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May 21, 2007

Obesity and Cancer

I'm really not sure about this at all:

Urgent action is needed to prevent a "cancer time bomb" exploding as a result of soaring obesity rates, a leading specialist warns today.

Research shows that up to 40 per cent of cancers can be prevented through diet and exercise but most people fail to take these steps, according to Dr Greg Martin, the science and research manager at the World Cancer Research Fund (WCRF).

At the launch of the WCRF's Cancer Prevention Week, which starts today, Dr Martin will say many people still do not appreciate the strong link between obesity and cancer.

Perfectly willing to accept that being a lard bucket increases your chance of getting cancer. But it's the evidence he looks to that slightly worries me:

Dr Martin described the increase of cancer over time as being like "an epidemic" which is spreading as people become more sedentary and eat less healthily.

He said: "When you look at a series of maps it's really like an epidemic, a virus spreading. In a lot of ways behaviour is communicable. All over the world people are starting to adopt the same kind of eating pattern. The frustrating thing is that people can make simple changes to their lifestyle to reduce their chances of getting cancer.

You see, there's (as he admits) a second factor: age. The longer you live, the more likely you are to get a cancer of some form or other. So the usual measure of cancer rates is in fact the age adjusted one. Which is, in the rich countries at least, falling. So there is no epidemic of cancer at all....which makes the worries over obesity a tad moot.

 

May 21, 2007 in Health Care | Permalink

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Comments

Lot of health scare related stories today.

Is it just part of the usual call for research funds (initial findings have shown etc), or perhaps a trail of new epidemics that the DoH will say it cannot cope with therefore more PFI is needed, possibly leading to the sell off of specialist areas of the NHS, or a lead into more government imposed social conditioning.

Posted by: IanP | May 21, 2007 9:46:21 AM

"Cancer caused by old age" isn't exactly a headline-grabber though... Hence the economy with the truth shown by most outbursts of junk science in its search for headlines and/or funding.

Posted by: Jeff | May 21, 2007 9:53:14 AM

"You see, there's (as he admits) a second factor: age. The longer you live, the more likely you are to get a cancer of some form or other."

True - but that doesn't explain away these recent, worrying reports about Cancer treatment in Britain now:

"Cancer patients are being systematically let down by the radiotherapy services in England, a damning government report concludes."
http://timesonline.co.uk/tol/life_and_style/health/article1779636.ece

"Cancer patients face 'stark inequalities' in access to treatment globally, with the UK lagging behind other western countries in its use of new drugs and survival rates, a report said today.

"The study found that uptake of new cancer drugs is 'low and slow' in the UK, as well as in New Zealand, Poland, Czech Republic and South Africa. Austria, France, Switzerland and the US were leaders in using new cancer drugs. . .

"Generally, the greatest differences in uptake were noted for the new colorectal and lung cancer drugs, which are among the world's top cancer killers for both men and women. The US uptake of bevacizumab for colorectal cancer was 10 times the uptake of the European average, with the UK having a very low uptake."
http://society.guardian.co.uk/health/story/0,,2076707,00.html

Posted by: Bob B | May 21, 2007 11:25:04 AM

Now look at the price per vial for bevacizumab compared with the price per vial for generic paclitaxel: IIRC it's about 25X higher.

Just because we use less of something that is marginally more effective and 25X more costly than the Americans, does not mean that they are using the optimum level and we are using too little.

(not to deny there are some paclitaxel-refractory cancers for which new-generation therapies are essential, just that the Americans massively overprescribe expensive new drugs because there is no real cost-based incentive to restrict them. The fact that the NHS restricts uneconomic access to Very Expensive Things is a point in its favour, much as it sucks if you're the person denied the marginally beneficial ultra-expensive treatment)

Posted by: john b | May 21, 2007 12:26:31 PM

And of course the other thing to remember is that in many cases drugs which are freely available in Scotland and Wales are denied to English patients who are left to die, go blind or whatever because under the Scottish Raj running Britain an English life simply isn't considered to be worth as much as that of a Scottish life.

Posted by: David B. Wildgoose | May 21, 2007 2:03:36 PM

So bevacizumab is marginally beneficial compared to paclitaxel John B? Comparing the side effect profile of taxanes vs monoclonal antibodies I would suggest it is substantially beneficial, it is only because side effects are costs ignored by monopoly healthcare providers that such drugs appear "uneconomic".

Posted by: Noel C | May 21, 2007 2:12:38 PM

The side effect profile is *very seldom* going to outweigh the upfront cost, though, given the relatively short length of a course of chemotherapy, and the fact that the net value in B/CA terms of a year of life (assuming that the difference in side effect profiles between taxanes and monoclonal antibodies is so substantial that one counts as not worth living and the other counts as 'normal' [*]) is around £25K, whereas the cost of the novel treatments is generally closer to £100K minimum.

This is precisely why the Yanks spend too much on drugs: the patient has too much say in determining how other people's money will be spent, and therefore lobbies (understandably from a personal point of view) for outcomes that don't make wider economic sense.

[*] obviously an exaggeration

Posted by: john b | May 21, 2007 4:57:44 PM

Everyone knows that cancer is caused by Global Warming.

Posted by: dearieme | May 21, 2007 6:07:45 PM