Cross AJ, et al. Faecal immunochemical tests (FIT) versus colonoscopy for surveillance after screening and polypectomy: a diagnostic accuracy and cost effectiveness study.
Gut 2018; online first DOI: 10.1136/gutjnl-2018-317297 https://thescpn.org/2TGrzhX
A triennial colonoscopy is recommended by Public Health England for those at increased risk of developing colorectal cancer (CRC) following removal of polyps. This study aimed to see whether an annual FIT test would help identify those at lower risk of developing CRC, reducing the need for surveillance colonoscopy. Of over 8000 potential participants (completed a FIT test one year after polypectomy) 74% were included in the study. Of these, 97% completed a FIT test at years 2 and 3. Three-year cumulative positivity was 13% at the 40μg/g haemoglobin threshold and 29% at 10μg/g and sensitivities were 59% and 33% at 40μg/g and 72% and 57% at 10μg/g for CRC and advanced adenoma (AA) respectively.
Conclusion: Replacing a surveillance triennial colonoscopy with an annual FIT test in this population could reduce the number of colonoscopies performed by 71%, significantly cutting costs but could miss 30%–40% of CRCs and 40%–70% of AAs.
Springmann M, et al. Health-motivated taxes on red and processed meat: A modelling study on optimal tax levels and associated health impacts
PLOS ONE;13(11):e0204139 DOI: 10.1371/journal.pone.0204139 https://thescpn.org/2M2RhLb
There is strong evidence that the consumption of red and processed meats increases the risk of developing colorectal cancer. One public health response might be to tax these products in the same way as other carcinogens e.g. tobacco, sugary drinks, alcohol to persuade the population to consume less and improve health. This study calculated optimal tax levels for 149 world regions taking account of the local health costs associated with ill-health from red and processed meat consumption. The study found 75% of health-related costs ($285 billion globally in 2020) were due to processed meat consumption. Optimal taxation would increase the prices for processed meat by 25% on average (range 1% in low-income countries to over 100% in high-income countries) and by 4% on average for red meat (range 0.2% to over 20%). Consumption of processed meat decreased by 16% (range 1% to 25%) whilst red meat consumption remained stable. Deaths attributable to red and processed meat consumption decreased by 9% and attributable health costs decreased by 14% globally with greatest reductions in high and middle-income countries.
Conclusion: Including the social health cost of red and processed meat consumption in the price of red and processed meat could lead to significant health and environmental benefits, in particular in high and middle-income countries.
Lee A, et al. BOADICEA: a comprehensive breast cancer risk prediction model incorporating genetic and nongenetic risk factors
Genetics in Medicine (2019) DOI: 10.1038/s41436-018- 0406-9
Breast cancer remains highly prevalent however susceptibility to the disease is multifactorial depending on genetic mutations and reproductive, hormonal, anthropomorphic, lifestyle, and imaging factors. By incorporating the effects of all known risk factors into the model, the authors demonstrated much greater levels of breast cancer risk stratification can be achieved both in the general population and in women with a family history of breast cancer.
Conclusions: BOADICEA can be used in the counselling process to guide high risk women on possible behavioural or lifestyle modifications e.g. reduction in BMI, alcohol intake, or HRT use to reduce their risk of developing breast cancer.=