Chernobyl, ionising radiation exposure, and cancer risk
The first review in this month’s TLO reviews the epidemiological evidence linking cancer incidence as a result of the 1986 Chernobyl nuclear explosion in the Ukraine. Most studies have focused on malignant diseases in children, specifically thyroid cancer and leukaemia. Authors of the review argue that there is good evidence to suggest that rates of thyroid cancer in children from the countries that were formally part of the Soviet Union have risen as a consequence of the Chernobyl accident. The findings for childhood leukaemia, they comment, are less conclusive. Among adult populations, there is no strong evidence to suggest that risk of thyroid cancer, leukaemia, or other malignant disease has increased as a result of the Chernobyl accident.
Hormone-replacement therapy (HRT) and breast cancer
HRT has been available for many years, but the important question of its place in development and progression of breast cancer remains controversial. This review summarises current clinical data, which suggest that short-term HRT use does not increase breast-cancer risk, although a small increase in risk is associated with long-term (more than 10 years) HRT use. The review highlights the need for prospective controlled trials in healthy women as well as those at higher risk of breast cancer or with a personal history of the disease.
A case for geriatric oncology
The increase in cancer incidence with increasing age is becoming more obvious and more important as the average age of the population increases. This review assesses the biological and clinical interactions of cancer and ageing and discusses the skills and knowledge necessary for caring for older patients.
A culture of mistrust
This month’s Leading Edge editorial examines the issues surrounding diet and cancer, especially media reports that often contradict each other; foodstuffs that are often touted as cancer preventives one week are later reported as harmful. The editorial discusses how data should be presented, analysed, and interpreted, and concludes that there is currently a culture of mistrust in which most people disbelieve the health risks associated with dietary advice.
Other Reviews:
- Telomerase inhibition and the future management of head-and-neck cancer
- Insulin-like growth factors and cancer
- Scientists and clinicians test their metal-back to the future with platinum compounds
THE LANCET INFECTIOUS DISEASES (TLID)
Does hepatitis C virus cause severe liver disease only in people who drink alcohol?
The authors of a review in this month’s TLID propose that hepatitis C virus, which infects 170 million people worldwide, rarely causes liver cirrhosis and liver cancer in the absence of alcohol consumption. Considerable money and effort has gone into finding drugs to treat hepatitis C, when abstinence from alcohol may be the most effective way of preventing disease progression.
And the winner is...
This month’s leading edge editorial discusses the gap between the alleged benefits of new pharmaceuticals, often launched amid a fanfare of publicity boasting new therapeutic benefit, and the more objective judgement of independent commentators within the pharmaceutical media. The French drug bulletin la revue Prescrire, for example, critically reviews all new drug launches and operates an annual awards scheme for the best innovations in the therapeutics. Despite numerous high-profile drug launches, the coveted ‘golden pill’ was not awarded by Prescrire last year, and no drug has received top rating in the bulletin since 1996.
The editorial comments: ‘A substantial gap has clearly emerged between what the editors of Prescrire believe to be the quality of service patients should receive and the quality of service that the pharmaceutical industry can deliver. Anti-infectives seem to be as ill-served as any segment of the pharmaceutical market, and there is no reason to believe that the editors of Prescrire are alone in their opinions among independent commentators on therapeutics.’
Other Reviews:
- Epidemiology of chronic hepatitis C virus infection in sub-Saharan Africa
- Role of nitric oxide in HIV-1 infection: friend or foe?
- Update on Kaposi’s sarcoma and other HHV8 associated diseases. Part 1: epidemiology, environmental predispositions, clinical manifestations, and therapy
- Could a herpesvirus be the cause of Kawasaki disease?
Journal
The Lancet Oncology