bmj.com -- Press Releases

Press Releases Saturday 31 October 1998
No 7167 Volume 317

Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on the
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the source BMJ article (URLs are given under titles).

(1) CURRENT MAMMOGRAPHY SCREENING PROGRAMMES ARE
DRIVEN BY POLITICAL INTEREST

(2) TB IS STILL RIFE FIFTY YEARS AFTER THE STUDY WHICH
FOUND A CURE

(1) CURRENT MAMMOGRAPHY SCREENING PROGRAMMES
ARE DRIVEN BY POLITICAL INTEREST

(Mammography and the politics of randomised controlled trials)
http://www.bmj.com/cgi/content/full/317/7167/1224

The debate over screening for breast cancer among women in their 40s
has assumed an importance out of proportion to its potential impact on
public health, argues Jane Wells from the Institute of Health Sciences
at the University of Oxford in this week�s BMJ. Randomised controlled
trials of the effectiveness of such screening have found that it significantly
reduces mortality in women over 50 years but that the benefit is smaller
and the associated harm is greater in younger women.

Wells argues that because breast cancer is an emotive issue, certain
professionals have used public fear to their advantage. For example,
some politicians in pursuit of votes may act in ways that reflect how
they believe the public wishes them to act, irrespective of the scientific
evidence.

The author concludes that "the mammography story illustrates some
of the many obstacles to putting research findings into clinical practice.
When trials do not give an unequivocal answer, when politicians and
interest groups become involved and when the professionals responsible
for promoting the public�s best interest fail to do so, objectivity is likely
to suffer."

Contact:

Dr Jane Wells, Specialist Registrar in Public Health Medicine,
Health Services Research Unit, Department f Public Health,
Institute of Health Sciences,
University of Oxford, Oxford
email: jwells{at}server.dphpc.ox.ac.uk

(Contact through Jill Shepherd at BMJ press office
Thursday 29 - Friday 30 October)

(2) TB IS STILL RIFE FIFTY YEARS AFTER THE STUDY
WHICH FOUND A CURE

(Tuberculosis: story of medical failure?)
http://www.bmj.com/cgi/content/full/317/7167/1260

In a week when the world of medicine is celebrating the 50th anniversary
of the first randomised controlled trial, Chris Holme, journalist at the
Herald newspaper in Glasgow, laments the irony that half a century on,
the disease that this trial found the means to eradicate, is still rife.

The MRC trial, which was published in the BMJ on 30 October 1948,
found Streptomycin to be an effective treatment of tuberculosis. In a
stinging attack in this week�s BMJ, the author writes that despite the
results of this trial there has been a failure to implement treatment
regimens, which has led to an international resurgence of the disease.

The author details the path of complacency that he believes has led to
the epidemic we are now witnessing in the 1990s and asks: "why after
an estimated one million controlled trials on every treatment under the
sun, have we failed to apply the results of the initial ones on tuberculosis
chemotherapy?"

Contact:

Chris Holme, Herald, Glasgow, Scotland

(Contact through Jill Shepherd at BMJ press office
Wednesday 28 - Friday 30 October)

Most of the remainder of this week�s BMJ is devoted to celebrating
the 50th anniversary of the first randomised controlled trial conducted
by the Medical Research Council into the effects of Streptomycin.

The papers included in this week�s issue are to be presented at a
two-day conference - Celebrating 50 years of Clinical Trials -
which takes place on 29 and 30 October at the Methodist Central
Hall, Westminster.

FOR ACCREDITED JOURNALISTS

Embargoed press releases and articles are available from:

Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact Jill Shepherd;pressoffice{at}bma.org.uk)

and from:

the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)