What the papers say! Exploring the myths of the media

1. What the papers say! Exploring the myths of the media Miss Tena Walters MB BS, FRCS, MS Consultant Breast Surgeon BMI and The London Breast Clinic 108 Harley St

2. Metro 1st September 2011Tariq Tahir

3. Breast Cancer Screening benefits overstated Gotzsche and Jorgensen • Women undergoing screening are misinformed about drawbacks • Its effectiveness is overstated • Survival rates are due to better treatment • Over-diagnosis leads to unnecessary mastectomy • Called for ‘honesty’ in the NHS

4. Disadvantages of Screening • Cost • False positives: 2 dimensional picture of 3 dimensional structure • Occult and low grade disease • Radiation exposure • Same as 4 days • 1/60 th CXR • 1/250 th CT Scan • 10 minutes on a transatlantic flight

5. Breast Cancer Benefits Overstated Response from Prof Julietta Patnick • 1 life saved for every 400 screened • 97% women with screen detected cancers alive after 5 years compared with 80% of all women diagnosed without screening • 1400 women saved per year by NHSBSP • Mortality in the screened population proven to be lower

6. NHS BSP • Mortality from breast cancer decreased by 30% since introduction of screening • Lowest mortality since 1950’s • Mortality decline similar in 50 – 60 year old group and 40 -49 year old • Since introduction of screening symptomatic service greatly streamlined • Increase in public awareness and decrease in stigma

7. European trends • Increase in mortality • Russia • Decrease in mortality • UK • Germany • Scandinavia • Poland • Czech Republic • Austria • Switzerland

9. Pain killer heart alertThe Daily Mail28th September 2011Tamara Cohen

10. Diclofenac • No need to panic! • 17 million prescriptions • Dr Patricia McGettigan Hull York Medical School • Study of 3 million people showed risk of 40% • Meta analysis of case control / cohort studies • Diclofenac summary relative risk of 1.4 • Naproxen 0.97 Ibuprofen 1.07

11. Comments -Painsupport ‘an even better health move would be to give up reading the Daily Mail altogether’ ‘Newspapers print to sell not to inform’ ‘if you listen to breaking news – we’ll be broken before them’ ‘dying of a heart attack more attractive than living in pain’

12. Calcium Supplements

13. Calcium Supplements and Heart Disease Daily Mail 30th July 2010 Calcium Supplements risk 30% higher risk of heart attacks Meta analysis of 11 trials - 2007 1000 people 14 more heart attacks 10 strokes and 26 fewer fractures Randomised study in USA in 38,000 patients showed reduction in cardiovascular events in 2008

14. The Independent 5TH October 2011Melanie Newman and Oliver Wright

15. Alternatives available cheaper • Cipramil costs £1.31 • Cipralex costs £14.91 • Cost to the NHS of £3.3 million Only one trial showed significant difference between the two drugs but trial was by a company called Arbacom which has not sponsored any research before or since

16. Anti hypertensive medicationCalifornia teachers study cohort • Increase in breast cancer risk 1.18 Er positive tumours rr 1.21 Premenopausal 1.56 No link in post menopausal women

17. What’s New? Herceptin and antibody combination Fewer side effects 14 month disease free interval compared with 9 month disease free interval The Holy Grail of cancer medicine