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Press releases Saturday 13 May 2006

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(1) FAMILY REFUSAL IS BIGGEST OBSTACLE TO IMPROVING UK ORGAN DONOR RATE

(2) SEARCH FOR CANCER GENES UNLIKELY TO SUCCEED, SAY EXPERTS

(3) OVER 80 MILLION AMERICANS RISKING EARLY DEATH THROUGH SMOKING OR OBESITY

(1) FAMILY REFUSAL IS BIGGEST OBSTACLE TO IMPROVING UK ORGAN DONOR RATE

(Potential for organ donation in the United Kingdom: audit of intensive care records)
http://bmj.com/cgi/content/full/332/7550/1124

The biggest obstacle to improving the organ donation rate in the United Kingdom is the number of relatives who refuse consent, say researchers in this week’s BMJ.

The United Kingdom has a serious shortage of organs for transplantation, as does almost every country. The donor rate in 2004 was 12.3 per million population, which is one of the lowest rates in Western Europe. Spain has an exceptional rate of 33 per million population, but most other European countries have rates between 13 and 22 per million population.

Researchers at UK Transplant carried out a two-year audit of all deaths in 341 intensive care units in 284 hospitals across the United Kingdom. This is the first comprehensive, UK-wide study to try to identify the number of patients dying in intensive care units who could donate their organs for transplantation.

Over the two year period, families of 94% of patients who could have been organ donors were approached for consent to donation.

A total of 41% of the families denied consent. The main reasons given included “relatives did not want surgery to the body,” “relatives not sure whether patient would have agreed to donation,” and “relatives divided over decision.”

The refusal rates for families of potential donors from ethnic minorities was 70%, twice that for white potential donors (35%), but the age and sex of the potential donor did not affect the refusal rate.

The maximum achievable potential donor rate during this study period was 23.2 per million population per year.

Intensive care units are extremely good in considering possible organ donation from suitable patients, say the authors. The biggest obstacle is the high proportion of relatives who deny consent.

However, when the Human Tissue Act comes into force in September 2006, the wishes and consent of the individual will be paramount. This may, in time, address this aspect and emphasises the benefits of increased registrations on the NHS organ donor register, they conclude.

Contact:

UK Transplant Press Office, Bristol, UK

(2) SEARCH FOR CANCER GENES UNLIKELY TO SUCCEED, SAY EXPERTS

(Common susceptibility genes for cancer: search for the end of the rainbow)
http://bmj.com/cgi/content/full/332/7550/1150

The hunt to find common genes that are associated with cancer is unlikely to be successful, say experts in this week’s BMJ.

Huge resources are being invested in the search for common inherited genetic variants that increase susceptibility to cancer. One US project, for example, will cost $14m. But devoting a large research effort to searching for common cancer susceptibility genes has several problems, write authors Stuart Baker and Jaakko Kaprio.

The first is that recent research suggests these genes are unlikely to exist or, if they do, are unlikely to have much of an effect on the incidence of cancer.

A second reason to play down the role of common susceptibility genes is studies suggesting that environmental, dietary, or lifestyle changes have a large effect on the incidence of cancer. These studies show changes in incidence within one or two generations, which is probably too quick to be related to the introduction of new genes.

A final reason to be sceptical comes from results from a study of cancers in twins. By analysing data from identical and non-identical twins, the authors showed that genetic susceptibility made only a small to moderate contribution to the incidence of cancer.

Studies that have shown links between common genes and cancer may be due to bias.

But, even if susceptibility genes were identified, showing clinical benefit would still be difficult, and further large trials would be needed, they add.

“The search for common cancer susceptibility genes faces important methodological and practical challenges for cancer prevention, given the small chance that such genetic variants exist and the difficulty and expense of proving substantial clinical benefit if they do exist,” they conclude. “Enthusiasm for this new field of research should not precipitate unwarranted expectations.”

Contact:

Stuart Baker, Biostatistician, Nation Cancer Institute, Bethesda, USA
Email: sb16i@nih.gov

(3) OVER 80 MILLION AMERICANS RISKING EARLY DEATH THROUGH SMOKING OR OBESITY

Online First
(Smoking, obesity, and their co-occurrence in the United States: cross sectional analysis )
http://bmj.bmjjournals.com/cgi/rapidpdf/10.1136/bmj.38840.608704.80

Over 80 million American adults are putting themselves at serious risk of long-term illness and early death through smoking, obesity, or both, finds a study published on bmj.com today.

Smoking and obesity are two of the leading causes of death and illness in the United States, but the overlap between the two conditions has never been measured.

Using data from the 2002 national health interview survey, researchers estimated the proportion of adults in the US who smoke and are obese. The results were stratified for various factors, such as income and education levels.

They found that 23.5% of adults were obese and 22.7% smoked (a total of 81 million).

About 4.7% (9 million) smoked and were obese. This proportion was particularly high in African Americans (7%) and in people with lower income and education levels.

Although this overlap is relatively low, the presence of these two conditions together may carry an increased risk to health, say the authors.

Treatments for people who smoke and who are obese need to be investigated, they add. Clinical trials should monitor the effects of programmes aimed at simultaneously stopping smoking and weight control. These results could be used to develop policies for prevention and treatment.

Contact:

Julia Cartwright, Press Room, American Legacy Foundation, Washington DC, USA

FOR ACCREDITED JOURNALISTS

Embargoed press releases and articles are available from:

Public Affairs DivisionBMA HouseTavistock SquareLondon WC1H 9JR
(contact: pressoffice@bma.org.uk)

and from:

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