Wednesday, January 18, 2012

HRT breast cancer alert that led to thousands of women abandoning treatment was 'based on bad research'

I have been pointing this out for years

British research which linked HRT to breast cancer and led to hundreds of thousands of women abandoning the treatment was ‘unreliable and defective’, says a damning review.

It is almost ten years since the study – the largest of its kind – contributed to a worldwide scare about the safety of Hormone Replacement Therapy. It was one of three major pieces of research which undermined the confidence of women and doctors in the therapy.

As a result GPs were advised to prescribe it on a short-term basis only to combat menopausal symptoms such as hot flushes and night sweats. They were also told not to use it as a treatment for the bone thinning disease osteoporosis – which can lead to deadly fractures. An estimated one million women gave up HRT in Britain, halving the number using it.

Scientists at Cancer Research UK’s Epidemiology Unit at Oxford, who carried out the MWS, said HRT doubled the risk of breast cancer and blamed it for an extra 20,000 British cases over the decade.

However, the new review led by Professor Samuel Shapiro, a leading epidemiologist at Cape Town Medical School, South Africa, says the size of the study was irrelevant because the design was flawed and this skewed its findings. Professor Shapiro claims the study failed on a number of criteria accepted in good quality research.

For example, cancers detected within a few months of the study’s start would have already been present when women were enrolled, but these were not excluded and this skewed the findings.

Women in the study were contacted through breast screening – but this in itself would have increased the number already aware of lumps or pre-cancerous changes and led to a bias in higher numbers of cancers being detected.

A key criticism is the ‘biological implausibility’ of HRT promoting new cancers – and of this effect being ‘switched off’ within months of a woman stopping using it.

The researchers also said the name Million Women Study implies an authority beyond criticism or refutation. ‘Size alone does not guarantee that the findings are reliable,’ said the review. ‘HRT may or may not increase the risk of breast cancer, but the MWS does not establish that it does.’

The review, published in the Journal of Family Planning and Reproductive Health Care, is the final in a series looking at research linking HRT to breast cancer, which found flaws in two other major studies.

Review co-author Dr John Stevenson, consultant metabolic physician at Imperial College, London, and Royal Brompton Hospital London, said: ‘So much damage has been done by frightening women off HRT, in terms of reducing their quality of life, preventing bone loss and fractures and improving the risk of cardiovascular disease.

‘HRT is one of the cheapest treatments in medicine and we have yet to count the cost to the NHS because of women not having HRT.’

Professor Dame Valerie Beral, who led the Million Women Study, said the review authors were influenced by work as consultants to HRT manufacturers, and that 20 other studies had come to the same conclusion as MWS. [An "ad hominem" attack is about as weak a rejoinder as you get]


Sweet, sour, salt, savoury, bitter AND fat: Scientists discover that tongue has 'sixth sense' for lipids

If you cannot resist a stodgy cake or chips, it may not be simply down to lack of willpower.

Some of us have a sixth sense of taste – for fat – and those of us who lack it could be more susceptible to piling on the pounds.

For years it was thought that the tongue could detect just four elements of taste – sweet, sour, salt and bitter. Then a fifth ‘savoury’ one was discovered.

Now scientists believe a genetic variant can make some people far more sensitive to fat molecules than others.

Until now, it had been assumed that the desire to eat fatty foods was to do with the sensory system, with some people attracted to its smell and texture.

But the Washington University School of Medicine researchers found that obese people’s cravings for fatty food may be related to their levels of a receptor called CD36.

Those with more of it are better at detecting the presence of fatty food, and seemingly less likely to gorge on it. Twenty-one overweight people were asked to taste solutions from three cups and point to which was different. One contained small amounts of a fatty oil, while the other two were fat-free.

Participants who made the most CD36 were eight times more sensitive to the presence of the fat than those who made around half the amount.

Researcher Professor Nada Abumrad said the finding could help treat obesity by finding a way to increase sensitivity to it.

‘What we will need to determine in the future is whether our ability to detect fat in foods influences our fat intake, which clearly would have an impact on obesity,’ she said.

As people eat more fat, it is possible they need more and more to satisfy their cravings, the researchers told the Journal of Lipid Research.

Previous tests of the CD36 receptor in animals have shown levels of it are not just genetic, but that eating more fat leads to less production of it.


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