Cross-sectional study of the provision of interventional oncology services in the UK

Objective: To map out the current provision of interventional oncology (IO) services in the UK. Design: Cross-sectional multicentre study. Setting: All National Health Service (NHS) trusts in England and Scottish, Welsh and Northern Ireland health boards. Participants: Interventional radiology (IR) departments in all NHS trusts/health boards in the UK. Results: A total of 179 NHS trusts/health boards were contacted. We received a 100% response rate. Only 19 (11%) institutions had an IO lead. 144 trusts (80%) provided IO services or had a formal pathway of referral in place for patients to a recipient trust. 21 trusts (12%) had plans to provide an IO service or formal referral pathway in the next 12 months only. 14 trusts (8%) did not have a pathway of referral and no plans to implement one. 70 trusts (39%) offered supportive and disease-modifying procedures. One trust had a formal referral pathway for supportive procedures. 73 trusts (41%) provided only supportive procedures (diagnostic or therapeutic). Of these, 43 (59%) had a referral pathway for disease-modifying IO procedures, either from a regional cancer network or through IR networks and 30 trusts (41%) did not have a referral pathway for disease-modifying procedures. Conclusion: The provision of IO services in the UK is promising; however, collaborative networks are necessary to ensure disease-modifying IO procedures are made accessible to all patients and to facilitate larger registry data for research with commissioning of new services

Incidence of advanced cutaneous malignant melanoma in the UK: a systematic review

Objectives: Cutaneous melanoma (CM) is one of the most aggressive forms of skin cancer. In 2008, CM was found to be the sixth most common cancer in the UK. The aim of this review was to systematically identify patients with advanced CM, limited to stage IIIc and stage IV disease. Methods: Literature searches were undertaken in the Cochrane Library, MEDLINE, CINAHL and EMBASE between December 2010 and March 2011. Webpages of the Office of National Statistics, Cancer Research UK and the Welsh Cancer Intelligence and Surveillance Unit were also scanned. A narrative synthesis was undertaken due to the heterogeneity of included studies. Results: Three observational studies were identified. One study was in East Anglia, England while the remaining two were in Scotland. Both studies in Scotland estimated that 2% of all melanoma patients had advanced CM at the time of diagnosis. It was also noted that, in East Anglia, the incidence of stage IV CM decreased from 0.42 to 0.13 per 100,000 population per year between 1991 and 2004. The review highlighted the challenges in identifying patients with advanced CM from available data. Conclusions: This review highlighted the lack of, and the need for primary studies to estimate the incidence of advanced CM in the UK. Defining this subgroup of patients is important for identifying patients for targeted treatment. We suggest that researchers must clearly define this population of patients in future studies

Reaction time and incident cancer: 25 years of follow-up of study members in the UK Health and Lifestyle Survey

<b>Objectives</b><p></p> To investigate the association of reaction time with cancer incidence.<p></p> <b>Methods</b><p></p> 6900 individuals aged 18 to 94 years who participated in the UK Health and Lifestyle Survey in 1984/1985 and were followed for a cancer registration for 25 years.<p></p> <b>Results</b><p></p> Disease surveillance gave rise to 1015 cancer events from all sites. In general, there was essentially no clear pattern of association for either simple or choice reaction time with cancer of all sites combined, nor specific malignancies. However, selected associations were found for lung cancer, colorectal cancer and skin cancer.<p></p> <b>Conclusions</b><p></p> In the present study, reaction time and its components were not generally related to cancer risk

Prostate cancer incidence in Golestan province, Iran (2004)

Prostate cancer is the most common cancer in men and therefore represents a major problem in public health.The aim of this study was to find and evaluate province-specific estimate of incidence in males by age groups for prostate cancer in Golestan province, Iran. The data used in this study were collected in a cancer registry program that was conducted by Health Deputy of Golestan province in IRAN for a period of 1 year (2004). Prostate cancer data was identified and collected in the population based cancer registries through the 18 Pathology Laboratories (where male populations referred to these centers) and using a structured questionnaire, trained personnel conducted in-person interviews to collect information on prostate cancer in Golestan province. Prostate cancer incidence among males in Golestan province was 5.17/100000 in gerenal. But the highest rate (ASR: 215.87/100,000) among males were showen to be in age 80-85. The incidence of prostate cancer in age 80-84 has risen sharply and it was the lowest in age 50-54 (ASR: 5.18/100,000). According to this information Golestan province harbor a rather incidence for prostate cancer (in age 80-84), comparable to the lower incidence rate reported in the world. For the present time it can be said that prostate cancer in males appear to be one of the most prevalent and serious type of cancer in Golestan province. © 2008 Science Publications

Towards the development of a resource allocation model for primary, continuing and community care in the health services - Volume 1

This report proposes a resource allocation model for the Irish health services based on the principle that each Irish resident should be provided with access to health services funded from general taxation and in proportion to their need for those services. At the moment, such a system cannot be deployed as some necessary financial information is not available. The information could be made available, and should be done as quickly as possible. If this information were made available, the model proposed here, while very crude, would serve as a good starting point for resource allocation and should be initiated as soon as possible. Any reasonable system of resource allocation would be an improvement on the system that is currently in place

The Daily Texan

Texas Student Medi

The relationship between quality of life (EORTC QLQ-C30) and survival in patients with gastro-oesopohageal cancer

It remains unclear whether any aspect of quality of life has a role in predicting survival in an unselected cohort of patients with gastro-oesophageal cancer. Therefore the aim of the present study was to examine the relationship between quality of life (EORTC QLQ-C30), clinico-pathological characteristics and survival in patients with gastro-oesophageal cancer. Patients presenting with gastric or oesophageal cancer, staged using the UICC tumour node metastasis (TNM) classification and who received either potentially curative surgery or palliative treatment between November 1997 and December 2002 (n=152) participated in a quality of life study, using the EORTC QLQ-C30 core questionnaire. On univariate analysis, age (P < 0.01), tumour length (P < 0.0001), TNM stage (P<0.0001), weight loss (P<0.0001), dysphagia score (P<0.001), performance status (P<0.1) and treatment (P<0.0001) were significantly associated with cancer-specific survival. EORTC QLQ-C30, physical functioning (P<0.0001), role functioning (P<0.001), cognitive functioning (P<0.01), social functioning (P<0.0001), global quality of life (P<0.0001), fatigue (P<0.0001), nausea/vomiting (P<0.01), pain (P<0.001), dyspnoea (P<0.0001), appetite loss (P<0.0001) and constipation (P<0.05) were also significantly associated with cancer-specific survival. On multivariate survival analysis, tumour stage (P<0.0001), treatment (P<0.001) and appetite loss (P<0.0001) were significant independent predictors of cancer-specific survival. The present study highlights the importance of quality of life (EORTC QLQ-C30) measures, in particular appetite loss, as a prognostic factor in these patients