Time for Cancer Research UK to Concentrate on Research

Cancer Research UK - Lincoln's Inn Fields 1
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Cancer Research UK is Supposed to do Research, Not Deliberate Scare-mongering

Cancer Research UK has produced another alarmist press release, this time in relation to oral cancer.

Apparently the number of cases of oral cancer amongst people in their 40s has risen 26% since the mid-1990s.

Here’s their take on that, from Hazel Nunn, their health information manager:

These latest figures are really alarming.

Around three-quarters of oral cancers are thought to be caused by smoking and drinking alcohol.

Tobacco is, by far, the main risk factor for oral cancer, so it’s important that we keep encouraging people to give up and think about new ways to stop people taking it up in the first place. But for people in their 40s, it seems that other factors are also contributing to this jump in oral cancer rates.

Alcohol consumption has doubled since the 1950s and the trend we are now seeing is likely to be linked to Britain’s continually rising drinking levels.

Let’s just have a look at that, shall we?

First, if tobacco was, by far, the main risk factor, then we would expect to have seen a fall in oral cancer, because smoking has been falling throughout that period (and for long before it as well). So that bit is demonstrably not true. Sorry, Hazel, tobacco is definitely not the main risk factor for oral cancer.

Second, what about “Britain’s continually rising drinking levels”? The truth is that drink consumption has been falling since about 2005. Of course, that doesn’t rule out drink as a cause for the rise in oral cancer. There may well be a time lag between changes in drink consumption and changes in the effects of drink consumption. But still, it is “really alarming” that Cancer Research UK’s health information manager seems to be blithely unaware of the fall in drinking over the last few years.

Third, why have they picked out “people in their 40s”? Let’s check. Cancer Research UK’s own website has information on oral cancer incidence. That information includes this interesting graph, of age-related oral cancer incidence over time:

Age Specific Oral Cancer Over Time

You can see that the rate declined sharply amongst people over 80 until around 1990, and has stayed roughly steady since. The rate stayed roughly constant amongst people over 70. All other age groups have shown a rise, with the biggest rise being in people in their 50s. People in their 50s have an oral cancer rate around three times as high as people in their 40s.

The BBC itself comments:

Other risk factors that may be involved include a diet low in fruit and vegetables, and the sexually transmitted human papillomavirus (HPV), which also causes cervical cancer.

Yes, folks, oral sex can give you cancer. Strangely they haven’t chosen to dwell on that.

That page on the Cancer Research UK website also has oral cancer rates by country. From that you can see that rates in Pakistan and Bangladesh are around three times as high as rates in Britain. So it may be that the rise in the size of immigrant populations from those countries could have had the statistical effect of increasing rates in Britain.

Other pertinent facts may be that most mouthwashes contain alcohol, that there has been a rise in cosmetic dentistry including tooth whitening procedures, that there has been a fall in the number of people having regular dental checkups (which can detect pre-cancerous conditions).

There has also been a rise in coffee consumption, especially black coffee consumption. (I suspect I am single-handedly responsible for at least half of this increase!) And there has been a rise in consumption of cannabis over the same period.

There have, of course, been a multitude of other changes that may account for the rise in oral cancer – a rise which has been going on, by the way, since at least 1980. Perhaps Cancer Research UK should do some research, and try to work out what the real causes are.

Who knows? Perhaps the drop in smoking has caused the rise in oral cancer. Now there’s a shocking (and indeed unlikely) thought – but one that is more consistent with the statistics than Cancer Research UK’s alarmism.

The good news is that oral cancer, though it is extremely nasty, is also pretty rare. There are only around 5,000 cases in total per year in the entire country.  What’s more, rates in Britain are less than half the EU average and around a fifth of the French rate, so it is probably not right to be too “alarmed” at this point.

The BBC article also, predictably, wheels out Don Shenker of Alcohol Concern who duly trots out his own alarmism:

While alcoholic liver disease remains the number one killer linked to alcohol, more and more people are suffering from oral cancers – and record drinking levels have undeniably played a part.

and called for tobacco-style health warnings on alcohol.

You have been warned. The Righteous have almost beaten smoking, and now they are coming after alcohol. Drinkers are the new smokers.

The proper use of statistics matters. Cancer Research UK do some great work, and that work is diminished when they play fast and loose with the facts. When they are associated with completely off the wall pressure groups like Alcohol Concern, it puts the public’s respect for them at risk.

What’s more, the more they come out with nonsense, the more people conclude that they should be ignored – which is a shame when they really do some very important work actually researching cancer. Their recent move into public campaigning for changes in behaviour, has nothing to do with cancer research, and they should lay off it.

>>> UPDATE: I accidentally based this blog post on last year’s scare story. This year’s is here. Here’s the quote from this year’s Cancer Research UK director of health information:

In the last 10 years, mouth cancer has become much more common and one reason for this could be because of higher levels of drinking – as this study reflects.

Along with being a non-smoker and keeping a healthy bodyweight, cutting back on alcohol is one of the most important ways of lowering your cancer risk.

Plus ca change.

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