Older people with cancer are more likely to die in England than in other leading countries because of “age bias” in the NHS according to new research.The study from the King’s Fund found that pensioners tended to be diagnosed with the disease later and were less likely to receive surgery.

Some 15,000 people over 75 in Britain die prematurely from cancer each year compared with better performing countries, according to estimates.

The report said there was “substantial evidence” that older patients were under treated on the NHS and that their chances of survival were “poorer as a result”.

It found the elderly were less likely to receive proper tests or surgery and more likely to be seen when their cancers were advanced and so beyond treatment.

The study identified “age bias” in the NHS as a factor behind this.

Catherine Foot, Senior Fellow at the King’s Fund, said: “England still has a way to go to reach cancer survival rates that are ranked with the best international performers. The evidence points to early diagnosis as being key to improving outcomes.

“We hope urgent priority is given to closing the gap in survival rates between different groups in society. We found that older people are particularly burdened by this, being more likely to have cancer, to be diagnosed later, to be under-treated and to experience worse outcomes.”

Ministers have repeatedly cited England’s relatively poor performance in cancer survival as justification for their unprecedented reform of the NHS, repeatedly claiming that 5,000 lives could be saved a year if standards were raised although some health experts have queried this figure.

The new report by the King’s Fund think-tank acknowledges that overall cancer survival rates are improving, but agrees with the Government that England’s performance is still worse than that of several other developed countries.

One important factor behind the generally lower survival rates in England is late diagnosis, the study found.

For example, the difference between England and the Nordic countries for all cancers is 10.8 per cent.

But, if patients who have been diagnosed late and have died after a year are excluded, this falls to 3.6 per cent. This suggests that late diagnosis causes a large chunk of the difference.

Chances of surviving colorectal, breast, lung and ovarian cancer are “persistently lower” in parts of Britain and Denmark than areas of Australia, Canada, Sweden and Norway, with the gap having “widened slightly” for lung cancer, according to the report.

It said there was “strong evidence” that delays in diagnosis by GP and in accessing care partly explained the difference.

In addition, some studies have suggested that patients in some parts of Britain are far less likely to likely to have surgery on tumours than others, while more people should receive radiotherapy.

Ciaran Devane, Chief Executive at Macmillan Cancer Support, said: “There is strong evidence to show that age, not their health, is the main consideration when choosing the most appropriate cancer treatment for older people. It is absolutely vital that we look at new assessment methods in order to improve survival rates and the experience of older people with cancer.”

From: http://www.telegraph.co.uk/Older-people-receive-worse-NHS-cancer-care

Women over 50 who persistently feel bloated or have lower abdominal pain should be offered a £20 blood test to check for ovarian cancer, a panel of experts has recommended.
Campaigners say hundreds of lives could be saved a year if GPs were quicker to spot symptoms of the disease – dubbed a “silent killer” because it is hard to diagnose early enough.

Ovarian cancer kills almost 4,400 women in Britain every year – one every two hours – making it the fourth most common cancer in females.

While almost three times as many die from breast cancer, those diagnosed with ovarian cancer are far more likely to die earlier.

Figures published in The Lancet show that about 82 per cent of British women with breast cancer survive to at least five years after diagnosis. For ovarian cancer the figure is just 36 per cent. The key reason for the difference is late diagnosis.

Consequently, the National Institute for Curbing Expenditure (Nice) is publishing its first guidelines to help doctors identify and manage the disease.

These include checking the level of a blood protein called CA125, if a women tells her GP she has been persistently experiencing symptoms which could be ovarian cancer.

The test, which costs around £20, is already available on the NHS but offering it sooner could give women a greater chance of survival by speeding up diagnosis and treatment.

Dr Fergus Macbeth, director of Nice’s Centre for Clinical Practice, said older women were often misdiagnosed with irritable bowel syndrome (IBS) when they actually had early stage ovarian cancer. Other possible symptoms include feeling full quickly and the need to urinate urgently or quickly.

He said: “While the symptoms are nonspecific, their persistence can be an important indicator of the disease.”

Women who experienced them 12 or more times a month should see a doctor, the guidelines say.

Although the CA125 test is a useful indicator, they cautioned that it only picked up around 50 per cent of early stage ovarian cancers. Sometimes women with tumours had no raised level of the protein, while others with raised levels sometimes did not have ovarian cancer.

Frances Reid, of the charity Target Ovarian Cancer, said: “This guidance tackles for the first time critical issues facing women who develop ovarian cancer, and could save hundreds of lives. British women must no longer die from delayed diagnosis”, she said.

From: http://www.telegraph.co.uk/GPs-should-offer-20-ovarian-cancer-blood-test

A British man has been sentenced to eight years in prison for his role in what law enforcers describe as the “most serious known breach” of the regulated UK medicines supply chain.
Following a four month trial in Croydon Crown Court, 64-year old Peter Gillespie was found guilty for working with an international network of criminals to introduce fake drugs into the UK’s legitimate supply chain during a five month period in 2007.

The case, known as Operation Singapore, centred on the importation of more than two million doses of counterfeit life saving medicines into the country.

More than half of these were captured by the Medicines and Healthcare products Regulatory Agency, but a huge amount – almost 900,000 doses – initially reached pharmacies and patients.

Despite an immediate recall of Eli Lilly’s antipsychotic Zyprexa (olanzapine), Bristol-Myers Squibb’s bloodthinner Plavix (clopidogrel) and AstraZeneca’s prostate cancer drug Casodex (bicalutamide), 700,000 doses were left unaccounted for, putting the health of many Britons in jeopardy.

Mick Deats, the MHRA’s head of enforcement, also revealed that plans to bring in three other counterfeit drugs – Pfizer/Eisai’s Alzheimer’s drug Aricept (donepezil), UCB’s antiepileptic Keppra (levetiracetam) and Johnson & Johnson’s antipsychotic Risperdal (risperidone) – had been foiled.

“They didn’t get to bring them in but they were definitely well on the way to being prepared to receive them,” he told the media, according to Reuters.

“This is serious criminal activity and puts people’s lives at risk,” Deats said, and stressed that the Agency would not hesitate “to take all appropriate action to eliminate the risks posed by counterfeit medicines and take action against those engaged in their supply”.

However, he also noted current evidence suggests that medicines supplied through the UK legitimate supply chain are genuine and safe to take.

Since 2004 there have been just 15 known instances of counterfeit medicines in the UK regulated supply chain, and given that 850 million prescriptions are dispensed every year in the UK, the likelihood of receiving a counterfeit medicine remains extremely rare, the MHRA said.

From: http://www.pharmatimes.com/Man_jailed_for_worst_ever_breach_of_medicines_supply_chain

The National Health Service could save around £200 million a year through more efficient prescribing by GPs, a report by the think tank The King’s Fund has found.
While its extensive inquiry into general practice in England praised the majority of care, it found significant variation in prescribing across the country, and that substantial savings could be made if family doctors were more efficient in prescribing certain drugs, particularly statins.

The extensive review also other widespread variations in the quality of care and performance throughout primary care.

For example, one-third of patients with stomach or oesophageal cancer who needed an urgent referral to hospital were actually given a non-urgent referral by GPs.

In fact, overall, an eight-fold variation at which practices urgently refer patients with suspected symptoms of cancer on to specialists in secondary care was found.

Continuity of care continues to be an issue, as only just over a quarter of patients are able to see the doctor of their choice in the lowest performing practices.

Crucially, there were also wide variations in admission rates for patients that could actually be treated outside hospital, which is particularly important as the effective management of patients within the community could also save the NHS hundreds of millions of pounds a year, The King’s Fund said.

On a more general note, the inquiry’s report strongly backs the position of GPs as generalists rather than specialists, but also notes that the profession must embrace the radical changes laid out in the government’s reform of the health system – particularly new commissioning powers -  in order to “maintain its international reputation for excellence”.

In addition, in order to help meet the growing challenges in healthcare, such as the ageing population and increasing demand on service, by building on the changes already taking place within the system.

It calls on GPs to accelerate the trend for multi-professional teams that work closely alongside specialists outside the practice, move away from being ‘gatekeepers’ to ‘navigators’ who essentially co-ordinate care for people with complex needs, and place a greater emphasis on prevention of ill health.

There must also be a much stronger focus on improving the quality of care, the report notes, and also calls on GPs to take responsibility for driving forward progress through a stronger commitment to transparency, particularly on performance data, peer review and benchmarking, and better data capture and use of information.

“Although general practice in this country remains the envy of the world, there is no room for complacency,” warned The King’s Fund’s chief executive Chris Ham.

“While many practices have been at the vanguard of innovation and quality improvement, too many GPs remain unaware of significant variations in performance and do not give priority to improving quality,” he noted.

NHS Confederation acting chief executive Nigel Edwards said improving primary care and GP services is one of the biggest challenges facing the NHS, and that the report “highlights the need to address the major variations in the standards of care patients are receiving”.

He calls for the introduction of a national process to compare general practice standards which, he claims, would not only empower patients to compare the standard of care, but would also help “drive down variation in diagnosis, referrals and prescriptions, all of which are central to saving lives”.

According to the British Medical Association a “culture of self-scrutiny has existed for many years but now more than ever, given the increased intensity and complexity of general practice work nowadays, GPs need time off the treadmill so they can look critically at what they do and make improvements”.

“A reduction in bureaucracy would help them to do this, as would stopping the constant reorganisations within the NHS”, it stressed.

From: http://www.pharmatimes.com/NHS_could_save_millions_of_pounds_with_better_prescribing

It is looking increasingly likely that PharmaMar’s Yondelis will not be available on the National Health Service for patients with ovarian cancer, after cost regulators again rejected the drug on questions over efficacy.
The National Institute for Curbing Expenditure (NICE) has republished draft guidance turning down the use of Yondelis (trabectedin), in combination with pegylated liposomal doxorubicin (PLDH), as a treatment for ovarian cancer that has returned six months or more after initial treatment with chemotherapy, including platinum for platinum-sensitive disease.

Ovarian cancer is the fifth most common cancer in women in the UK, with more than 6,500 patients diagnosed every year.

In around 80% of cases the cancer will return following first-line treatment, and it is estimated that just over two fifths of these could be eligible for treatment with Yondelis, a marine-based anticancer drug derived from the sea-squirt that attacks cancer cell DNA to prevent cell growth and spread.

But the Institute’s Appraisal Committee said it has serious concerns over how Yondelis’ effectiveness compares to that of other treatments available on the NHS. Crucially, PharmaMar did not submit any evidence comparing its drug to platinum-based chemotherapy regimens in treating relapsed disease, despite the latter being the gold standard therapy in such cases.

“This means that we cannot be sure that [Yondelis] extends patients’ lives for longer than the most routinely used treatments,” explained NICE chief executive Andrew Dillon.

Evidence ‘not robust’

New evidence considered did suggest that Yondelis might be most effective in women with ‘partially platinum-sensitive’ ovarian cancer, i.e. when the disease comes back between six and 12 months after initial platinum chemotherapy.

However, the Committee said it was not sure that the effectiveness of the drug in this subset of patients was “genuinely different from that seen in the wider group of patients for which the drug is licensed”, and so concluded that the data were not robust enough.

Taking all the uncertainties into account, the Committee calculated that the incremental cost-effectiveness ratio (ICER) for Yondelis could be higher than £95,000 per QALY gained for the entire eligible population, and £68,000 for the partially platinum-sensitive subgroup, despite a proposed patient access scheme under which PharmaMar offered to pick up the tag for treatment with its drug following the fifth cycle of treatment.

“Even when taking into consideration the Patient Access Scheme, through which the manufacturer limited the total cost of the drug, the committee concluded that the cost of trabectedin was too high relative to the uncertain benefits it may provide patients,” Dillon said.

Meanwhile, the Institute has announced that Sir Professor Sir Michael Rawlins has been reappointed as its chair for another year’s term, until March 31, 2012.

Professor Rawlins has held the position since NICE was created by the then Labour government in 1999 to curb the NHS’s expenditure on drugs.

From: http://www.pharmatimes.com/Another_NICE_no_for_PharmaMar_s_Yondelis

The results of a Phase III trial have shown the ability of GW Pharmaceuticals’ cannabinoid based medicine Sativex to reduce severe spasticity associated with Multiple Sclerosis.
According to the data, published in the European Journal of Neurology, about half of MS patients who had failed to respond to standard therapy experienced an improvement in spasticity after taking Sativex Oromucosal Spray (delta-9-tetrahydrocannabinol and cannabidiol).

The trial hit its primary goal of demonstrating that Sativex induced a significant improvement in the scores of spasticity, spasm frequency and sleep disturbance related to spasticity compared to a placebo.

Following a four-week, single-blind therapeutic trial period involving 572 patients, Sativex was shown to have reduced the mean score for spasticity, with 48% of patients achieving a clinically meaningful improvement of =20% in spasticity severity.

Of these responders, 241 took part in a 12-week, randomised, placebo-controlled trial phase, at the end of which the number of patients reporting an improvement in spasticity scores of =30% was significantly greater in the Sativex group (74%) than in the control arm (51%).

“We have been aware for a long time that cannabinoid medicines can significantly improve spasticity, which is a common, complex symptom of MS, and now the results from this study prove the positive impact they can have on patients’ symptoms, and ultimately their lives,” said Professor John Zajicek, Honorary Consultant in Neurology, Derriford Hospital and Chair of Clinical Neurosciences at PCMD, University of Plymouth, commenting on the findings.

MS affects around 100,000 people in the UK, and spasticity is a common symptom that is considered to be a major cause of disability, interfering with many every day activities such as walking, picking up objects, washing or dressing.

Sativex was approved by health regulators in the UK and Spain last year, but only in patients who have not responded to other medication and who show a clinically significant improvement in symptoms during a trial run of therapy.

Overall, GW Pharma is celebrating a stellar year with 27 sales hike GW Pharma s cannabis-based MS drug approved in Spain GW rolls out cannabis-based MS drug Sativex in UK Sativex deemed approvable by regulators in UK Spain. GW Pharma’s share has also received a boost on initial Sativex research on reducing cancer pain data.

From: http://www.pharmatimes.com/Study_backs_use_of_cannabis-based_Sativex_to_treat_MS

Dying cancer patients have been refused costly life extending drugs on cost grounds despite a Government promise to end the “scandal” forever.
Their requests have been rejected by regional health authorities who were accused of operating covert “blacklists” to restrict dozens of treatments to save money.

An investigation by The Sunday Telegraph has uncovered more than 80 cases in which desperately sick NHS patients have been refused the cancer drugs their doctor sought, in the four months since a £200 million fund was introduced to stop health authorities rationing treatments.

The fund was a key move by the Coalition so that those suffering from cancer would never again be refused drugs on grounds of cost.

Ministers were responding to years of anger over a system which meant patients were unable to secure life-extending drugs because central NHS rationers had decided the treatments were not “cost effective”.

Announcing the fund last summer, Andrew Lansley, the Health Secretary, promised to end “the scandal” of cancer patients being refused the drugs that their doctors sought, because of restrictions by the National Institute for Health and Clinical Excellence (NICE).

A £50 million stopgap version of the fund was launched in October, before the annual £200 million investment starts in April.

But this newspaper’s investigation has raised serious concerns over its operation, including:
* At least 86 cases involving terminally-ill patients being turned down;
* Extreme variations in access to drugs, with one NHS region promising free access to more than three times as many cancer treatments as another;
* Local policies so restrictive that in many parts of the country, consultants are expected not to even bother asking for drugs which are not on the “priority lists”.

In its first four months, the fund has paid for approximately 1,300 patients’ drugs – even though research last March suggested up to 20,000 cancer patients’ lives were being shortened each year by drugs rationing.

The Government has allowed each NHS regional health authority to set its own rules about which drugs are put on priority lists, creating a postcode lottery across the country.

If treatments are not on the list, patients and their doctors have to fight harder to justify why they should get them.

Bureaucrats have created complex structures, leaving terminally-ill patients to spend their last months fighting for drugs which could increase their survival.

The policies say every possible funding route for drugs must be exhausted before the NHS will even consider dipping into the fund.

Cancer charities warned that some NHS authorities were attempting to “drive a coach and horses” through the Government pledge.

They fear the £50 million fund may actually end the financial year underspent because of the restrictions.

Andrew Wilson, chief executive of charity The Rarer Cancers Foundation, said: “We are deeply concerned that health authorities are creating really restrictive policies which go entirely against the spirit of the fund – which was that clinicians would be able to decide what treatment their patients need.

“Some organisations are effectively operating blacklists of drugs, while others are making every patient go through lengthy bureaucracy to apply as an exceptional case, when in fact they are a cancer patient requiring treatment should be sufficient. The way some of these organisations are operating drives a coach and horses through the principle of the scheme.”

In most parts of the country, if a patient requires a treatment such as Avastin for bowel cancer – which NICE says is too expensive – their doctors must first apply to see if their primary care trust will fund it as an “exceptional case”.

If that is refused, as would normally be the case, a separate application is then made to request authorisation from the cancer drugs fund – and if that too is refused, patients and doctors are left to attempt an appeal.

Patients refused include those seeking Avastin for advanced bowel, breast and brain cancer, Tyverb for breast cancer and drugs to treat tumours of the bladder and kidney.

NHS authorities said they had turned down requests because they did not think there was enough evidence patients would benefit from drugs their doctors sought. In other cases, they were refused help because their medical history did not match the precise criteria drawn up by trusts.

There is also concern over the “postcode lottery” in availability of drugs.

NHS North West has cited 22 drugs which should normally be funded – while NHS South Central, spanning five counties from Oxfordshire to the Isle of Wight, lists just six treatments which would automatically be allowed.

The policies are so restrictive that in Yorkshire and the Humber, just 82 patients have been given funding. Yet across the East of England, with a similar population, 201 cases were funded.

Even those areas which seemed to have the most generous policies have tightened their belts as end of financial year approaches.

In the North West, which had backed the use for Avastin for some advanced breast cancers, and Glivec for cancer of the stomach, says patients who have not been given funding will now have to wait until April before their cases are even considered.

Several have changed their rules even in during the four months since the fund was set up, so that several patients in London were denied drugs under one set of criteria, only to have their cases reconsidered all over again as their health declined.

Mike Hobday, head of policy at charity Macmillan Cancer Support, said he was “very worried” by the findings of the investigation.

He said: “Every cancer patient should get the drugs their doctor recommends, regardless of what type of cancer they have, or where they live.

“A few extra months towards the end of a patient’s life can mean the difference between seeing a child get married or graduate.”

Health Minister Anne Milton said: “Since October, more and more patients are being treated with life-extending drugs that they wouldn’t have got under the previous system. Demand for the fund will vary across the country; we set up the fund in order to balance out existing variation in access.”

From: http://www.telegraph.co.uk/Cancer-sufferers-refused-life-extending-drugs-despite-Government-pledge

Here is a cancer rates league table of the countries with the highest overall rates of cancer, for men, for women and for breast cancer in women, according to the World Cancer Research Fund.

In total there were 12.7 million new cases of cancer worldwide in 2008The latest global figures show that in 2008, there were 12.7 million cases of cancer diagnosed worldwide.

The highest rates of cancer were found in Australia/New Zealand and North America, and the lowest rate was in Africa.

The cancer rate in Australia and New Zealand was nearly three times that in Africa.

Of the total number of cases 48% are in Asia and 25% in Europe. Only 14% of cancers diagnosed worldwide are from regions with the highest rates i.e. Australia, New Zealand and North America. This apparent disparity is likely due to the large population size in Asia.

The most common cancer in men is prostate cancer except for Asia where it is lung cancer. In all regions the most common cancer in women is breast cancer.

Age standardised incidence rates for cancer (excluding non-melanoma skin cancer) in 2008

The tables show the countries with the top ten cancer rates – how many people in every 100,000 develop cancer every year – in four different categories.

Overall cancer rates
1. Denmark (rate: 326.1)
2. Ireland (317)
3. Australia (314.1)
4. New Zealand (309.2)
5. Belgium (306.8)
6. France (Metropolitan) (300.4)
7. USA (300.2)
8. Norway (299.1)
9. Canada (296.6)
10. Czech Republic (295)
[22. United Kingdom (266.9)]

Cancer in men
1. France (Metropolitan) (360.6)
2. Australia (360.5)
3. Ireland (355.9)
4. Uruguay (354.4)
5. Hungary (352.3)
6. Belgium (351.3)
7. Czech Republic (348.8)
8. Norway (338.4)
9. New Zealand (337.6)
10. USA (335)
[33. United Kingdom (280)]

Cancer in women
1. Denmark (325.3)
2. New Zealand (287.1)
3. Ireland (285.1)
4. Israel (280.4)
5. The Netherlands (276.5)
6. Belgium (275.7)
7. Canada (275)
8. Australia (274.4)
9. USA (274.4)
10. Norway (270.3)
[12. United Kingdom (260.5)]

Breast cancer (women)
1. Belgium (109.2)
2. Denmark (101.1)
3. France (Metropolitan) (99.7)
4. The Netherlands (98.5)
5. Israel (96.8)
6. Iceland (95.5)
7. Ireland (93.9)
8. Uruguay (90.7)
9. Switzerland (89.4)
10. New Zealand (89.4)
[11. United Kingdom (89.1)]

From: http://www.wcrf.org/cancer_facts/millions_new_cancer_worldwide.php and GLOBOCAN 2008 http://globocan.iarc.fr

Women in Britain are more likely to be be diagnosed with breast cancer than those in most other developed countries because of their unhealthy lifestyles, according to a new study.
Analysis of data collected by the respected World Health Organisation shows Britain has higher rates of the potentially fatal disease than the USA, Australia, Germany and Spain.

In only 10 of the 50 countries assessed by the researchers do women have a higher chance of being diagnosed with breast cancer than those in the UK.

The experts said that many of the 46,000 breast cancer cases in the UK each year could be avoided if British women drank less, ate more healthily or took more exercise.

More than a quarter of women who develop the disease in Britain die from it, as survival rates have remained low despite record investment in the NHS under Labour.

Professor Martin Wiseman, medical and scientific adviser for the World Cancer Research Fund, which compiled the new study, said: “We know that people in high-income countries are more likely to be overweight, to drink a lot of alcohol and to be inactive.

“When you look at the list, it is clear that the countries that do worse for these factors tend to be nearer the top.

“The high incidence rates in the UK, Denmark and other high-income countries are not inevitable and lifestyle changes can make a real difference to people’s risk.”

Sarah Woolnough, Cancer Research UK’s director of policy, said: “We do know that up to half of all cancers could be prevented by changes to lifestyle such as giving up smoking, keeping a healthy weight and cutting down on alcohol. People can also reduce their risk by eating a healthy balanced diet that is high in fibre, fruit and vegetables and low in red and processed meat.

“All these things, along with taking regular exercise and avoiding sunburn, can reduce the risk of developing cancer.”

More and more British women have been developing breast cancer in recent decades as diets have worsened, excessive drinking has become more common and exercise rates fallen.

Detection rates have improved thanks to the development of advanced screening techniques and increased awareness, but 12,000 women still die from the disease each year as Britain spends less on treatment drugs than other European nations.

Earlier this month the Department of Health announced a new £750 million cancer strategy aimed at saving the lives of 5,000 people a year in England, by giving GPs greater access to advanced diagnosis and improving investment in radiotherapy.

The WHO, through a project called GLOBOCAN, collects figures on the incidence of and deaths from the most common types of cancer for countries across the world, standardised for age in order to aid comparisons.

Its most recent data, analysed by the WCRF for today’s report, show that Belgium had the highest rates of breast cancer in 2008, with 109.2 cases per 100,000 women.

Britain is 11th, with 89.1 cases per 100,000, not as bad as Denmark, the Netherlands, Israel, Ireland or New Zealand but worse than many other leading nations as well as less developed countries where lifestyles are less sedentary. Just 50 in every 100,000 women develop breast cancer in Estonia and Montenegro, for instance.

Britain is the 12th worst of the 50 countries in terms of rates of all cancers among women.

The picture is slightly better for men, where the UK ranks as the 33rd worst. Overall, across both sexes, Britain is ranked 22nd worst out of 50 countries with 267 out of every 100,000 people developing tumours.

International studies have shown that Britons now eat and drink more than their counterparts in many other countries.

Recent figures from the Office for National Statistics show that one in seven women over the age of 16 drinks more than double the recommended daily allowance of alcohol every week, while 24 per cent of women in England are classified obese.

Denmark was given the overall title of “cancer capital of the world”, and although it has a good record of diagnosing the disease, the WCRF said the country’s residents drank a lot and Danish women were heavy smokers.

Meg McArthur, Senior Policy and Information Officer, Breakthrough Breast Cancer, said: “Although these statistics show that we have further to go before we have a future free from the fear of breast cancer in the UK, it is important to remember that more women than ever are surviving due to better screening, improved treatment and greater awareness.

“Breast cancer is thought to be due to a combination of lifestyle, genetic and environmental factors and although some risk factors cannot be changed, women can reduce their risk by drinking less, maintaining a healthy weight and exercising regularly.”

The Government and leading cancer charities insist that Britain’s position near the top of the cancer incidence tables shows that the disease is being picked up by doctors, which aids early treatment, and point out that other countries may not record data so accurately.

Sarah Woolnough, from Cancer Research UK, added: “Comparing cancer incidence rates between different countries can be misleading due to differences in how the data is collected. In some countries, such as the UK, the whole population is accounted for in the data. But in others, coverage is much smaller, so the overall figures might not actually be representative of the whole country.

“Age is the biggest risk factor for cancer, so high-income countries where people live for longer will tend to have higher incidence rates.”

The National Cancer Director, Professor Sir Mike Richards, said: “There are many important factor to consider when looking at cancer incidence figures – for example smoking, alcohol, obesity, and other lifestyle choices.

“We want to vastly improve cancer outcomes – that’s why we will shortly be launching the first ever Government awareness campaign for cancer, to promote earlier diagnosis and to save more lives.”

From: http://www.telegraph.co.uk/Alcohol-and-poor-diet-linked-to-UK-breast-cancer-rates

Everyone aged over 45 should consider a small daily dose of aspirin to help protect themselves against heart disease and cancer, a panel of experts have suggested.Evidence is building that the benefits of taking aspirin for many healthy middle aged and older people “far outweigh” the side effects, according to the academics.

In particular, individuals at higher risk from the country’s two biggest killers would be helped by taking the painkiller as a preventive medicine, they added.

The experts were speaking at the Royal Society of Medicine a month after research from Oxford University published in The Lancet showed that taking 75mg of aspirin daily for five years reduces the risk of getting bowel cancer by a quarter, and deaths from the disease by a third.

A 75mg dose is a quarter of the standard over the counter pill.

Earlier studies had already shown that a low daily dose could reduce the risk of developing heart disease.

Members of the panel said that the recent research was potentially of “enormous importance” to public health.

Bowel, or colorectal, cancer is the third most common form of the disease in Britain, with 39,000 diagnoses annually and 16,000 deaths.

The Lancet study suggests greater aspirin use could potentially save thousands of lives a year in relation to this one cancer alone.

But research is also looking into whether aspirin could have a preventive effect on other types of cancer as well.

Combined, all cancers claim more than 150,000 lives in Britain every year, while cardiovascular disease accounts for some 200,000 deaths.

Prof Peter Rothwell, the Oxford neurologist who led the bowel cancer study and was part of yesterday’s panel, has started taking a daily dose of aspirin himself. He said: “I suspect that in five to 10 years’ time we will be prescribing aspirin to middle-aged people, not only for the known vascular benefits.”

But members of the public might take matters into their own hands before then, he predicted.

“If it becomes clear that there are benefits for other cancers, then the balance of risk and benefit will become so clear that people may take the decision to take it for themselves,” he said. “It seems implausible that this effect on colorectal cancer is going to be a completely isolated phenomenon in relation to other cancers, given that we know that there are similarities between how cancers develop.”

Prof Rothwell said that he thought it would be “sensible” for people to start taking aspirin at about 45, when the chance of developing bowel and other cancers began to rise. “The risk of cancer goes up substantially between the age of 40 and 55,” he said.

As aspirin had a preventive effect, it was advisable to start taking it daily towards the beginning of that period, he explained. However, he said it was ultimately up to individuals to decide whether to take the drug, “rather than us making definitive statements”.

Prof Peter Elwood, of Cardiff University’s School of Medicine, who conducted the first trial into the effect of aspirin on heart disease in the 1970s, said: “I think we are on the brink of another breakthrough of enormous importance to the community in general.”

Prof Gordon McVie, a leading cancer specialist, from the European Institute of Oncology, said the discussion among the experts was whether this was metaphorically a “put-it-in-the-water moment”.

Opinion on the subject varies however. Experts are divided particularly over the question of to whom aspirin should be recommended as a daily preventive medicine.

The drug was formulated as a painkiller more than a century ago but researchers are finding that it can help in diseases ranging from heart disease to dementia.

Advocates believe that its active ingredient is akin to a vitamin that almost everybody should take, as our modern diet does not provide it. Others point out that taking the drug is known to double the incidence of intestinal bleeding, from about one in 1,000 people per year to about two.

The question is how much of the population – in terms of their age and their risk of developing serious diseases – should be recommended to take aspirin on a daily basis.

Prof McVie said: “I think there’s a frankly conservative feeling in this group, that for [colorectal] cancer, it should be targeted for people at higher risk.”

Prof Sir John Burn, a geneticist at Newcastle University, said: “The problem is, if we recommend something to the whole population, then we will see side effects.

“We know aspirin can cause gastrointestinal bleeding. That is to some extent holding back the situation.” Prof Dion Morton, a colorectal surgeon at University Hospital Birmingham, was another of those attending yesterday’s meeting, which was convened by the Aspirin Foundation.

He said that medicine was increasingly using a “stratified approach, where we target the right drugs at the right patients”.

He thought regulatory approval should be sought for doctors to prescribe aspirin as a preventive medicine for those at a higher risk of bowel cancer. “If they have not been told in writing they should be advocating it, they won’t advocate it,” Prof Morton said.

While intestinal bleeding was serious, research suggested that aspirin increased the risk only of less serious cases, said Prof Elwood. He said there was some evidence that the intestines adjusted to aspirin over the long term.

From: http://www.telegraph.co.uk/Daily-aspirin-dose-for-everyone-over-45-to-protect-from-cancer-heart-disease