Monday, February 18, 2008

Social class and cancer detection

By Dr. Syed Ashraf Imam

The Muslim guy writing below is not a very good researcher or he would not be peddling the old snake-oil about mammogram screening. Its utility is now regarded as dubious. In the circumstances, I don't think any of his other statements can be taken at face value either. My guess is that he is just another leech trying to bleed the taxpayer in the name of doing good

When I first joined the fight against breast cancer nearly 30 years ago, the tools we used were primitive. Mammography was very much in an experimental form and our diagnoses were often flawed. Even the treatments we used then seem primitive by today's standards. Fortunately, for most women, breast cancer is no longer a death sentence. Improvements in detection, treatment, education and our understanding of the disease have allowed us to take great leaps forward to eradicating it. However, those of us in the field are reminded every day that we are not there yet. In California alone, nearly 20,000 women are diagnosed with breast cancer per year. And more than 4,000 women die from the disease.

Therefore, the mantra in our fight is early detection. And there's a reason for it. Women who discover breast cancer at an early stage have a better chance of surviving. Breast cancer at its early stage is more often detected in women in higher-income groups than those in lower incomes. Unfortunately, this disparity makes this disease deadly for the least fortunate among us.

The reality of early detection rarely has anything do with luck. The women who are diagnosed at an early stage are more often those with access to proper health care and an advanced awareness of the disease. They are more likely to receive appropriate treatment in time, and, therefore, more likely to survive. Their counterparts, who do not have access to information and care comprise the bulk of those women diagnosed with late stages of breast cancer, the life-threatening stage of the disease.

It's simple to see why this is the case. Among uninsured women over 40, only one-third have yearly mammograms. In contrast, 64 percent of women with health insurance received such an examination last year. With such obvious disparities, it would seem that a few easy remedies would be in order. First and foremost is giving more women access to health care in California. We're ranked 44th in the nation in providing women access to healthcare, with 21 percent of women without access. That ought to change.

Luckily, we have begun to move in the right direction in Sacramento. The California Department of Health Services' Every Woman Counts program has already invested millions of dollars in state funds toward increasing access to care for under-insured women. As a result, more women can get the screenings for the early detection of breast cancer and possibly treatment they wouldn't otherwise receive. Unfortunately, the program has the funding to provide health care for only one-fifth of the 1.2 million eligible women. As a result, the current level of available funds is far from being adequate.

We can do better than that. Los Angeles is joining the Komen Community Challenge - a national grassroots campaign to close the gaps in research, public policy and access to quality care. Susan G. Komen for the Cure is asking communities to rally together in order to close these deadly gaps. In California, it means asking state legislators to provide $12 million in funding for the State Department of Public Health Services' Every Woman Counts program, providing another 24 percent of eligible women access to care that could save their lives. If our leaders in Sacramento step up the plate, Every Woman Counts really will serve every woman who needs it - and no woman will ever be turned away.

As a researcher I recognize the important role of science in our fight to eradicate breast cancer. I also know that we can't just fight breast cancer in the laboratory alone. Let's come together and close the gaps that make breast cancer deadlier for some women than others. The past three decades have seen us greatly reduce the number of women who die from breast cancer.


Study Links Diet, Activity to Lung Cancer Risk: Eat Your Veggies, Work Outside for Cancer Prevention

It's just another stupid study based on self-reports -- with no doubt the usual class bias of such studies. There was NO measurement of ACTUAL vegetable consumption

Eating four or more servings of green salad each week as well as working outside in the yard or garden a couple of times a week may significantly lower the chance of developing lung cancer in smokers and nonsmokers, according to a recent study. "The results are exciting because the study is applicable to everyone, and it may have a positive impact on the 15% of people who are diagnosed with lung cancer who are non-smokers," says Michele Forman, Ph.D., lead author on the study and a professor in M. D. Anderson's Department of Epidemiology. Forman adds that although this is a very preliminary analysis, the results give researchers important clues about how smokers and non-smokers might be able to reduce their risk of developing lung cancer. [Policy recommendations made on the basis of "a very preliminary analysis"??]

This study sought to determine if physical activity and diet have an impact on whether people develop lung cancer. Forman says frequency of eating salad is a marker of vegetable consumption. Gardening was chosen as a physical activity because a wide range of people can participate in it, and other physical activity did not appear to influence risk prediction. It is one of the few activities people with lung cancer report doing.

The investigators found that physical activity like gardening reduced the risk of developing lung cancer by: 45% in former smokers; 33% in smokers. Smokers who eat three servings or less of salad a week have double the chance of lung cancer compared to smokers who eat four or more salads weekly, according to the study results.

Researchers used a food-frequency questionnaire for participants to report about their diets during the previous year in healthy patients or the year before diagnosis of lung cancer in patients. Data was collected on: Cancer patients a year prior to diagnosis; Cancer-free individuals a year prior to interview. Participants also were asked about physical activity, including sports and other forms of exercise, throughout their adult years.

These findings are part of an ongoing study that is examining several risk factors for lung cancer. It matches people being treated for lung cancer at M. D. Anderson with cancer-free people who are patients at Kelsey-Seybold Clinic, a private physician group in Houston. More than 3,800 participants are involved in the study.

What's next? Forman says more research is needed on the connection between lifestyle and cancer. "We do not know yet whether these habits of eating well and exercising are markers for other lifestyle factors that might be even more important, such as lack of alcohol consumption," she says. "We have a lot of puzzles in the picture yet to analyze."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

"What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!


No comments: