Union address. But in the latest paper, “Targeting the Cancer Moonshot” in JAMA Oncology, this kind of effort will never cure cancer without public health and prevention.
While there have been some important and notable cures for certain types of cancer in the last half-century, Alfred I. Neugut, MD, PhD, Myron M. Studner Professor of Cancer Research and professor of Epidemiology at Columbia University’s Mailman School of Public Health, and co-author Cary P. Gross, MD, Yale University School of Medicine, drive home the point that these cures are responsible for only a small fraction of improvements in mortality.
Taking low dose aspirin regularly for at least six years is associated with a modest but significant reduction in the risk of cancer, especially cancer of the gastrointestinal tract, research published in JAMA Oncology has shown.1
The study found that taking aspirin at least twice a week was associated with a 3% lower incidence of developing any type of cancer. This was primarily due to a 15% lower risk of gastrointestinal tract cancers and a 19% lower risk of cancers of the colon and rectum. But regular aspirin use was not associated with a lower risk of breast, advanced prostate, or lung cancer.
The new study used data from two large prospective studies: the Nurses’ Health Study and the Health Professionals Follow-Up Study. Among the 88 084 women and 47 991 men who underwent follow-up for as long as 32 years, the researchers found 20 414 cancers in women and 7571 in men.
The study found that, compared with non-regular use, regular aspirin was associated with a lower incidence of gastrointestinal tract cancers (relative risk 0.85 (95% confidence interval 0.80 to 0.91)), especially colorectal cancers (0.81 (0.75 to 0.88)). The benefit of aspirin in patients with gastrointestinal tract cancer was seen with the use of at least 0.5-1.5 standard aspirin tablets a week. The minimum duration associated with benefit was six years.
Drew, D. A. et al. Nature Reviews Cancer 16, 173–186 (2016). Published online: 12 February 2016
Aspirin (acetylsalicylic acid) has become one of the most commonly used drugs, given its role as an analgesic, antipyretic and agent for cardiovascular prophylaxis. Several decades of research have provided considerable evidence demonstrating its potential for the prevention of cancer, particularly colorectal cancer. Broader clinical recommendations for aspirin-based chemoprevention strategies have recently been established; however, given the known hazards of long-term aspirin use, larger-scale adoption of an aspirin chemoprevention strategy is likely to require improved identification of individuals for whom the protective benefits outweigh the harms. Such a precision medicine approach may emerge through further clarification of aspirin’s mechanism of action.
Figure 2: The hypothesized inter-related mechanisms of aspirin chemoprevention.