Volunteers are sought for a major epidemiological study on the causes, preventions and possible cures of breast cancer
A 50-year study of breast cancer has been launched to find ways to prevent one of the major killers of women. Researchers aim to recruit 100,000 British women aged from 18 to 79, who will be studied over the course of their lives for factors affecting their risk of disease. It is the biggest study ever launched with a specific focus on breast cancer. It is backed by the charity Breakthrough Breast Cancer.
About 40, 000 women a year develop breast cancer in the UK and 13,000 die. Although the death rate has fallen in recent years thanks to improved treatments, the incidence of the disease is increasing. It is likely that at least 30% of cases of breast cancer – 10,000 to 15,000 a year – could be prevented by giving advice to women on how to reduce their risk if the causes of the disease were better understood. The Institute of Cancer Research, one of the leaders of the study, reckons now that an epidemiological project with up to a 50-year follow-up may be necessary to clinch uncertain evidence emerging from experimentation on animals and from epidemiological studies on people with inadequate statistical power; that is to achieve a focus unblurred by genetic diversity (susceptibility of various species to spongiform encephalopathies offers current examples of this).
Comparisons in migrant populations have provided classic examples of epidemiology in the human condition. A wide difference in risk between Japanese women living in Japan, who have low rates of breast cancer, and Japanese women who emigrate to the USA, with risks increased 2 or 3 times, suggests environmental and lifestyle causes, probably related to changes in diet consequent upon the move. Other studies have followed movements of Polish and Greek populations to Australia, and parallels can be found among animal populations separated by quite short distances.
The EPIC (European Prospective Investigation of Cancer) involving nearly ½ million human subjects is yielding results on a general survey of cancer and some other disorders. The Biobank genetic survey will be another major study involving interpretations of the human genome; similar studies in other countries (e.g. Iceland, which has greater genetic homogeneity) are starting.
The size of these campaigns is enormous and costly. Breakthrough Breast Cancer aims to raise £12 million to pay for the first 10 years of the study, including the cost of buying 7.2 million tubes to store the blood samples collected. The ICR will raise a further £5m.
Any woman in Britain can take part in the study, known as the Breakthrough Generations Study, and the researchers are especially looking for related women, including adult sisters, daughters and mothers to study interactions between genetic and environmental factors. Sets of twins would be especially interesting. Blood samples will be taken at intervals of 5 years and the women will be asked to fill in questionnaires about their lifestyle to provide the most detailed information yet on the potential causes of the disease and means of prevention and cure.
VEGA and its predecessors have had a long interest in raising volunteers for epidemiological studies, particularly as they reduce the need for experiments on animals. We try to ensure that protocols, procedures and information to volunteers and their own health advisers is satisfactory, that appropriate confidentiality is observed, and that the information and materials are used and administered for the common as well as the individual good. Veggies make an interesting group with different diets and lifestyles from the majority in the UK and are able to offer to put their habits to the test.
Men suffer from breast cancer too. It’s rare, and Breakthrough Cancer is not intending to study it at the moment.
The Living Shall Learn From the Dead
Or something like that – in Latin of course – is the motto on the door of the hospital mortuary, where the fridges may have been enlarged to accommodate the growth, literally, of our population, but the pathologists (in the pursuits of autopsy and postmortems the NHS is coy to name) decline. From such services doctors’ training and errors in diagnosis can be assessed, and incipient and unsuspected diseases can be detected. Autopsy should not be a dying skill, even when a post-mortem is not legally required. The shock of the furred arteries found in young victims of accident and war instigated campaigns in the effects of lifestyle, including diet, on cardiovascular disease.
Dying for the cause and costly postmortems extend the limits of charity and popularity, but it can be a painless way of augmenting medical knowledge and therapy without recourse to experiments on animals. Perhaps insurers underwriting private health policies should guarantee their clients this last option for surgical treatment and assessment.
Autopsy is a skill much used in veterinary medicine and improved with new technology. Belated postmortems on ancient remains increasingly engage archaeologists too.