How alcohol industry organisations mislead the public about alcohol and cancer

Alcohol consumption increases the risk of several types of cancer, including several common cancers | Drug and Alcohol Review

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As part of their corporate social responsibility activities, the alcohol industry (AI) disseminates information about alcohol and cancer. We examined the information on this which the AI disseminates to the public through its ‘social aspects and public relations organizations’ and related bodies. The aim of the study was to determine its comprehensiveness and accuracy.

Most of the organisations were found to disseminate misrepresentations of the evidence about the association between alcohol and cancer. Three main industry strategies were identified:

  1.  denial/omission: denying, omitting or disputing the evidence that alcohol consumption increases cancer risk.
  2. distortion: mentioning cancer, but misrepresenting the risk.
  3. distraction: focussing discussion away from the independent effects of alcohol on common cancers. Breast cancer and colorectal cancer appeared to be a particular focus for this misrepresentation.

Full reference: Petticrew, M. et al. (2017) How alcohol industry organisations mislead the public about alcohol and cancer. Drug and Alcohol Review. Published online: 7 Septmeber 2017

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Cancer in the West Midlands

This report provides an overview of the burden of cancer and the extent of the identified risk factors, across the West Midlands. | Public Health England

The aim of this report is to equip care providers and policy makers with an insight into the burden of cancer, as well as providing an overview of the extent of the identified risk factors, across the West Midlands population.

It is intended to be used by commissioners of health services to enable more timely diagnosis and improve treatment pathways, and also by local authority commissioners in terms of the wider prevention agenda.

Full document:  Cancer in the West Midlands.

 

Reducing the socioeconomic gradient in uptake of the NHS bowel cancer screening Programme

The aim of this study was to determine whether a supplementary leaflet providing the ‘gist’ of guaiac-based Faecal Occult Blood test (gFOBt) screening for colorectal cancer could reduce the socioeconomic status (SES) gradient in uptake in the English NHS BCSP | BMC Cancer

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The trial was integrated within routine BCSP operations in November 2012. Using a cluster randomised controlled design all adults aged 59–74 years who were being routinely invited to complete the gFOBt were randomised based on day of invitation. The Index of Multiple Deprivation was used to create SES quintiles. The control group received the standard information booklet (‘SI’). The intervention group received the SI booklet and the Gist leaflet (‘SI + Gist’) which had been designed to help people with lower literacy engage with the invitation. Blinding of hubs was not possible and invited subjects were not made aware of a comparator condition. The primary outcome was the gradient in uptake across IMD quintiles.

In November 2012, 163,525 individuals were allocated to either the ‘SI’ intervention (n = 79,104) or the ‘SI + Gist’ group (n = 84,421). Overall uptake was similar between the intervention and control groups (SI: 57.3% and SI + Gist: 57.6%; OR = 1.02, 95% CI: 0.92–1.13, p = 0.77). Uptake was 42.0% (SI) vs. 43.0% (SI + Gist) in the most deprived quintile and 65.6% vs. 65.8% in the least deprived quintile (interaction p = 0.48). The SES gradient in uptake was similar between the study groups within age, gender, hub and screening round sub-groups.

Providing supplementary simplified information in addition to the standard information booklet did not reduce the SES gradient in uptake in the NHS BCSP. The effectiveness of the Gist leaflet when used alone should be explored in future research.

Full reference: Smith, S.G. et al. (2017) Reducing the socioeconomic gradient in uptake of the NHS bowel cancer screening Programme using a simplified supplementary information leaflet: a cluster-randomised trial. BMC Cancer. 17:543

Drinking coffee may help prevent liver cancer, study suggests

People who drink more coffee are less likely to develop liver cancer, an analysis of data from 26 studies has found | Story via The Guardian | BMJ

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Researchers have found that people who drink more coffee are less likely to develop hepatocellular cancer (HCC), the most common form of primary liver cancer – and the effect was also found in decaffeinated coffee.

Experts from the University of Southampton and the University of Edinburgh examined data from 26 studies involving more than 2.25 million participants.  Compared with people who drank no coffee, those who drank one cup a day had a 20% lower risk of developing HCC, according to the study, published in the journal BMJ Open.

Those who consumed two cups a day had a 35% reduced risk and for those who drank five cups, the risk was halved. They found the protective effect for decaf was “smaller and less certain than for caffeinated coffee”

Full story via The Guardian

Full reference: Kennedy OJ, Roderick P, Buchanan R, et al. Coffee, including caffeinated and decaffeinated coffee, and the risk of hepatocellular carcinoma: a systematic review and dose–response meta-analysis

Diet, nutrition, physical activity and breast cancer

The report analysed 119 studies and including data on 12 million women and 260,000 cases of breast cancer | World Cancer Research Fund

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Image source: WCRF

Many epidemiologic studies have classified breast cancer cases by menopausal status at time of diagnosis, and therefore in this report we chose to highlight associations between diet, weight, and physical activity separately in premenopausal and postmenopausal breast cancer, where possible.

Key findings: premenopausal breast cancer

There is strong evidence that:

  • consuming alcoholic drinks increases risk
  • undertaking vigorous physical activity decreases risk
  • being overweight or obese between the ages of about 18 and 30 years decreases risk
  • being overweight or obese in adulthood before the menopause decreases risk
  • developmental factors leading to greater linear growth (marked by adult attained height) increase risk
  • factors that lead to greater birthweight, or its consequences, increase risk
  • breastfeeding decreases risk (breast cancer type unspecified) in the mother
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Image Source: WCRF

Key findings: postmenopausal breast cancer

There is strong evidence that:

  • consuming alcoholic drinks increases risk
  • being physically active (including vigorous physical activity) decreases risk
  • being overweight or obese between the ages of about 18 and 30 years decreases risk
  • being overweight or obese throughout adulthood increases risk
  • greater weight gain in adulthood increases risk
  • developmental factors leading to greater linear growth (marked by adult attained height) increase risk
  • breastfeeding decreases risk (breast cancer type unspecified) in the mother
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Image source: WCRF

Benefits and harms of breast cancer screening in women aged 40-49 years

Early detection of breast cancer through screening can lower breast cancer mortality rates and reduce the burden of this disease in the population | International Journal of Cancer

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In most western countries, mammography screening starting from age 50 is recommended. However, there is debate about whether breast cancer screening should be extended to younger women. This systematic review provides an overview of the evidence from RCT’s on the benefits and harms of breast cancer screening with mammography in women aged 40 to 49 years. The quality of the evidence for each outcome was appraised using the GRADE approach.

Four articles reporting on two different trials, the Age trial and the Canadian National Breast Screening Study-I (CNBSS-I), were included. The results showed no significant effect on breast cancer mortality (Age trial: RR 0.93, 95% CI 0.80-1.09; CNBSS-I: HR 1.10 (95% CI 0.86-1.40) nor on all-cause mortality (RR 0.98, 95% CI 0.93-1.03) in women aged 40 to 49 years offered screening. Among regularly attending women the cumulative risk of experiencing a false-positive recall was 20.5%. Overdiagnosis of invasive breast cancer at five years post cessation of screening for women aged 40to 49 years was estimated to be 32%; 20 years post cessation of screening 48%. Including ductal carcinoma in situ, these numbers were 41% and 55%.

Based on the current evidence from randomised trials, extending mammography screening to younger age groups cannot be recommended. However there were limitations including relatively low sensitivity of screening and screening attendance, insufficient power, and contamination, which may explain the non-significant results.

Full reference: van den Ende, C. et al. (2017) Benefits and harms of breast cancer screening with mammography in women aged 40-49 years: A systematic review. International Journal of Cancer. DOI: 10.1002/ijc.30794

Clinics should choose women’s breast screening appointment times to improve attendance

For women who miss a breast screening appointment, giving a fixed date and time for a new appointment could improve poor attendance and be a cost-effective way to shift national participation trends | ScienceDaily

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In England, participation in breast cancer screening has been falling in the last ten years, getting close to the national minimum standard of 70 per cent, with screening particularly low in areas of socioeconomic deprivation.

The NHS Breast Screening Programme (NHSBSP) invites women aged 50-70 to mammographic screening every three years. The usual practice for those who don’t attend their first offered appointment is to issue them with a second invitation letter. Some centres supply ‘open’ invitations, asking women to telephone to make an appointment, while others send an invitation with a fixed date and time, requiring no effort from the invitee to book an appointment.

Read the full overview via ScienceDaily here

Read the original research article here