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James Raftery: Ever higher cancer drug prices—driven by US policies and genetic sequencing

1 Jul, 15 | by BMJ

The high prices charged by companies for cancer drugs has led to lots of speculation, but very little explanation. The most interesting attempt to explain these high prices has been made by a US oncologist Scott Ramsey. As the article is paywalled, I summarise it below (with thanks to the author for a copy).
His identifies two major factors: US health policies and technology. more…

The BMJ Today: Cancer, climate, and dementia

23 Jun, 15 | by BMJ

cancer_radiotherapyCancer diagnosis
The National Institute for Health and Care Excellence (NICE) has released new guidelines to try to speed up the diagnosis of cancer. They recommend that all GPs should have direct access (without referral) to magnetic resonance imaging and computed tomography, upper gastrointestinal endoscopy, colonoscopy, and occult blood screening. At present, only some GPs have such access. more…

Richard Smith: Communicating with patients about ductal carcinoma in situ

7 Sep, 11 | by BMJ Group

Richard Smith Ductal carcinoma in situ (DCIS) is a condition we don’t understand. We don’t know its significance, how to describe it, and how to treat it. Worse, we may have created it. Its incidence in the US in 1975 was 1.87 per 100 000; now it’s 32.5. During that time there has been no drop in invasive cancers. The increase is because of mammography. How does a doctor communicate with a woman about such a confusing and uncertain condition? more…

Research highlights – 2 September 2011

2 Sep, 11 | by BMJ Group

Research questions“Research highlights” is a weekly round-up of research papers appearing in the print BMJ. We start off with this week’s research questions, before providing more detail on some individual research papers and accompanying articles.


Domhnall MacAuley: From the American College of Sports Medicine annual meeting (Denver)

3 Jun, 11 | by BMJ Group

Domhnall MacauleyThe next big thing in physical activity research: sitting doing nothing. Steve Blair (University of South Carolina), a major player in the physical activity research world, suggests that the pattern of inactivity is important. Sedentary behaviour, irrespective of the overall level of activity is itself a risk factor- sitting doing nothing may be harmful, even if you exercise. This evidence is from epidemiological studies where residual confounding is the greatest  potential limitation, but the findings could have major potential implications. You might immediately think of adolescents watching  television or video games, but it is relevant to all of us whose work  involves endless hours sitting in front of a computer. more…

Cheryl Rofer: Increased cancer risks from radiation for workers and children in Japan

2 Jun, 11 | by BMJ Group

Cheryl RoferI’ve finally gotten to where I’ve wanted to be in working through Biological Effects of Ionising Radiation (BEIR) VII: capable of evaluating radiation doses at Fukushima in terms of health risk. I would have liked to have been able to evaluate the radiation readings at various places around Japan in terms of health risk, but that is a few steps further still.

It’s too bad that it’s this difficult. For the environmental data, one must go from counts per second (becquerels), to energy absorbed (grays), to biologically effective energy absorbed (sieverts), to cancer risk via BEIR VII. That last step has been most of what I’ve done in this series. So it’s not surprising that this aspect, which is what most citizens are interested in, is dealt with poorly by the media, which present multiples of various radiation standards, not enough to understand health risks. more…

Cheryl Rofer on the BEIR VII report

13 Apr, 11 | by BMJ

Cheryl Rofer
I’ve been looking for numbers. What is the probability of a radiation dose of x millisieverts producing a cancer?

I should have found the BEIR VII report, BEIR standing for Biological Effects of Ionizing Radiation, some time ago. It’s been almost 20 years since BEIR V was a constant background presence at my job, the guide for understanding the radiation that my workers and I might be exposed to, one of the small number of studies used by governments to develop exposure standards. I happened on it quite accidentally, a week or so ago. more…

Mervyn Dean reflects on culture specific medicine

21 Feb, 11 | by BMJ


In the past 10 days or so I’ve settled into some sort of routine at KCMC, seeing patients on the wards in the morning, and in the afternoons either following up on administrative matters or trying to arrange teaching sessions, the latter with some small degree of success. more…

Georg Röggla at the 45th meeting of the EASD

6 Oct, 09 | by BMJ

Georg RögglaThe 45th annual meeting of the European Association for the Study of Diabetes (EASD) took place in Vienna, Austria, from September 30th to October 2nd  The town centre and all places of interest were flooded with the bright red congress-rucksacks. more…

Domhnall MacAuley on a dead certainty

10 Jul, 09 | by BMJ Group

Domhnall Macauley

So, who gets cancer? Have you a mental image? With heart disease, our classic picture is of an overweight hypertensive smoker, living between the pub and the chip shop. But, you rarely hear that someone “looks a likely candidate for cancer”. more…

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