Mon 23 May 2016 07.30 BSTLast modified on Mon 21 May 2018 11.13 BST
One doctor who worked on the JAMA Internal Medicine study suggests that any exercise is likely to be beneficial. Photograph: Alamy
Just in case you haven’t got the message that exercise is good for you, two huge research studies
this week shout it louder than ever. Which is just as well, since almost one-third of adults are classified as “inactive”. Exercise is already known to reduce the risk of breast, colon and endometrial cancer (cancer of the lining of the uterus)
by between 10% and 40%. Now, a pooled analysis of data from studies looking at 1.4 million adults between the ages of 19 and 98 has found that exercise reduces
the risk of an additional 10 cancers, including oesophageal, stomach, bladder and kidney. What’s more, for many cancers, exercise reduces the risk even in overweight people. This is particularly interesting, because the mechanism by which exercise is
thought to protect from cancer is weight reduction.
It seems that exercise may work its magic in a variety of ways. Dr Marilie Gammon, an epidemiologist from the Gillings School of Global Public Health in Chapel Hill, North Carolina, who wrote an editorial to accompany the paper in the peer-reviewed journal JAMA Internal Medicine, says that exercise may help to repair DNA when
it is damaged by cancer-promoting substances. Exercise may also alter hormone levels and reduce inflammation.
The study showed that the risk of oesophageal cancer for those taking the
most exercise was 42% lower than for those taking the least. For seven of the cancers, the risk reduction was one-fifth or more. Gammon says the data was based on four hours of activity a week – the standard recommendation to prevent heart disease.
How active you have to be to reduce your cancer risk is unknown. Gammon suggests anything is likely to be beneficial – even taking the stairs instead of the lift.
But why stop at exercise? The second study of lifestyle and cancer, which took data from 136,000 Americans, found that anyone who quits smoking; does two and a half hours of moderate exercise a week; has no more than one drink a day if a woman or two
if a man; and keeps to a BMI between 18.5 and 27.5 is likely to reduce their risk of bowel cancer by 30% and breast cancer by 12%.
Get on your bike
So, are you doing enough to reduce your risk of getting cancer? While these studies
can’t prove that exercise reduces the risk of cancer – because they only report an observed association – they show a strong link, which is enough for me to get out my bike tomorrow. The fact that you can be overweight and still see a reduction
in risk means you can get the benefit whatever your size. Dr Stephen Moore, the author of the JAMA Internal Medicine paper, is reported to run every day. Get moving.
Neuroscientists have studied treadmill runners, ultramarathon athletes – and a number of lab animals – to investigate the effects of running on grey matter
Thu 21 Jun 2018 13.13 BSTLast
modified on Wed 27 Jun 2018 12.12 BST
Coloured sagittal MRI scans of the human brain. Photograph: Simon Frazer/SPL/Getty Images
It may seem obvious – as you push on through
a long run, veering wildly between sensations of agony and elation – that running can have a huge effect on your state of mind. It is an intuitive idea that a growing number of neuroscientists have begun to take seriously, and in recent years they have
started to show us what actually plays out on the hills and valleys of your grey matter as you run.
Their findings confirm what many runners know from their own experience: we can use running as a tool to improve the way we think and feel. And we are
now learning precisely why running can return focus, vanquish stress and improve mood. Plus we know why – if you’re lucky – you might get a brief glimpse of nirvana.
It would be crazy to believe that running is a universal solution to all of our psychological challenges. Indeed, from your brain’s
perspective, you may not want to push it too hard. German neuroscientists scanned the brains of some of the competitors before, during, and after the TransEurope Foot Race, in which competitors slog through 3,000 miles, over 64 consecutive days. In the middle of this absurdly extreme ultramarathon, the runners’ grey matter had shrunk in volume by 6%: the ‘normal’ shrinkage associated with old age is just 0.2% each year. Luckily, the story doesn’t end too badly:
eight months later the runners’ brains were back to normal.
But if covering immense distances can be counter-productive, it is clear now that more moderate runs can result in very real benefits. First, in a world where smartphones
bombard us with stimulation and blur the boundaries between work and life, a clutch of recent studies shows why going for a run can help regain a sense of control.
A 2018 experiment from West Michigan University, for example, showed that running quickly for half an hour improves “cortical flicker frequency” threshold. This is associated with the ability to better process
information. Two others, from the Lithuanian Sports University and Nottingham Trent University, showed that interval running improves aspects of “executive function”. This is a suite of mental high-level faculties that include the ability to marshall
attention, tune out distractions, switch between tasks and solve problems. Among the young people studied, measurable gains were clear immediately after 10 minutes of interval sprints. They also accumulated after seven
weeks of training.
A brain imaging study led by David Raichlen at the University of Arizona ties in neatly with these results. They
saw clear differences in brain activity in serious runners, compared to well-matched non-runners. For obvious reasons, you cannot run while you are inside a brain scanner, so the neuroscientists studied the brain at rest. First, they saw increased co-ordinated
activity in regions, mainly at the front of the brain, known to be involved in executive functions and working memory. This makes sense. Second, they saw relative damping down of activity in the “default mode network”, a series of linked brain
regions that spring into action whenever we are idle or distracted. Your default mode network is the source of your inner monologue, the instigator of mind-wandering and the voice that ruminates on your past. Its effects are not always welcome or helpful,
and have been associated with clinical depression.
Raichlen’s was a preliminary study, but if corroborated in the future, it will lend fresh weight to the
idea that running can be a form of moving mindfulness meditation. Brain scans show that meditation and running can have a somewhat similar effect on the brain; simultaneously engaging executive functions and turning down the chatter of the default mode network. Again, this seems intuitively right: in the
midst of a run, you are likely to be immersed in the present moment, tuned into your bodily state, and conscious of your breath. These are all key aims of mindfulness-based practices. Lacing up your trainers and going for a run could, therefore, be a way to
reap some of the psychological benefits of mindfulness. Companies, too, are cottoning on to the therapeutic effects of running: I recently worked with running-shoe company Saucony to create a podcast about the effects
of running on the mind.
All of this might start to explain why some people find that running, like mindfulness, can be a useful way to overcome stress and depression. Recent research from the Karolinska Institute in Sweden shows, at a
chemical level, how running can defuse at least one important biological stress pathway.
When you are under stress, metabolic processes in your liver convert the amino acid tryptophan into a molecule with the mumble-inducing name
of knyurenine. Some of that knyurenine finds its way into your brain, where its accumulation has been strongly associated with
stress-induced depression, anxiety disorders and schizophrenia. When you exercise, the levels of an enzyme called kynurenine aminotransferase build up in your muscles. This enzyme breaks down knyurenine into the related molecule kynurenic acid, which, importantly,
cannot enter the brain. In this way, exercising your skeletal muscles by running clears from your bloodstream a substance that can cause
mental health problems. It is important to note that, for technical and ethical reasons, some of the details of this mechanism have been proven only in laboratory animals.
At first glance, it is not obvious why working your leg muscles should have a direct effect on your mental
state. This work provides rare insight into the often-mysterious links between brain and body – and is a powerful reminder that your brain is just another bodily organ. What you choose to do with your body will, inevitably, have psychological consequences.
Running can do more for your mood than smooth out stress. Some lucky souls gloat about their experiences of the “runner’s high”, which, they claim, is a powerful feeling of ecstasy and invincibility. Running has never quite done that for me, but we do now know more about the potent chemical rewards that running triggers in the brain.
The popular idea of the “endorphin rush” was born in the 1980s and 90s, when a series of studies showed that the levels of beta-endorphin increase in your bloodstream during the course of a run. Beta-endorphin targets the same receptors as opiates, and has some similar biological effects. The endorphin rush hypothesis always had a flaw, however,
since beta-endorphin does not cross readily the blood-brain barrier. And if it didn’t make it into your brain, how could it give you a high?
2008, German neuroscientists put that right. They used functional brain imaging to show that, in trained runners, beta-endorphin
levels do indeed spike in the brain after a two-hour run. Increased levels endorphin activity in the brain also correlated with the runners’ self-reported feelings of euphoria.
It is not just home-brew opiates that can dull the pain and
raise your spirits while you are on the run. Endocannabinoids are a diverse family of bodily chemicals which, like cannabis, bind the brain’s cannabinoid receptors. The levels of endocannabinoids circulating in the blood rises after 30 minutes of moderately intense treadmill running. Rigorous experiments, conducted on lab mice, show that running-induced endocannabinoids are responsible for reductions in anxiety and perception of pain. It is a good bet that the same mechanism works in our minds. For many of us, running may never deliver a drug-like high. But we now see why a run that feels like murder at the
start can leave you feel satisfied and at ease by the home straight.
Some of these studies are preliminary and need fleshing out. And it is definitely the case that your gender, genetic profile, fitness, expectations and many other factors besides will
influence the way your brain responds to running. Even so, I read all these neuroscientific studies as good news stories.
While the physical benefits of running and aerobic exercise are well established, we are starting to see why running can have profound
benefits for mental health, too. Hopefully, knowing this will redouble your determination to get out there and run more often.
This article contains affiliate links, which means we may earn a small commission if a reader clicks through and makes a purchase. All our journalism is independent and is in no way influenced by any advertiser or commercial
initiative. The links are powered by Skimlinks. By clicking on an affiliate link, you accept that Skimlinks cookies will be set. More information.
It’s official! Coffee causes cancer (except when it doesn’t)
Coffee shops in California may soon have to display cancer warnings. But don’t worry, because new evidence points to the drink’s
Fri 30 Mar 2018 14.07 BSTLast modified on Thu 2 Aug 2018 17.52 BST
Love coffee? Just don’t drink more than three cups a day. Photograph: Alamy
Tasting notes: Nutty and rich, with a subtle bitterness.
Sounds just like
me. You’re hardly rich.
My bitterness isn’t very subtle either. But look, can we skip all the usual nonsense? I think I know what coffee is. I do drink it several times a day. Ah well, in that case I have
vital news regarding your health.
Go on then. I can’t prove that drinking coffee won’t add a further 0.001% to your lifetime risk of cancer.
feel too bad about it. I can’t find my keys two mornings out of three. Yes, but you’re not fighting an eight-year lawsuit in the California courts about your keys.
No, I’m not. Whereas Starbucks
and a bunch of other coffee companies are being sued over their failure to warn consumers
about the risks of acrylamide.
Acrylamide! I’m terrified already of whatever that is! From now on I’ll only drink coffee
made from organic, hand-roasted, lengthily described beans. Feel free, but it won’t make much difference. Acrylamide isn’t an additive. It forms naturally during the roasting process. You’ll also get it from browned toast, roast
potatoes and various other things.
It’s known to cause cancer in laboratory animals,
and it is presumed to do the same to people, who are advised not to brown their food too much, and not to keep potatoes in the fridge.
I’ll see to it immediately. And now Elihu Berle, a superior court
judge in Los Angeles, has ruled that Starbucks and the others have not proved that the acrylamide in their coffee would cause fewer than one excess case of cancer per 100,000 people. Nor that any other health benefits outweighed this risk.
thought coffee was good for you? Oh, sure. There’s lots of evidence to suggest that.
Eh? A group of researchers at the University of São Paolo recently found that regularly drinking at least three cups a day reduces the hardening of your coronary arteries.
Great! Other research suggests coffee might protect against diabetes, Parkinson’s
and hypertension. Although it is often quite messy research. And the São Paolo team don’t advise drinking more than three cups a day.
Look, just tell me one thing: is my coffee habit good for me or bad for me?Yes, it probably
Do say: “Coffee-drinking is associated with a higher incidence of pretentious conversation.”
Don’t say: “Those who abstain from coffee experience a higher risk of not getting
Bowel cancer screening age in England to be lowered to 50
Ministers accept experts’ view that age when screening starts should fall by 10 years
Fri 10 Aug 2018 14.17 BSTLast modified on Fri 10 Aug 2018 16.18 BST
Bowel cancer screening kits are already offered to over-50s in Scotland. Photograph: Alamy
Bowel cancer screening in England is to start 10 years earlier, at the age of 50, after ministers accepted
the findings of a review.
The UK national screening committee recommended offering the service to people aged 50-74, using the faecal immunochemical home test (FIT) method, after it reviewed available evidence. Ministers accepted the proposals of the
independent experts on Friday.
The BBC newsreader George Alagiah and
the former health secretary Andrew Lansley are among those who have called
for earlier screening for the disease.
Alagiah, who is receiving treatment for bowel cancer for the second time, previously said it could have been caught sooner if England provided screening for over-50s, as was the case in Scotland.
Lord Lansley, who said he was also being treated for the disease in April, urged the government to cut the age of screening to 50 “in line with international best practice”.
FIT, which is easier to use
than the current test and more accurate in detecting potential cancer, was already due to be rolled out in the autumn and will initially be offered to those aged 60-74. It is expected to be rolled out to over-55s, followed by over-50s, but no timetable has
yet been given. FIT is already offered to over-50s in Scotland.
Prof Anne Mackie, the director of screening at Public Health England
(PHE), said: “The risk of bowel cancer rises steeply from around age 50-54 and rates are significantly higher among males than females. Starting screening 10 years earlier at 50 will help spot more abnormalities at an early stage that could develop into
bowel cancer if not detected.
“The committee recognises that this change will take time but wants the FIT test to be offered to all aged 60 and over as soon as possible, and options considered for a rollout plan where screening can be offered
at 55 and eventually to all aged 50, ensuring we have the best bowel screening programme possible.”
Men and women in England and Wales are currently offered a one-off bowel scope at the age of 55. The practice
is expected to remain in place until the new home test is rolled out.
The public health minister Steve Brine said: “We are determined to make our cancer survival rates the best in the world. With the rollout of FIT as a
new bowel screening test from the autumn – a much more convenient and reliable test – we have a real opportunity to reshape our bowel screening programme and potentially detect the stages of bowel cancer much earlier.
“We are now considering
opportunities and taking expert advice on how a sustainable, optimal bowel cancer screening programme starting at age 50 can work in the future.”
Simon Stevens, the chief executive of NHS England, said: “These important recommendations will
be carefully considered in the NHS long-term plan, which will set out ambitious improvements in cancer prevention
and care for the decade ahead.”
Colorectal cancer is the third leading cause of cancer deaths in the developed world – but mortality has decreased by 30% in the past 20 years
Mon 16 Apr 2018 06.30 BSTLast modified
on Wed 2 May 2018 15.17 BST
screening programme is for over-55s but you should get screened if you have a greater than average risk of getting bowel cancer. Photograph: Alamy Stock Photo
Be aware of early warning signs (blood in stool, frequent/loose stools,
abdominal pain/bloating after eating, or weight loss) and see your GP if you are concerned. But don’t panic. Colorectal (bowel) cancer is the third leading cause of deaths from cancer in the developed world, but only 5.4% of us will develop it. The good
news is that colorectal cancer deaths have decreased by 30% in the past 20 years – partly because of screening, earlier detection and better treatment.
Especially if you’re over 60
Age is the greatest risk factor: 99% of cases occur in people over 40 and 85% in people over 60. Most people
diagnosed are in their 70s. Unfortunately, it’s often older people who are most reluctant to report abnormal bowel symptoms.
Know your family history
important to know your family’s medical history, with the proviso that most people who get bowel cancer don’t have any particular
inherited tendency and their children won’t be at increased risk compared with the general population. But in 5-6% of cases there is a genetic predisposition and there are likely to have been other cases in the family. If you have a single first-degree
relative with bowel cancer, your risk is two to three times higher than average (or higher if that relative was under 45 years old when they developed the cancer). If you have two affected first-degree relatives, your risk may be as high as four times the
average. The most common inherited conditions that cause bowel cancer are familial adenomatous polyposis and Lynch syndrome.
Stay slim and active
Obesity increases the risk of developing and
dying from bowel cancer by 1.5 times. The association is stronger for men than women. If you are obese, try to stay active;
physical activity seems to offset some of the increased risk of being overweight. Most studies suggest that eating lots of fibre reduces the risk, but that may be partly because people who are a healthy weight tend to have a high-fibre diet.
on the meat
Processed, smoked and cured meats can increase the risk
of bowel cancerbecause they contain chemicals called nitrosamines. People who eat the most processed meat have
about a 17% higher risk of developing bowel cancer, compared with those who
eat the least. That means 56 out of 1,000 people may get bowel cancer among people who never eat processed meat, 61 out of 1,000 average meat eaters and 66 out of 1,000 among those who eat the most processed meat. The NHS advice is that red meat (pork, beef and lamb) is a good source of protein, but that eating more than 90g a day is associated with an increased risk of bowel cancer. One lamb chop is 70g, so if you have a couple of
chops, you may want to give red meat a miss the following day.
An aspirin a day?
Taking a low dose (75mg) of aspirin a day for five years may reduce your risk of bowel cancer, but the risk of gastric bleeding is thought to
outweigh the potential benefits. The jury is still out on this one. Likewise, there is no robust evidence yet that statins or hormone replacement therapy prevent bowel cancer.
This article contains affiliate links, which means we may earn a small commission if a reader
clicks through and makes a purchase. All our journalism is independent and is in no way influenced by any advertiser or commercial initiative. The links are powered by Skimlinks. By clicking on an affiliate link, you accept that Skimlinks cookies
will be set. More information.
New screening test cuts bowel cancer risk by a third, study finds
One-off examination, being introduced across NHS, was able to prevent 35% of bowel cancers overall and 40% of deaths
Wed 22 Feb 2017 00.01 GMTLast modified
on Wed 20 Sep 2017 23.09 BST
Bowel scope screening will not detect bowel cancers higher up in the bowel. Photograph: Dimitris Legakis/Athena Pictures
A one-off screening test being introduced across the NHS cuts
the risk of developing bowel cancer by a third, a long-term study has found.
The test, which is being rolled out across England, will invite men and women to have bowel scope screening around the time of their 55th birthday.
This is in addition
to the current test from the age of 60, the faecal occult blood test (FOB), which is posted to people’s homes.
FOB detects blood hidden in small samples of faeces, with further tests recommended if blood is detected.
in the medical journal the Lancet has found that the bowel scope test reduces the risk of all cases of the cancer by a third. Experts predict it will save thousands of lives every year.
works by threading a tiny camera attached to a thin flexible tube into the lower part of the bowel. As well as detecting tumours, it helps spot small growths, called polyps, on the bowel wall. If left untreated polyps can become cancerous, and any found during
a bowel scope can usually be removed immediately.
Bowel scope screening will not detect cancers higher up in the bowel and patients may need a colonoscopy if they have persistent symptoms.
But the research found the new test was able
to prevent 35% of bowel cancers overall and 40% of deaths.
In the lower bowel, the test prevented more than half of potential cancers from developing in that area.
Researchers from Imperial College London followed more than 170,000 people
for 17 years on average, of whom more than 40,000 had the bowel scope test.
There are more than 41,000 new cases of bowel cancer every year in the UK, and about 16,000 deaths.
Prof Wendy Atkin, Cancer Research UK’s bowel screening expert and lead author at Imperial, said: “Although no screening test is perfect, this study shows that bowel scope is effective in
reducing cancer deaths for at least 17 years.
“Bowel cancer can be prevented. And the bowel scope screening test is a great way to reduce the number of people diagnosed with the disease so it’s vital that no one misses out on the opportunity
to get the test.”
Julie Sharp, Cancer Research UK’s head of health information, said: “Like other types of screening, bowel scope is meant for people without symptoms. It’s a great way to help reduce the number of people developing
or dying from bowel cancer, but it can’t pick up everything.
“So it’s still important to take part in the rest of the bowel screening programme and not ignore the home testing kits when they arrive.”
The government estimates
the bowel scope test will take at least another three years before it will be offered to everyone eligible across England. This is in order to train specialist staff to carry out the tests. Governments in Scotland, Wales and Northern Ireland have not yet committed
to introducing the test.
The research was funded by the Medical Research Council and National Institute for Health Research.
About half of bowel cancers occur in the lower part of the bowel and the rectum – the area covered by the bowel scope test.
The health secretary, Jeremy Hunt, said: “This report is really encouraging – prevention and early diagnosis
are key to improving outcomes, and this new screening test could help us save thousands more lives.
“Cancer survival is at its highest rate ever, but more must be done: we are investing £300 million a year by 2020 to increase diagnostic
capacity for all cancers, so we can save more from this devastating disease.”
Fri 1 Jun 2018 07.33 BSTFirst published on Fri 1 Jun
2018 00.17 BST
Ovarian cancer cells. Researchers hope the tests for cancer cells will become part of a ‘universal screening’ tool. Photograph: Media for Medical/UIG
via Getty Images
A blood test for 10 different types of cancers could one day help doctors screen for the disease before patients show symptoms,
researchers at the world’s largest gathering of oncologists have said.
The test, called a liquid
biopsy, screens for cancer by detecting tiny bits of DNA released by cancer cells into blood. The test had particularly good results for ovarian and pancreatic cancers, though the number of cancers detected was small.
Researchers hope the test will
become part of a “universal screening” tool that doctors can use to detect cancer in patients.
“This is potentially the holy grail of cancer research, to find cancers that are currently hard to cure at an earlier stage when they are
easier to cure,” said Dr Eric Klein, lead author of the research from Cleveland Clinic’s Taussig Cancer Institute.
“We hope this test could save many lives.”
The study, by a research team that also included scientists from Stanford University, was presented at the annual conference
of the American Society of Clinical Oncologists in Chicago.
Simon Stevens, the chief executive of NHS England, said “new techniques” such as cancer blood tests could “unlock enormous survival gains, as well as dramatic productivity
benefits in the practice of medicine”.
“Now, as the NHS marks its 70th anniversary, we stand on the cusp of a new era of personalised medicine that will dramatically transform care for cancer and for inherited and rare diseases,” said
The research scrutinised the cases of more than 1,600 people, 749 of whom were cancer-free at the time of the study, with no diagnosis, and 878 of whom had been newly diagnosed with a disease.
The test was most accurate for diagnosing
pancreatic, ovarian, liver and gallbladder cancers, correctly finding the diseases in at least four out of five patients.
The blood test found lymphoma and myeloma with slightly less accuracy, at 77% and 73%, and bowel cancer in two out of three patients. Lung cancerwas detected in 59% of patients. Head and neck cancer was detected in 56% of patients.
said their results showed promise in the approach of blood screenings for cancer, but noted further “clinical development” was needed.
The number of patients in whom cancers were detected was small. For example, although the test detected
ovarian cancer with 90% accuracy, only 10 ovarian cancers in total were detected.
Nevertheless, researchers aim to develop a tool that could be used by for all people regardless of their family history. “Potentially this test could be used for
everybody,” said Klein.
Prof Nicholas Turner from the Institute of Cancer Research in London described the findings as really exciting and as a possible universal screening tool. “Far too many cancers are picked up too late, when it is no
longer possible to operate and the chances of survival are slim,” he said. “The goal is to develop a blood test, such as this one, that can accurately identify cancers in their earliest stages.”
Klein added: “It is several steps
away and more research is needed, but it could be given to healthy adults of a certain age, such as those over 40, to see if they have early signs of cancer.”
Bowel cancer expert warn that antibiotics should not be taken for a ‘tickle’ in the throat or a cold. Photograph: Alamy Stock Photo
The overuse of antibiotics could increase a person’s risk of developing bowel cancer, the findings of a US study suggest.
in medical journal Gut found extended use of antibioticssignificantly increased the chance of polyp formation in the colon, a precursor of bowel cancer.
The findings add weight to emerging evidence that the type and diversity of bacteria in the gut may have a key role in the development
of cancer, according to the authors of the study.
An Australian bowel cancer expert, Associate Professor Graham Newstead, the head of the colorectal unit at the Prince of Wales private hospital and director of Bowel Cancer Australia, said the research had “credence”.
“We know already that if you take antibiotics you frequently get diarrhoea,” Newstead said.
This happened because the antibiotic
killed some of the normal bacteria, leading to an overgrowth of the abnormal bacteria in the gut.
But Newstead said the study did not look at the effect of antibiotics on the colon and caution must be taken.
monitored the health of more than 120,000 nurses, aged between 30 and 55, who were part of the the Nurses Health Study
launched in 1976.
Between 2004 and 2010, 1,194 abnormal growths in the colon and rectum were diagnosed.
Those who had taken antibiotics for two months or more between the ages of 20 and 39 were 36% more likely to be diagnosed with an adenoma,
or polyp, compared with those who had not taken antibiotics for any extended period in their 20s and 30s.
Similarly, women who had taken antibiotics for two months or more during their 40s and 50s were 69% more likely to be diagnosed with an adenoma.
And those who had taken these drugs for 15 days or more between the ages of 20 and 39, and between the ages of 40 and 59, were 73% more likely to be diagnosed with an adenoma.
does seem to indicate that people who have too many antibiotics might be at more risk of of getting polyps than people who have less of them,” Newstead said.
“And, remembering that not all polyps turn to cancer but
the cancer comes from the polyps. If you have more polyps or tendency to get polyps then maybe you are slightly more at risk of getting cancer.”
The message to be taken from the study was not to use antibiotics for a “tickle” in the
throat or a cold, Newstead said.
An x-ray showing cancer of the colon. Photograph: BSIP/UIG via Getty Images
A fifth of bowel cancer patients who received an emergency diagnosis in one year in England had characteristic symptoms the year before, suggesting their disease could have been caught
earlier, researchers say.
With the majority of patients having seen a doctor in the 12 months before their diagnosis, whether emergency or non-emergency, the authors of the new study say multiple factors could be behind the finding.
sample [of patients] we have analysed come from more than 200 GP practices, so this suggests that it is not a problem of specific doctors, it suggests that it is a system-wide problem,” said Cristina Renzi, lead researcher of the study from University College London and the London School
of Hygiene and Tropical Medicine.
“Emergency presentations are associated with worse patient-reported outcomes and disruptions to hospital services,” she added. “Cancer survival after an emergency
colorectal cancer diagnosis is also substantially lower.”
With the study also showing that more than half of bowel cancer patients who receive an emergency diagnosis had no record of relevant symptoms up to a month beforehand, Renzi believes
more needs to be done to support GPs, while patients should be encouraged to discuss all symptoms of concern with
Writing in the British Journal of Cancer, the researchers, from four British universities,
described how they analysed GP records and cancer registration data from more than 1,600 patients over the age of 25 who had been diagnosed with either colon or rectal cancer between 2005 and 2006.
While Renzi admits that the situation might have
changed since the data was collected, the proportion of emergency diagnoses made for rectal cancers, she said, has remained fairly constant over the last decade, while those for colon cancers has dropped slightly.
Of the 1,029 colon cancer patients,
35% were diagnosed in an emergency situation, such as A&E or an emergency GP referral, compared to 15% of the 577 with rectal cancer. Emergency diagnoses were more common among women, those aged 80 or over and, for rectal cancer, those with a low socio-economic
When researchers examined up to five years of medical history for the colorectal cancer patients, whether diagnosed in an emergency situation or not, they discovered that more than 95% had seen a doctor in the previous 12 months. “In both
cases it seems that they have been to their doctor multiple times and increasingly so the year before diagnosis,” said Renzi.
Those diagnosed in non-emergency situations were more likely to have symptoms typical of bowel cancer, including “red
flag” symptoms such as rectal bleeding, anaemia or a change in bowel habits. But, the authors report, 18% of colon cancer patients and 23% of rectal cancer patients diagnosed in emergency situations also showed at least one red flag symptom in the 12
months before their diagnosis.
That, the authors said, suggests that around 20% of colorectal cancer patients could have been diagnosed earlier. That they were not, says Renzi, could be down to a number of factors.
“It might be that the
doctor has referred them to have a diagnostic test and maybe the cancer progressed more rapidly; it might be that the patient had to come back and they didn’t,” said Renzi. “For now, we haven’t been able to really understand what went
wrong after they were seen with the typical red flag symptoms.”
With many of those given an emergency diagnosis showing no red flag symptoms or other relevant signs, such as weight loss, Renzi said it was important that patients talk to their
GP about all symptoms they are experiencing, while doctors need access to specialists and diagnostic facilities.
“The GPs need more support to deal with patients who present with non-specific symptoms in order to be able to diagnose cancer earlier,
even in those cases,” she said.
Tue 21 Oct 2008 00.01 BSTFirst published on Tue 21 Oct 2008 00.01 BST
This article is over 9 years old
Manchester University is launching an inquiry into the safety of one of its most famous buildings amid fears that radioactive contamination may have contributed to the deaths of four staff.
The investigation will focus on the Rutherford building,
where Ernest Rutherford, one of the founding fathers of atomic physics, worked with radioactive materials at the beginning of the 20th century.
Some university staff are concerned that radiation left over from Rutherford's experiments may have been
a factor in the academics' deaths, all four of whom died of cancer and worked in or close to the room where Rutherford kept his radioactive materials.
David Coggon, a leading public health expert, will lead the independent review. The inquiry
follows the release of a report calling for the health risks of the building to be investigated. The report was written by three university psychologists who worked in contaminated rooms in the building after it was vacated by the physics departments in the
The spate of cancer deaths began in 1992 when a 62-year-old psychologist called John Clark died of a brain tumour. Dr Clark worked in the room directly below Rutherford's from 1971 to 1987. His death was followed by that of Hugh Wagner, also
62, who died of pancreatic cancer last year, Vanessa Leitao, 25, who died of a brain tumour this February, and Arthur Reader, 69, who died of pancreatic cancer last month.
Radiation readings taken in 1999 found that four rooms in the building were contaminated.
A university survey in 2006 found minor radioactive contamination in the building, which was below levels that must be reported to the Health and
"We believe that the evidence presented to date does not support a connection between the deaths of former staff and possible exposure to radioactive contamination. We do not believe there to be any risk to current occupants of the
Rutherford building," a university spokesman said.