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  • Could computers help GPs diagnose cancer early? - Cancer Research UK - Science blog
    During Macmillan s test run GPs from 439 practices across England had access to the software between March and November 2013 These GPs were divided into two groups with one using a version that showed results from the Risk Assessment Tool and the other using a version that showed results from QCancer The software recorded the scores produced for patients by the two algorithms to see if there were differences between them Teams here at Cancer Research UK then analysed the data collected One of the Department of Health s Policy Research Units also gathered feedback from interviews with patients and GPs to get more detail on how they felt about the CDS software Our evaluation comes with some caveats for example participation and providing feedback was voluntary That means that the data on how the programmes were used isn t comprehensive and may not be representative so the results can t necessarily be generalised to all GPs And it wasn t possible to get data on key things like the number of cancers diagnosed or the stage at which they were diagnosed during the trial run So we don t know if using the software meant that patients were diagnosed at an earlier stage and did better in the long run Despite this the evaluation has provided vital insights into GPs and patients views and experiences of using the programmes including how they could be improved What s the verdict I think I probably did pick up a lung cancer that I wouldn t have done I wouldn t have thought about it if I hadn t had some of those prompts GP who took part in the pilot Overall our evaluation suggests the CDS systems can raise GPs awareness of cancer symptoms both alert and remind GPs when patients are potentially at risk influence the decisions GPs make about how to care for patients In fact in nearly a fifth 19 of cases GPs said that had they not used the symptom checker they would not have referred investigated the patient Looking by cancer type GPs said that using the lung cancer symptom checker was most likely to influence them in a third 33 of cases it lead them to refer investigate patients that they wouldn t otherwise have done The oesophageal and pancreatic cancer symptom checker was least likely to influence them 9 of cases However there was no strong evidence that access to the software increased urgent referrals for suspected cancer the two week waits for the cancers the CDS programmes covered Interestingly the risk calculated by the symptom checker was different from the GP s perceived level of risk nearly half 46 of the time This highlights the potential of the software to help GPs identify patients at risk But it could also reflect the fact that the GPs sometimes felt they were in a better position to assess their patient s risk GPs also expressed several concerns including that they didn t always agree with or understand how to interpret the risk scores produced for their patients the risk scores produced by the algorithms used in the software rely on data recorded in a patient s medical records which may not necessarily be 100 accurate This could flag patients who aren t actually at risk or miss others who are they could end up with prompt fatigue both because of how regularly the programmes prompt them and because other systems on their computers also flag various things in a 10 minute consultation it was sometimes difficult to use the symptom checker function properly looking at their computers to use the CDS software meant GPs felt they weren t focusing on interacting and talking to their patients What did patients think Patients echoed some of these concerns that GP s would be over reliant on the computer and they would tend to look at the screen rather than at them leaving them feeling excluded Despite those concerns overall the patients did generally think that it was a good idea to find ways for GPs to make use of the RAT and QCancer algorithms in some form The key will therefore be to ensure that GPs are trained in how to use the CDS programmes software in collaboration with patients and in a way that doesn t reduce the quality of the interaction What s next Given that GP software providers are now working with Macmillan to continue developing the CDS software and make it more widely available to GPs what needs to be done to address these concerns And how do we make sure that their introduction will benefit GPs and patients Here are some of our thoughts Training will be vital During the trial run Macmillan worked with local cancer networks to try to offer all participating GPs comprehensive training on how to use the software and interpret its results Despite this 17 of GPs who fed back after using the symptom checker said they had not had any training on how to use the CDS programmes CDS software isn t the only show in town One of their key benefits appears to be that they can make GPs think cancer when they might not otherwise and increase their awareness of cancer related symptoms symptom combinations and cancer risk factors But this can be achieved through other means too and work to enable GPs to examine and improve all aspects of both their own work and that of their practice must continue such as audits and sharing GP practice cancer profiles It is a combined approach alongside the GP s clinical judgement and expertise that s likely to produce most benefit for patients and doctors alike Further evaluation is a must For example the data we collected showed that the two different algorithms RAT and QCancer gave quite different risk scores for around a third 34 of patients GP practices will still be receiving one of at least two versions of the software meaning

    Original URL path: http://scienceblog.cancerresearchuk.org/2014/11/21/could-computers-help-gps-diagnose-cancer-early/ (2016-02-11)
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  • The Mail and Telegraph’s coverage of new cancer survival figures was misleading - Cancer Research UK - Science blog
    But the story remains less positive for some types of cancer lung pancreatic oesophageal cancer and brain tumours still have low survival partly because they tend to be diagnosed at a later stage when they re much harder to treat What the figures definitely did not show was signs that cancer survival is decreasing We were therefore worried to see alarmist headlines appearing in two major media outlets that proclaimed survival for some cancers was starting to fall A closer look After doing some digging it appears that some ambiguous wording from ONS is partly responsible for the papers getting the message so wrong Included in the ONS publication is a comparison of survival for patients diagnosed in the latest 5 year period 2008 2012 and one year earlier 2007 2011 Clearly there s a lot of overlap in the years that are being looked at It s also a very short period of time for any big changes in survival to happen as that requires improvements in the stage at which patients are being diagnosed with cancer and how effectively it s being treated It s therefore unsurprising that the changes seen are relatively small generally around 1 3 When it comes to statistics small changes need to be treated with caution it s possible that they could represent random variation in the figures between years rather than a genuine increase or decrease In the case of the decreases reported in the media as well as some of the increases they fail to pass the tests used to show that these changes are not just down to random variation Put simply we can t trust that these changes are real or in the language of statisticians they were not statistically significant Is this significant In their publication ONS don t mention whether the changes they re reporting are statistically significant or not ONS have simply described the changes in the survival figures which increased for the majority of the 24 cancer types that they looked at apart from the six exceptions that were picked up by the media This omission means that the survival figures have been misinterpreted We passed on our concerns to ONS but disappointingly they do not intend to add this clarity to their description of the data These were alarming headlines in the media which are based on very small changes that could have been avoided with a bit more clarity and broader fact checking This is important to us for a number of reasons If we are using statistics to examine data and using this to make decisions about what we think should be the focus of political action then these figures should be accurate and need to be interpreted correctly Patients could be alarmed about what this means for the care they are receiving We want to discourage fatalistic attitudes so patients visit their GP when they have symptoms and avoid a situation where they may believe their chances of surviving their cancer

    Original URL path: http://scienceblog.cancerresearchuk.org/2014/11/04/the-mail-and-telegraphs-coverage-of-new-cancer-survival-figures-was-misleading/ (2016-02-11)
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  • It may seem unlikely, but could a statistician save your life? - Cancer Research UK - Science blog
    information in databases like ENCORE is that it will increasingly enable us to make more comparisons between different parts of the country hospitals and even individual surgeons For example the NHS recently published information on consultant led surgical teams for a range of diseases across England including death rates Those surgeons who refused to do so were named and shamed The information can be found on the NHS Choices website But this comes with a huge caveat It s not easy to make these kinds of comparisons in health care It s not enough just to compare outcomes for patients with the same disease Firstly as pointed out in a recent paper in the Lancet we need to have a large enough number of patients to know the results are a fair reflection of overall performance otherwise the statistics are meaningless To compare things accurately and meaningfully we also need to know that patients were diagnosed at the same stage and age had similar levels of general health and other factors that influence how likely they are to survive And we need to bear in mind that they may have attended several hospitals during their treatment Without these criteria the performance of hospitals or clinicians could be unfairly called into question For example a specialist surgeon who operates on more of the most difficult to treat patients may have worse results than someone operating on patients who are easier to treat But these obstacles are becoming less of a problem the more data we have to tackle them Does more mean better After the whizz bang of ENCORE Professor Henrik Moller from Kings College London presented some fascinating statistics looking at the differences between hospitals that treated the most oesophageal and gastric upper GI cancer patients compared to those that treat the fewest The paper is available online The differences in outcomes were largest in short term Patients who had surgery in hospitals performing the most operations were almost half as likely to die in the first 30 days after surgery than those treated in hospitals performing the least And even a year after surgery patients from the higher volume hospitals were still 18 per cent less likely to have died Although this analysis can t explain what is causing these differences it can show us the areas to investigate For example Is a hospital operating on large numbers of patients better set up to care for them before and or after surgery and are its surgeons more technically skilled Alternatively are hospitals with better outcomes simply more likely to have patients referred to them and therefore treat more patients rather than better outcomes simply being the result of treating larger numbers of patients And finally could it be that surgeons with better outcomes prefer to work in hospitals treating larger numbers of patients The answers to these questions may help determine how this work could benefit patients but without knowing there were differences we wouldn t be asking them

    Original URL path: http://scienceblog.cancerresearchuk.org/2013/07/09/it-may-seem-unlikely-but-could-a-statistician-save-your-life/ (2016-02-11)
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  • Tom Stansfeld | Cancer Research UK - Science blog
    Development Fellowship Grand Challenge award View all schemes and deadlines Applying for funding Start your application online Guide to filling in your application form How to make a successful application Funding committees Manage your research grant Manage your grant online Guide to managing a grant online Notify us of new publications Update your profile How we deliver research Our research strategy Our institutes Our centres Our research partnerships More Drug discovery and development Recently funded awards Researcher case studies ABOUT US What we do We beat cancer We fundraise We develop policy Our organisation Our strategy Our Trustees CEO and Executive Board Annual report and accounts Annual review Current jobs Graduates and interns Your development Benefits Cancer news Science blog Latest press releases Latest news reports Search all news More Contact Us Press office Publications HOME ABOUT CANCER SUPPORT US NEWS RESOURCES FUNDING RESEARCH ABOUT US You are here Home border 0 Support us Home About us Cancer news Science blog Author Tom Stansfeld Author Tom Stansfeld The risk factor new evidence on obesity and prostate cancer Category Science blog November 20 2014 Tom Stansfeld The World Cancer Research Fund has published some important new research on prostate cancer and obesity we explore the findings Read More Obesity and cancer adding more weight to the evidence Category Science blog August 13 2014 Tom Stansfeld Here we explore a new study looking at the link between obesity and the risk of 22 of the most common cancer types Read More 10 tips to keep the children healthy this summer holiday Category Science blog August 12 2014 Tom Stansfeld Summer is officially here so we ve put together a few suggestions for how you can keep children healthy this summer holiday Read More Older Posts Newer Posts Popular posts Most read today

    Original URL path: http://scienceblog.cancerresearchuk.org/author/tomstansfeld/ (2016-02-11)
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  • Is being inactive really ‘as bad as smoking’? - Cancer Research UK - Science blog
    womb cancers in the UK that adds up to more than 3 000 cases a year What does the new research say The latest research attempted to pull together the results of all the main studies on inactivity levels worldwide estimate how much disease this could potentially lead to and then calculate how many premature deaths could be avoided if this situation were remedied By its very nature this was going to result in an approximation much of the worldwide data is patchy relying on questionnaires rather than direct measurements Methods vary from study to study And data is missing for many countries especially in the developing world But when they pulled all the available data together the researchers calculated that inactivity causes about 9 per cent of all the premature deaths worldwide This they calculate is about 5 3 million of the 57 million deaths worldwide in 2008 And they propose that it includes ten in every hundred breast cancers and bowel cancers quite a lot higher than Professor Parkin s estimates Despite this the researchers said they thought this may even be an underestimate Survey data they point out tend to overestimate how active people are The study only included colon and breast cancers whereas womb cancer is also linked to inactivity And they based their global risk calculations on data predominantly from North America and Europe But Professor Parkin reckons that bias from such self reporting of inactivity levels isn t a big issue here After all he told us the risks of inactivity are calculated from studies that also rely on self report so the bias should cancel itself out In addition he thinks that the way that the researchers made their estimates almost certainly skews the figures in the opposite direction and that this outweighs all these other factors Gross exaggeration As is so often the case with such things the devil is in the detail In his 2011 study Professor Parkin calculates the fraction of cancer deaths due to inactivity in a sophisticated way He took the government s 30 minute recommendation as the ideal amount of exercise and broke the UK population down into different groups people who got a little bit less than this people who got a fair bit less than this people who got a lot less than this etc Then he calculated how many deaths could be avoided if all those below the minimum recommended activity level increased it to the government s recommendations but no higher This meant a small number of avoidable deaths for the least deficient group added to a larger number for the next group and so on This contrasts with what the WHO team did Using the results of several studies they calculated the risk of cancer in the least active group of subjects relative to the most active They then assumed that everyone who got less than the 5 30 minutes a day threshold could reduce their risk by this amount if they

    Original URL path: http://scienceblog.cancerresearchuk.org/2012/08/15/is-being-inactive-really-as-bad-as-smoking/ (2016-02-11)
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  • Healthy Resolutions 2012 – what’s new? - Cancer Research UK - Science blog
    We d like to see some more research to understand what s going on Losing weight can cut cancer risk Good news for everyone who resolved to lose weight this year A review published last summer found that people who intentionally lost weight seemed to reduce their risk of cancer We ve known for some time that being overweight or obese can increase the risk of certain cancers including some of the most common types but it has been less clear whether deliberately losing weight rather than avoiding putting weight on can reduce that risk But according to this study it can and even small bits of weight loss can help contribute to reducing the risk Another good reason to cut down on alcohol We already know that alcohol causes seven types of cancer This year saw more evidence that heavy drinking could also be linked to stomach cancer The European Prospective Investigation into Cancer EPIC found that men drinking more than four drinks a day had a higher stomach cancer risk 65 per cent greater than those who drank very small amounts Another study looked at the results of 59 separate studies into alcohol and stomach cancer They concluded that there was no evidence of a link with moderate drinking but that heavy drinking did increase the risk by about 20 per cent compared to non drinkers These studies aren t conclusive on their own more evidence would be needed to say for sure whether drinking lots of alcohol can cause stomach cancer to develop But they do give us an indication and another good reason to stick to New Year s Resolutions to cut down on drinking R UV Ugly In December Cancer Research UK teamed up with Sk n clinics on our R UV Ugly campaign to show young people the damage that sunbeds can do If you visit the R UV Ugly Facebook page you can claim two free skin assessments to see for yourself the damaging effects of sunbeds Using a sunbed for the first time under the age of 35 increases the risk of malignant melanoma the most serious type of skin cancer by 75 per cent R UV Ugly will also be going on tour so look out for it if you live in the North of England New era for lung cancer screening research Lung cancer is the second most common cancer in the UK affecting around 40 000 people every year And sadly less than 1 in 10 of those people will survive the disease for more than five years after their diagnosis Part of the reason for this is that lung cancer is often diagnosed late when options for treatment are more limited and less likely to be successful The results of the National Lung Screening Trial which were published in the New England Journal of Medicine in June have shaken up this area of research The trial did show a clear benefit there were 20 per cent fewer deaths from lung cancer amongst the people receiving screening from a new technique called spiral CT scanning compared to chest x rays But the downside is that following up a positive screening result can come with a whole raft of new problems and complications for patients So screening could end up doing more harm than good as Hazel discussed in this blog post So it seems to be a case of solving the problem of whether lung screening has the potential to save lives only to encounter a whole new set of problems to find out if it can ever work in practice We ll keep you posted on the next wave of research Hello to HPV testing and Gardasil HPV testing which spots the DNA of the virus that causes cervical cancer started to become part of the national cervical screening programme from April 2011 HPV tests will automatically be carried out on borderline smear results which should reduce the number of women having unnecessary investigations and the worry that goes along with these extra tests And in November the government announced that the contract for the next round of HPV vaccination would go to Gardasil replacing the current vaccine of choice Cervarix Gardasil is more effective than Cervarix against the HPV strains that cause genital warts and is still highly effective against those related to cervical cancer Gardasil will take over from Cervarix from September 2012 Healthy Living 2012 Encouragingly most of the research into reducing cancer risk last year helped us understand more about the advice we already encourage people to follow and confirmed the benefits of living a healthy life The best ways to cut the risk are to not smoke eat healthily keep a healthy weight limit alcohol be safe in the sun and keep active And though healthy living isn t a guarantee it can help stack the odds in your favour So what are the best ways to achieve this If your resolve is flagging as we head towards February or you simply need some new ideas our Healthy Living pages here to help Research has shown that smokers are four times more likely to quit with professional support Find out more about the NHS and Quit helplines plus other useful tips to help you make the break with smoking Eating a healthy diet and keeping a healthy weight are resolutions that support one another especially if you throw in some activity That s one of the reasons we got together with Weight Concern to formulate our Ten Top Tips they re designed to fit into your life and are based on the best scientific evidence Cutting down on alcohol has a variety of benefits for your health But what level should you aim to get down to The government suggests no more than three to four units about two pints of standard beer or two regular glasses of wine a day for men and two to three units one standard pint or a

    Original URL path: http://scienceblog.cancerresearchuk.org/2012/01/23/healthy-resolutions-2012-whats-new/ (2016-02-11)
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  • Joining forces against womb cancer - Cancer Research UK - Science blog
    tumour the cancer s chief stronghold Meanwhile chemotherapy travels around the bloodstream to try and kill off any dividing cancer cells that may have broken rank and started growing elsewhere For several types of cancer this combo of chemotherapy and radiotherapy together has been proven to reduce the likelihood of any remaining cancer cells being able to regroup and start growing elsewhere in the body as a secondary tumour There s a lot of research looking to establish the best treatment for cancers that start in the womb endometrium And in particular who should have what Researchers in the USA and Europe have looked at using both chemotherapy and radiotherapy after surgery for women at a high risk of the cancer coming back This combined treatment has been useful in other gynaecological cancers But there s not yet enough proof to say whether it should become routine So a group of London based researchers with help from Cancer Research UK funding are now running a clinical trial to find out if having radiotherapy and chemotherapy after surgery could further improve the outlook for womb cancer patients Watch this short video featuring trial co ordinator Dr Melanie Powell to find out more about the PORTEC 3 trial and how it could bring benefits to women with womb cancer Treating womb cancer As with many other types of cancer the outcome of womb cancer depends on how advanced it is when it is diagnosed In other words the stage of the cancer The outlook for the majority of women diagnosed with womb cancer is good Most cases are picked up at an early stage increasing the chances of successful treatment and about 8 out of every 10 80 per cent of women live for at least five years Many of these women will have been cured of their cancer But if the disease is diagnosed at a later stage after it s begun to spread it can be harder to treat successfully Around 1 in 10 of women who get womb cancer have high grade tumours which can be harder to treat and are more likely to come back after treatment The first and most important stage of treatment for womb cancer and indeed for almost all types of cancer is often surgery This gets rid of most of the tumour but if there s a chance the cancer could come back if it s been diagnosed at a late stage or is a high grade then a further course of radiotherapy to the pelvis can help In either case it s unlikely that any treatment will kill every single cancer cell in the body The body s own immune system usually deals with any stragglers but a few can sometimes slip through the net and start growing again after treatment has finished This is why cancer can sometimes come back in another part of the body The PORTEC 3 Trial To find out whether adding chemotherapy to the mix could reduce

    Original URL path: http://scienceblog.cancerresearchuk.org/2010/10/18/joining-forces-against-womb-cancer/ (2016-02-11)
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  • Introducing our Women of Influence Initiative - Cancer Research UK - Science blog
    us Cancer news Science blog Introducing our Women of Influence Initiative Introducing our Women of Influence Initiative Category Science blog January 27 2014 Emma Rigby Our pioneering Women of Influence Initiative brings together a unique network of top business women to mentor the charity s most promising young female scientists and clinicians as they move up the career ladder into senior positions The network is also fundraising to support the scientists life saving cancer research Tamara Box the Chairwoman of the Women of Influence board tells us what the scheme plans to achieve and why she was so keen to be involved Tamara Box Chairwoman of our Women of Influence board When Cancer Research UK asked me to lead an initiative to champion the efforts of their female scientists I was more than honoured These women are hardworking exceptionally intelligent and most important passionate about finding cures for cancer Like commercial business endeavours research requires funding but the arduous and time consuming process of securing grants and sponsorship and running teams of people is one for which academic studies may not have fully prepared the scientists That s where the Women of Influence comes in The women on the Women of Influence board have many years of experience in both the private and public sectors We ve all experienced our challenges in organisations where women were under represented and sometimes even disregarded and each of us now has a particular interest in tipping the scales closer to equality in our own professions By supporting the female Fellows funded by Cancer Research UK we re not only supporting their important work in making real progress in understanding and ultimately curing cancer but also holding them up as role models to encourage a new generation of girls to choose careers in the sciences Inspiring a new generation The Women of Influence board will explore all avenues in our efforts to raise further funds to support the work of our female Fellows Our target is 1 million and we have two years to meet it though we d love to beat that both in time and money Moreover while Women of Influence work towards the goal of gender balance in our respective professions we need to encourage younger women to consider the richly rewarding work that awaits them in the Science Technology Engineering and Mathematics STEM sector And you can find no better role models than the amazing women at Cancer Research UK We hope to showcase these talented women regularly through our fundraising efforts Mentoring and professional support The Women of Influence will also mentor Fellows as they navigate their own career paths encouraging and supporting them into ever more senior roles in cancer research We hope that the skills we use every day in the business world will complement their scientific expertise to help them continue their important work and increase their contributions to science I believe cancer will eventually be eradicated but I d like to see that day be

    Original URL path: http://scienceblog.cancerresearchuk.org/2014/01/27/introducing-our-women-of-influence-initiative/ (2016-02-11)
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