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What the papers say! Exploring the myths of the media Miss Tena Walters MB BS, FRCS, MS Consultant Breast Surgeon BMI and The London Breast Clinic 108.

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Presentation on theme: "What the papers say! Exploring the myths of the media Miss Tena Walters MB BS, FRCS, MS Consultant Breast Surgeon BMI and The London Breast Clinic 108."— Presentation transcript:

1 What the papers say! Exploring the myths of the media Miss Tena Walters MB BS, FRCS, MS Consultant Breast Surgeon BMI and The London Breast Clinic 108 Harley St 108 Harley St

2 Metro 1 st September 2011 Tariq Tahir

3 Breast Cancer Screening benefits overstated Gotzsche and Jorgensen Women undergoing screening are misinformed about drawbacks Women undergoing screening are misinformed about drawbacks Its effectiveness is overstated Its effectiveness is overstated Survival rates are due to better treatment Survival rates are due to better treatment Over-diagnosis leads to unnecessary mastectomy Over-diagnosis leads to unnecessary mastectomy Called for ‘honesty’ in the NHS Called for ‘honesty’ in the NHS

4 Disadvantages of Screening Cost Cost False positives: 2 dimensional picture of 3 dimensional structure False positives: 2 dimensional picture of 3 dimensional structure Occult and low grade disease Occult and low grade disease Radiation exposure Radiation exposure Same as 4 days Same as 4 days 1/60 th CXR 1/60 th CXR 1/250 th CT Scan 1/250 th CT Scan 10 minutes on a transatlantic flight 10 minutes on a transatlantic flight

5 Breast Cancer Benefits Overstated Response from Prof Julietta Patnick 1 life saved for every 400 screened 1 life saved for every 400 screened 97% women with screen detected cancers alive after 5 years compared with 80% of all women diagnosed without screening 97% women with screen detected cancers alive after 5 years compared with 80% of all women diagnosed without screening 1400 women saved per year by NHSBSP 1400 women saved per year by NHSBSP Mortality in the screened population proven to be lower Mortality in the screened population proven to be lower

6 NHS BSP Mortality from breast cancer decreased by 30% since introduction of screening Mortality from breast cancer decreased by 30% since introduction of screening Lowest mortality since 1950’s Lowest mortality since 1950’s Mortality decline similar in 50 – 60 year old group and year old Mortality decline similar in 50 – 60 year old group and year old Since introduction of screening symptomatic service greatly streamlined Since introduction of screening symptomatic service greatly streamlined Increase in public awareness and decrease in stigma Increase in public awareness and decrease in stigma

7 European trends Increase in mortality Increase in mortality Russia Russia Decrease in mortality Decrease in mortality UK UK Germany Germany Scandinavia Scandinavia Poland Poland Czech Republic Czech Republic Austria Austria Switzerland Switzerland

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9 Pain killer heart alert The Daily Mail 28 th September 2011 Tamara Cohen

10 Diclofenac No need to panic! No need to panic! 17 million prescriptions 17 million prescriptions Dr Patricia McGettigan Hull York Medical School Dr Patricia McGettigan Hull York Medical School Study of 3 million people showed risk of 40% Study of 3 million people showed risk of 40% Meta analysis of case control / cohort studies Meta analysis of case control / cohort studies Diclofenac summary relative risk of 1.4 Diclofenac summary relative risk of 1.4 Naproxen 0.97 Ibuprofen 1.07 Naproxen 0.97 Ibuprofen 1.07

11 Comments -Painsupport ‘an even better health move would be to give up reading the Daily Mail altogether’ ‘Newspapers print to sell not to inform’ ‘if you listen to breaking news – we’ll be broken before them’ ‘dying of a heart attack more attractive than living in pain’

12 Calcium Supplements

13 Calcium Supplements and Heart Disease Daily Mail 30 th July 2010 Calcium Supplements risk 30% higher risk of heart attacks Meta analysis of 11 trials people 14 more heart attacks 10 strokes and 26 fewer fractures Randomised study in USA in 38,000 patients showed reduction in cardiovascular events in 2008

14 The Independent 5 TH October 2011 Melanie Newman and Oliver Wright

15 Alternatives available cheaper Cipramil costs £1.31 Cipramil costs £1.31 Cipralex costs £14.91 Cipralex costs £14.91 Cost to the NHS of £3.3 million Cost to the NHS of £3.3 million Only one trial showed significant difference between the two drugs but trial was by a company called Arbacom which has not sponsored any research before or since

16 Anti hypertensive medication California teachers study cohort Increase in breast cancer risk 1.18 Increase in breast cancer risk 1.18 Er positive tumours rr 1.21 Premenopausal 1.56 No link in post menopausal women

17 What’s New? Herceptin and antibody combination Fewer side effects 14 month disease free interval compared with 9 month disease free interval The Holy Grail of cancer medicine


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