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Chief Medical Officer’s Report 2006-11-07

Posted by clype in Health, Statistics.
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Lung cancer, one of the country’s biggest killers, could be virtually eradicated from Scotland in the next two decades, The Chief Medical Officer Harry Burns MD said yesterday 2006-11-06.

The Chief Medical Officer said the ban on smoking in public places, which was helping more people to quit, would dramatically reduce lung cancer cases to just a few hundred a year — rather than 4 500 currently.

[Picture of Harry Burns]
‘Imagining Scotland with no lung cancer is not trivial speculation,’ The Chief Medical Officer said, as he launched his annual report into the state of the nation’s health.

‘In the 1960s, one in 100 men died of lung cancer.

‘Today, rates are falling all the time and, thanks to the smoking ban, I expect the reduction in deaths to accelerate until dying from the disease becomes rare.’

  • But lung cancer experts described his comments as ‘rubbish’ and ‘over-optimistic’.

The report also said there were other signs of improving health, including increased life expectancy, breastfeeding and immunisation rates. But it warned that alcohol and obesity were now the main health concerns.

Scotland has the highest death rate in Europe from cirrhosis of the liver among men, and the number of people who are overweight or obese is on the rise.

The Chief Medical Officer said Scotland needed to keep the pressure on tackling tobacco use, not just to reduce lung cancer but also other illnesses such as heart disease, stroke and asthma.

‘The ban in public places is really, really important, but we need to continue to persuade people of the serious harm they are doing to their health by smoking, and we can get the smoking rate down even more.

‘The notion of Scotland as a high tobacco-using country is one that can be changed. If Scots choose to turn their backs on tobacco, then there is no reason why we can’t make lung cancer a relatively rare tumour again.’

The Chief Medical Officer said he expected this to happen within the ‘next couple of decades’. But his optimism was met with some scepticism. The Chairman of the UK Lung Cancer Coalition Mr.Mick Peake MD, said he felt The Chief Medical Officer was being ‘very over-optimistic’. He continued:

‘Firstly, not everyone will stop smoking, however much we would like them to. Secondly, around 15 per cent of lung cancers are not caused by smoking.’

The Chairman of the UK Lung Cancer Coalition said that seeing lung cancer cases fall by half would be a ‘fantastic’ result of the ban in public places. But he added:

‘To expect that lung cancer will be virtually eliminated is not what is going to happen.’

Chief Executive of The Roy Castle Lung Cancer Foundation Mr.Mike Unger, described The Chief Medical Officer’s comments as ‘rubbish’.

[Picture of Mike Unger]
‘If everyone stopped smoking today, we would still have lung cancer for 25 to 30 years,’ he said.

‘Even if the ban on smoking in public places does help more people quit, we are likely to get a best-case scenario where still around 17 per cent of people smoke.’

Chief Executive of The Roy Castle Lung Cancer Foundation pointed out that between 10 and 15 per cent of lung cancers were not linked to smoking.

‘These people are being stigmatised by the silly statements made by The Scottish Chief Medical Officer. These cases are not going to go away.’

Medical Oncologist at The Beatson Oncology Centre in Glasgow Mr.David Dunlop MD, said he expected to be treating people with lung cancer for many years to come.

‘None of us would want to issue some over-optimistic view to the health service, patients and families that the war is won. That would be the wrong message. This is a long game,’ he said.

Alcohol

In yesterday’s report, ‘Health in Scotland 2005’, The Chief Medical Officer warned that there was ‘little doubt’ that alcohol consumption was still rising in Scotland.

In 2004/5, more than 31 000 people were admitted to hospital with an alcohol-related diagnosis — accounting for 4 per cent of all admissions.

The number of people diagnosed with alcohol-related liver disease rose by 52 per cent between 1997/98 and 2004/5. Further, it is estimated that 29 per cent of men and 17 per cent of women are exceeding recommended safe drinking levels.

Teenage drinking is also a problem, with 46 per cent of 15-year-olds girls reporting drinking in the past week in 2004, compared with 25 per cent in 1990.

The Chief Medical Officer said there should be continued debate about the best way of tackling Scotland’s alcohol culture. But he stopped short of saying whether he supported raising taxes or the age limit for alcohol purchases.

The Chief Medical Officer also highlighted the predicted rise in illnesses caused by obesity by 2023. About 65 per cent of men and 60 per cent of women in Scotland are either overweight or obese. Childhood obesity is also rising.

The Chief Medical Officer said the food, transport and leisure industries needed to work together change eating and exercise habits.

‘If we continue as we are, the prevalence of obesity in the population will continue to increase. Ultimately, this will see the return of children dying before their parents,’ he said.

Health problems were worse among the most deprived communities, he added. The Scottish National Party’s Health Spokesman Ms.Shona Robison said:

[Picture of Shona Robison]
‘Health inequalities, alcohol and obesity are major public health concerns.

‘It is utterly unacceptable that, in the 21st century, many Scots are consigned to an early death due to the underlying problems of poverty.’

The Scottish Conservative Health Spokesman Ms.Nanette Milne, said:

[Picture of Nanette Milne]
‘Scotland now has the highest death toll in Europe from cirrhosis of the liver amongst men.

‘This backs up recent findings that show someone dies from alcohol abuse in Scotland every six hours.’

Treatment was ‘a horrendous experience’

Ms.Celia Danks said her family experienced ‘utter devastation’ when she was diagnosed with lung cancer in 2006-05.

The 58-year-old, from Blairingone, Fife, had suffered ill health for a few years before finally being told she had lung cancer.

‘When the tests came back as lung cancer, I was horrified.

‘The first thing I found after I was diagnosed was the lack of support for people with lung cancer.

‘I had to go out and find it myself, and it is provided by charities and not the NHS.’

Ms.Danks underwent eight rounds of chemotherapy and 12 round of radiotherapy. She said she found the treatment ‘quite barbaric’.

‘I had to have the radiotherapy on quite a significant part of my chest and found it very difficult to swallow.

‘It was quite a horrendous experience.

‘I have been told that there is no cure, but was also told I am in remission. But I don’t know how long that will last, whether it will be weeks or months.

‘It is like a fear you live with.’

Ms.Danks, who used to be a nurse and smoked for 30 years, said she was shocked that the UK came near the bottom of the international league table when it came to treating cancers.

She also said that The Chief Medical Officer’s comments that lung cancer could be virtually eradicated were ‘unrealistic’.

‘You have these smoking cessation classes and you go once a week and that’s it.

‘But smoking is like a drug, it’s like alcohol, and they should put more money into something which is going to have more of an impact.’

Ms.Danks, who is married with two grown-up sons, has received help from ‘Macmillan Cancer Support’ and ‘The Roy Castle Lung Cancer Foundation’.

‘They have been wonderful, but it was not easy to find that help and I could not have done it without a computer,’ she said.

  • Around 4 500 people are diagnosed with lung cancer in Scotland each year.
  • More than 4 000 people died from lung cancer in Scotland in 2005, making it Scotland’s biggest cancer killer.
  • Only 20 per cent of patients with lung cancer will be alive one year after diagnosis, falling to six per cent after five years.
  • Between 80 and 90 per cent of lung cancers are due to smoking.
  • In Scotland, 29 per cent of men and 22 per cent of women are smokers.
  • For every lung cancer death in the UK, just 117 GBP is spent on researching the disease. This compares to 3 700 GBP for breast cancer and 10 000 GBP for each leukaemia death.

SLOW BATTLE WITH DEADLY FOE

The link between smoking and lung cancer was first suggested by physicians in 1951. However, it was not until 1954 that Sir Richard Doll and colleagues confirmed the connection.

Only at this point did the government decide it was time to make a public statement on an issue which was to dominate the health arena for decades afterwards.

Then Health Minister Mr.Iain Macleod, gave a press conference in which he chain-smoked throughout and reported on the findings.

‘It must be regarded as established that there is a relationship between smoking and cancer of the lung,’ he conceded.

Before his death in 2005, Sir Richard described the government’s slow reaction to his research as ‘shameful’.

But campaigners say it is often forgotten that about 15 per cent of lung cancers occur in non-smokers.

Some of these may be due to passive smoking, but the cause of the remainder is still unclear.

Charities say lung cancer sufferers are often stigmatised because, regardless of their background, people assume they have brought their illness on themselves.

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