Releases Saturday 15 June 2002
No 7351 Volume 324

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(1)  STRESS NOT LINKED TO BREAST CANCER
RELAPSE

(2)  PREGNANCY PREVENTION PROGRAMMES ARE
INEFFECTIVE

(3)  TEACHER-LED SEX EDUCATION OF LIMITED
BENEFIT

 

(1)  STRESS NOT LINKED TO BREAST CANCER
RELAPSE

(Stressful life experiences and risk of relapse of breast
cancer: observational cohort study)
http://bmj.com/cgi/content/full/324/7351/1420

Women with breast cancer need not fear that stressful
experiences in life will bring about the return of their
disease, conclude researchers in this week's BMJ.

The study involved 222 women, aged under 60, who had
been diagnosed with a primary operable breast tumour
between May 1991 and July 1994. The team collected
data on stressful life experiences and depression from 12
months before diagnosis to five years afterwards.
Biological factors known to influence prognosis of breast
cancer were also taken into account.

They found no evidence that women who have a severely
stressful life experience in the year before being diagnosed
with breast cancer, or in the five years afterwards, are at
any increased risk of developing a recurrence of their
disease. In fact, women who had one or more severely
stressful life experiences after diagnosis had a lower risk of
recurrence than those who did not.

These findings contradict an earlier study that showed
severely stressful life experiences increase the risk of
recurrence of breast cancer, say the authors. However,
different study methods may explain the contradictory
results.

"We took the prospective study as the more robust, and
the results suggest that women with breast cancer need not
fear that stressful experiences will precipitate the return of
their disease," they conclude.

Contacts:

Jill Graham, Health Psychologist, or Amanda Ramirez,
Professor of Liaison Psychiatry, Cancer Research UK
London Psychological Group, Guy's, King's and St
Thomas's School of Medicine, St Thomas's Hospital,
London, UK
Email:  jill.graham{at}kcl.ac.uk
 

(2)  PREGNANCY PREVENTION PROGRAMMES ARE
INEFFECTIVE

(Interventions to reduce unintended pregnancies among
adolescents: systematic review of randomised controlled
trials)
http://bmj.com/cgi/content/full/324/7351/1426

Pregnancy prevention programmes for adolescents do not
delay sexual intercourse, improve use of birth control
among young men and women, or reduce the number of
pregnancies in young women, finds a study in this week's
BMJ.

Researchers in Canada reviewed 26 trials of adolescents
(aged 11 to 18 years) that evaluated pregnancy prevention
programmes including sex education classes, abstinence
programmes, family planning clinics, and community based
programmes.

The prevention strategies evaluated did not delay the
initiation of sexual intercourse or improve use of birth
control among adolescents. They also did not reduce
pregnancy rates in young women.

A separate analysis of five trials - four abstinence
programmes and one school based sex education
programme - were associated with an increase in number
of pregnancies among partners of young male participants.

This review shows that we do not yet have a clear solution
to the problem of high pregnancy rates among adolescents
in countries such as the United States, the United
Kingdom, and Canada, say the authors.

They conclude that design of future pregnancy prevention
programmes for young people should be guided by further
research that examines: · social determinants of unintended
pregnancy among young people · characteristics of
countries with low pregnancy rates in young people ·
characteristics of effective programmes to prevent high risk
behaviours in young people · suggestions from young
people · strategies to promote healthy sexual relationships
in adulthood

Contact:

Alba DiCenso, Professor, School of Nursing, McMaster
University, Hamilton, Ontario, Canada
Email:  dicensoa{at}mcmaster.ca
 

(3)  TEACHER-LED SEX EDUCATION OF LIMITED
BENEFIT

(Limits of teacher delivered sex education: interim
behavioural outcomes from randomised trial)
http://bmj.com/cgi/content/full/324/7351/1430

Improvements in teacher-delivered sex education have
some beneficial effect on the quality of young people's
sexual relationships, but do not reduce sexual risk taking in
adolescents, finds a study in this week's BMJ.

Researchers evaluated a specially designed sex education
programme (SHARE), delivered by teachers to 13-15
year olds in Scotland between 1993 and 1996. The
programme aims to reduce unsafe sexual behaviours,
reduce unwanted pregnancies, and improve the quality of
sexual relationships. Twenty-five secondary schools and
5,854 pupils took part in the evaluation at follow-up.

In comparison with conventional sex education, the
SHARE programme was evaluated more positively by
pupils and their knowledge of sexual health improved. It
had a limited positive effect on the quality of relationships,
but had no effect on condom or other contraceptive use. It
neither encouraged nor discouraged sexual activity.

Although there are various ways of interpreting these
results, the lack of effect on behaviour was not attributable
to the inadequate delivery of the programme in certain
schools, stress the authors. Rather, the evidence suggests
that the programme was unable to override broader social
influences and the effect of conventional sex education,
particularly when it was delivered to a whole year group.

At follow-up, only one third reported they had had sexual
intercourse. To clarify the impact of the programme once
most have started sexual relationships, the authors are
following up these young people to the age of 20.

In the meantime, they suggest that the SHARE programme
is preferable to conventional sex education and that
modifications to the delivery of SHARE should be
explored. However, we cannot rely on sex education alone
to improve young people's sexual health, they conclude.

Contacts:

Daniel Wight, Senior Researcher, Medical Research
Council Social and Public Health Sciences Unit, Glasgow,
Scotland
Email:  danny{at}msoc.mrc.gla.ac.uk

or

Gillian Raab, Professor, Applied Statistics Group, School
of Mathematics and Statistics, Napier University,
Edinburgh, Scotland
or

Marion Henderson, Senior Researcher, Medical Research
Council Social and Public Health Sciences Unit, Glasgow,
Scotland
 

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