Releases Saturday 16 September 2000
No 7262 Volume 321
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
journal's web site (http://bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) SCREENING LEADS TO SUBSTANTIAL REDUCTION
IN BREAST CANCER DEATHS
(2) EUROPEANS
WILL ADJUST TO GLOBAL WARMING
BUT WILL STILL
DIE OF COLD
(3) WOMEN
WITH EPILEPSY ARE POORLY MANAGED
DURING PREGNANCY
(4) ONSET
OF FOREARM PAIN CAN BE PREDICTED
(1) SCREENING
LEADS TO SUBSTANTIAL REDUCTION
IN BREAST CANCER DEATHS
(Effect of NHS breast screening programme
on mortality
from breast cancer in England and
Wales, 1990-8:
comparison of observed with predicted
mortality)
http://bmj.com/cgi/content/full/321/7262/665
(Editorial : How effective is screening
for breast cancer ?)
http://bmj.com/cgi/content/full/321/7262/647
The introduction of an NHS breast screening
programme,
along with improvements in treatment for
breast cancer, led
to a 21% reduction in breast cancer deaths
in England and
Wales between 1990 and 1998, finds a study
in this week's
BMJ.
Using national data on breast cancer deaths
for 1971-89,
Blanks and colleagues were able to predict
the number of
deaths for 1990-8. The effect of screening
and other factors
on breast cancer deaths during this period
was then estimated
by comparing observed deaths with those
predicted among
women aged from 50-54 and from 75-79 years,
the effect of
screening being restricted to certain
age-groups.
They found that in 1998, estimated deaths
from breast cancer
were 21% below that predicted in the absence
of screening
or other effects in women aged 55-69.
Of this fall, 6-7% was
as a direct effect of screening, and equates
to 320 prevented
deaths. Other factors, such as improvements
in treatment and
presentation of cancers at an earlier
stage, also play major
roles in the substantial reduction in
deaths from breast cancer.
Despite several limitations in projecting
deaths into future
years, the authors are confident that
further effects from
screening, together with improved treatments,
should result in
yet further reductions in breast cancer
deaths, particularly for
women aged 55-69, over the next 10 years.
Contact:
Kate Husher or Erica Boardman at Press
Office, The
Institute of Cancer Research, 123 Old
Brompton Road,
London SW7 3RP
E-mail: press{at}icr.ac.uk
(2) EUROPEANS
WILL ADJUST TO GLOBAL WARMING
BUT WILL STILL DIE OF COLD
(Heat related mortality in warm and
cold regions of Europe:
observational study)
http://bmj.com/cgi/content/full/321/7262/670
(Editorial : Saving lives in extreme
weather in summer)
http://bmj.com/cgi/content/full/321/7262/650
Heat related deaths start at higher temperatures
in hot regions
of Europe compared to cold regions, suggesting
that people
have adjusted successfully to differences
in summer
temperatures across Europe, and can be
expected to adjust
to the global warming predicted in the
next 50 years,
according to a study in this week's BMJ.
A team of European researchers calculated
the average
number of deaths among men and women aged
65-74 years
at successive 3C temperature bands across
seven European
regions - north and south Finland, south
west Germany,
Netherlands, London, north Italy and Athens.
The authors
found for each region the 3C temperature
band in which there
was least mortality, and found that this
band was significantly
higher in hotter regions (14-17C in north
Finland and 23-26C
in Athens). As a result, when temperatures
rose above these
bands, regions with hot summers did not
have significantly
more heat related deaths than cold regions.
The team also found that cold related deaths
were much
more numerous than heat related deaths,
across all regions.
They were 78 times more numerous than
heat related deaths
in London, which had the highest rate
of cold related deaths
of any region.
These findings suggest that populations
in Europe have
adjusted to differences in average summer
temperatures
ranging from 13.5C to 24C. This gives
grounds for
confidence that they would also adjust
� with little increase in
heat related deaths � to the global warming
of around 2C
predicted to occur in the next 50 years,
say the authors.
However, the authors suggest that pre-emptive
measures
against heat stress, such as improving
ventilation in the homes
of vulnerable people, in advance of global
warming should be
considered.
Their most important conclusion is that
cold will continue to
cause massive mortality every winter,
particularly in Britain,
unless effective steps are taken to improve
protection against
cold stress.
Contact:
W R Keatinge, Professor of Physiology,
Queen Mary and
Westfield College, London, UK
Email: w.r.keatinge{at}qmw.ac.uk
(3) WOMEN WITH
EPILEPSY ARE POORLY MANAGED
DURING PREGNANCY
(Population based, prospective study
of the care of women
with epilepsy in pregnancy)
http://bmj.com/cgi/content/full/321/7262/674
Guidelines for the management of women
with epilepsy are
not being followed, according to a study
in this week's BMJ.
Researchers in Newcastle upon Tyne interviewed
300
pregnant women with epilepsy during 1997-8
about the care
they received, advice given prior to conception
and control of
their epilepsy. General practice and hospital
notes were
reviewed after the women had given birth
to check advice
given and assess pregnancy outcomes. The
authors found that
most women (61%) were managed by a general
practitioner.
Control of epilepsy was poor, with more
than 70% of women
reporting ongoing seizures, and compliance
with medication
was variable.
Only 38% of women recalled receiving advice
prior to
conception. However, review of the notes
of 25 women who
denied having received advice showed that
eight had been
counselled. Malformations were more common
in babies
born to mothers with epilepsy, although
not all malformations
were attributable to anti-epileptic drugs,
add the authors.
Most published guidelines are targeted
at neurologists, say
the authors, and therefore fail to improve
the management of
women under the care of their general
practitioner.
Considerable expansion of epilepsy services
in primary and
secondary care is needed if the guideline
recommendations
are to be achieved, they conclude.
Contact:
Susan Fairgrieve, Genetic Nurse Specialist,
Department of
Human Genetics, Royal Victoria Infirmary,
Newcastle upon
Tyne, UK
Email: JohnBurn{at}newcastle.ac.uk
(4) ONSET OF FOREARM PAIN CAN BE PREDICTED
(Role of mechanical and psychosocial
factors in the onset of
forearm pain: prospective population
based study)
http://bmj.com/cgi/content/full/321/7262/676
The concept that forearm pain is caused
purely by repetitive
movements of the arms or wrists, particularly
in the
workplace, is called into question in
this week's BMJ. A new
study suggests that several other factors
� such as high levels
of psychological distress and dissatisfaction
with support from
colleagues at work - predict the onset
of forearm pain.
Over a period of two years, researchers
at the University of
Manchester obtained questionnaires from
more than 1,200
individuals in Greater Manchester aged
18-65 years. The
questionnaire contained a picture of a
blank manikin and
respondents were asked to shade the site
of any pain
experienced during the previous month
and lasting at least
one day. A detailed occupational history
was obtained for all
participants and further information was
collected for those
who specifically reported forearm pain.
A total of 105 participants (8.3%) reported
forearm pain,
with little difference between men (8.9%)
and women
(7.9%). Among these, 67% also reported
shoulder pain,
65% back pain and 45% chronic widespread
pain. This is
consistent with the view that forearm
pain rarely occurs in
isolation from other regional pain syndromes,
say the authors.
In the workplace, repetitive movements
of the arms or wrists
and dissatisfaction with support from
supervisors and
colleagues were associated with the highest
risk of future
forearm pain. The authors also found that
high levels of
psychological distress, presence of other
physical symptoms
and general anxiety about health were
all important predictors
of forearm pain.
This study emphasises the multifactorial
nature of forearm
pain in the population, say the authors.
They suggest that
misleading terms such as "repetitive strain
injury" - implying a
single uniform cause - should be avoided.
Contact:
Professor Gary Macfarlane, Unit of Chronic
Disease
Epidemiology, University of Manchester,
Manchester, UK
Email: G.Macfarlane{at}man.ac.uk
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact: pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
