The politicising of cancer may be doubly wrong

The Times

The Times (Scotland) headlining English data to feed anxiety with NHS Scotland and, of course by proxy, implicate the SNP Government, is one thing, an all-too-familiar thing, but the headline has triggered something else.

The other data is from campaign group estimates and against a background of taget-busting performance in cancer waiting times. See:

https://talkingupscotlandtwo.com/2021/09/28/nhs-scotland-smashes-one-cancer-waiting-time-target-despite-increased-demand-and-treats-17-more-on-time-than-nhs-england/

It’s a sensitive matter but, one more time, I’ll raise it – is living with an undiagnosed cancer always a bad thing? Treatment can be extremely damaging to health and as we say in NHS Tayside last year reducing treatment does not always lead to worsening outcomes. See:

All of the data referred to in the Times is about treatment but there is nothing to evidence any consequent increase in deaths due to lack of treatment.

On December 6th 2020, from Pete Whitehouse, Director of Statistical Services at the National Records of Scotland on 2nd December: 

Excess deaths from all causes began to increase in October, but this is almost entirely due to the corresponding rise in COVID-19 deaths. Deaths from causes such as respiratory diseases and cancer are below average levels for this time of year.

https://www.nrscotland.gov.uk/news/2020/deaths-involving-covid-19-week-48-23th-29th-november

Over the whole of 2020, cancer deaths seem to have reduced.

According to the NRS, there were 16 275 deaths due to ‘Malignant Neoplasms (C00-C97)’ but there had been 16 478 in the previous year, 2019.

I can’t see any sign of other types of cancer in the NRS data.

https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/weekly-and-monthly-data-on-births-and-deaths/monthly-data-on-births-and-deaths-registered-in-scotland

While some of these deaths may not yet have happened yet, surely enough will have, to push the figures up?

When I first became aware of this apparent anomaly of fewer cancer deaths this year, I wrote to several professors of oncology and epidemiology – no answers. I wrote to several politicians responsible or opposition spokespersons for health – vague non-answers.

Update:

My wife, not an epidemiologist but a TV detective, has suggested: ‘What if Covid killed many before they could die of the cancer they had?’

Could there be enough of them to stem the tide, so to speak?

That was December 2020. Has the tsunami of cancer deaths arrived yet, well-over a year since treatment was reduced?

https://www.nrscotland.gov.uk/statistics-and-data/statistics/statistics-by-theme/vital-events/general-publications/weekly-and-monthly-data-on-births-and-deaths/monthly-data-on-births-and-deaths-registered-in-scotland

The NRS data has only malignant neoplasms, circulatory, respiratory and other causes of death so I take the first is the same as cancer deaths.

So, between 2019 and 2020, no tsunami, no significant change at all and between 2019 and 2021 so far, a reduction in cancer deaths in 4 out of 5 months.

Is much cancer treatment just ritualistic. Remember when NHS Tayside reduced chemo doses for breast cancer and the death rate was no different?

After Reporting Scotland called them ‘dysfunctional’ forcing an unnecessary inquiry did NHS Tayside’s chemotherapy dosage variations actually do good?

The Times

4 thoughts on “The politicising of cancer may be doubly wrong

  1. I assume the Times article is based on the same UK data that was quoted in the Scotsman this morning, i.e. from Breast Cancer Now – https://breastcancernow.org/about-us/media/press-releases/50-rise-in-number-women-in-uk-who-have-not-had-vital-breast-screening-services-restarted

    They say “around 1,480,000 fewer women in the UK had breast screening between March 2020 and May 2021, compared to pre-pandemic levels”, and go on to show the breakdown by nation – “1,283,886 in England; 92,660 in Scotland”. They also give the numbers for Wales and NI, but I’ve only looked at England and Scotland.

    Doing the usual calculation, based on the latest England/Scotland population ratio of 10.35 (mid-2020), we find that England had 33.9% more than their share should have been on a population basis.

    Liked by 1 person

    1. Addendum: Breast Cancer Now also published the data before screening services resumed – https://breastcancernow.org/about-us/media/press-releases/almost-one-million-women-in-uk-miss-vital-breast-screening-due-covid-19

      Again they provide a breakdown by nation, and the England/Scotland excess at that point was only 4.3%. From the more recent data I’ve given above, that means the England/Scotland excess has grown from 4.3% at the point screening was resumed to 33.9% now.

      That seems to suggest the resumption of screening has been much less successful in England.

      Liked by 1 person

  2. How do they know people are living with undiagnosed cancer. If people are undiagnosed how do they know they have got it. Cancer death rates are going down. Or people died before they got it in the past. Heart attacks and strokes are going up.

    Lifestyle changes can affect heath outcome. Gov could put on a sugar, salt tax for process food. People overconsumption of alcohol/drugs. Increase alcohol tax and restrict availability. Increased rehab facilities. Finland once had a poor health record. Gov changes were made. Now they have one of the best. Countries with less drink/drugs and healthy diet have better health records. Japan 85, Spain 84. Fish and vegetables. Mediterranean diet. Exercise. Pubs are closing down. Gyms are opening. Genetics play a part. The health of women when they conceive.

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  3. “Is much cancer treatment just ritualistic. Tayside reduced chemo doses for breast cancer and the death rate was no different?”
    No. Tayside reduced chemo doses for some women with triple negative BC rather than the standard “hit them with the biggest dose their body can take without killing them” because they had evidence to suggest that such damaging (cardio-toxicity, nerve damage, etc) doses were greater than required to save these women’s lives. You only get one shot of treatments (chemo, rads, surgery) for a roughly 75% chance of still being around 2 years later with locally advanced TNBC and the earlier you get scans, biopsies, pathology and into treatment the better. Of course there are lots of more leisurely cancers but until you get lab results you wont know what you’ve got. Oncologists dont prescribe treatments except for good clinical reasons.

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