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Seeking medical abortions online is safe and effective, study finds

A study into women who seek abortion pills online in the face of strict laws against terminations has found that almost 95% safely ended their pregnancy without surgical intervention.

Experts say the study underscores the safety of medical abortion, and highlights that women who go on to experience symptoms of possible complications do follow advice to seek medical help at clinics or hospitals.

“This is abortion entirely outside the formal healthcare setting: it is an online telemedicine model, but this research shows that it can be both safe and highly effective,” said Abigail Aiken, assistant professor of public affairs at the University of Texas at Austin.

Worldwide about 43,000 women die each year as a result of not having access to safe and legal abortions.

Abortion in Ireland is currently legal only if a termination saves a woman’s life. In Northern Ireland abortion is also allowed if there is a permanent or serious risk to the woman’s mental or physical health.

However, the 1861 Offences Against the Person Act means that women can face life imprisonment for administering a drug to induce miscarriage, as the 1967 Abortion Act was not adopted in Northern Ireland.

Writing in the British Medical Journal, Aiken and an international team of researchers reveal how they probed the outcomes for women in Ireland and Northern Ireland who had sought the abortion drugs mifepristone and misoprostol through Women on Web – a digital community that provides medical consultations, abortion drugs and online support.

Of the 1,636 women who were sent the drugs between the start of 2010 and the end of 2012, the team were able to analyse self-reported data from 1,000 individuals who confirmed taking the pills. All were less than 10 weeks pregnant.

The results reveal that almost 95% of the women successfully ended their pregnancy without the need for surgical intervention. None of the women died, although seven women required a blood transfusion and 26 needed antibiotics.

Of the 93 women who experienced symptoms for which the advice was to seek medical attention, 95% did so, going to a hospital or clinic.

“When we talk about self-sought, self-induced abortion, people think about coat hangers or they think about tables in back alleys,” said Aiken. “But I think this research really shows that in 2017 self-sourced abortion is a network of people helping and supporting each other through what’s really a safe and effective process in the comfort of their own homes, and I think is a huge step forward in public health.”

But while Aiken said that previous research found that women in Ireland and Northern Ireland have welcomed being able to buy abortion pills online, she pointed out that the approach was far from the ideal solution for women wishing to end their pregnancy.

“I think that even though it is a positive thing for public health, it is not a positive thing for women’s lives because they still have to feel like criminals,” she said.

Aiken added that the study had limitations, not least that it relied – albeit through necessity – on self-reported information, and did not have data for more than 450 women who were sent the abortion medication but made no further contact with Women on Web.

Richy Thompson, director of public affairs and policy at the British Humanist Association, welcomed the study, but said covert online access to abortion pills wasn’t enough.

“That still doesn’t help women who have to access an abortion later on and so cannot use pills, and those women currently have to go to Britain in order to have an abortion and are charged up to £900 by the NHS,” he added. “Also, it does not remove from those women the risk of prosecution for having obtained abortion pills.”

Indeed, one ongoing case is that of a woman from Northern Ireland who was prosecuted for obtaining abortion pills for her daughter after a GP reported her to the police.

“Hopefully this research will only reinforce the need to end the legal injustice that women, while perhaps being able to access safe abortion pills in practice, nonetheless can face prosecution for doing so,” said Thompson.

Mara Clarke, founder of the Abortion Support Network, which helps women from Ireland, Northern Ireland and the Isle of Man travel to the UK for terminations, agreed. “More and more people contacting us are expressing fear of criminal prosecution,” she said, adding that women should beware of online scammers when searching for abortion pills.

While Clarke welcomed further evidence of the safety of the two drugs, she stressed that organisations such Women on Web and the Abortion Support Network are only a plaster on the problem facing women.

“Anything that helps women have terminations safely and encourages them to have terminations safely is ace in my book, but my end goal is for the abortion support network to be put out of business by law reform,” she said.

Stroke and dementia risk linked to low-sugar drinks, study finds

Consuming a can a day of low- or no-sugar soft drink is associated with a much higher risk of having a stroke or developing dementia, researchers claim.

Their findings have prompted renewed questions about whether drinks flavoured with artificial sweeteners can increase the risk of serious illness, as heavily sugared drinks have already been shown to do.

“Drinking at least one artificially sweetened beverage daily was associated with almost three times the risk of developing stroke or dementia compared to those who drank artificially sweetened beverages less than once a week,” according to the American researchers who carried out a study published in Stroke, the journal of the American Heart Association.

“After adjustments for age, sex, education (for analysis of dementia), calorific intake, diet quality, physical activity and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischaemic stroke, all-cause dementia and Alzheimer’s disease dementia,” the co-authors write.

Those consuming at least a can of so-called diet drinks every day were 2.96 times more likely to suffer an ischaemic stroke and 2.89 times more likely to develop Alzheimer’s disease than those who drank them less than once a week, they found.

Ischaemic strokes occur when blood cannot get to the brain because of a blockage, often one caused by a blood clot forming in either an artery leading to the brain or inside a vein in the brain itself. They comprise the large majority of the 152,0000 strokes a year which occur.

Surprisingly, though, the research also contradicted previous studies by finding that sugared drinks did not raise the risk of either serious outcome. It is based on data for more than 4,300 participants in the Framingham Heart Study, a long-term medical research project in the United States.

“To our knowledge, our study is the first to report an association between daily intake of artificially sweetened soft drink and increased risk of both all-cause dementia and dementia because of Alzheimer’s disease,” the co-authors added.

However, they admitted that they cannot prove a causal link between intake of diet drinks and development of either medical condition because their study was merely observational and based on details people provided in questionnaires logging their food and drink habits.

Matthew Pase, a senior fellow in the department of neurology at Boston University’s school of medicine who was one of the co-authors, said that despite no evidence of a causal link, the apparent connection between sweetened drinks and the two conditions “does identify an intriguing trend that will need to be explored in other studies”.

This is not the first time that sweetened drinks have been implicated in the development of serious ill-health. The paper quotes the Northern Manhattan study as having found that “daily consumption of artificially sweetened soft drink was associated with a higher risk of combined vascular events but not stroke”. It also cites the conclusion of the Nurses Health study and Health Professionals follow-up study that “greater consumption of sugar and artificially sweetened soft drinks was each independently associated with a higher risk of incident stroke over 28 years of follow-up for women and 22 years of follow-up for men”.

Sales of diet versions of soft drinks have boomed in recent years as sales of fully sugared ones have declined sharply.

Defra’s Family Food Survey, published last month, found that sales of regular soft drinks fell by 34.6% between 2010 and 2014, while low-calorie drinks purchases increased by 35.8%. Now just 38% of all soft drinks consumed are fully sugared, it said.

However, experts and health charities warned against reading too much into the new findings reported in Stroke.

“This research does not show that artificially sweetened drinks cause dementia. But it does highlight a worrying association that requires further investigation,” said Dr James Pickett, head of research at Alzheimer’s Society.

Naveed Sattar, professor of metabolic medicine at Glasgow University, said: “This is an interesting paper, but I would strongly caution against the conclusion that artificially sweetened drinks may increase the risk of stroke and Alzheimer’s. There is little other strong evidence to support a link between artificially sweetened drinks and adverse health outcomes.”

The results could have been skewed by people who had already become ill switching to low- or no-sugar drinks, Sattar added.

Dr Mary Hannon-Fletcher, head of health sciences at Ulster University, said: “These data are sound as far as they go. However it is important to note ‘the associations between recent and higher cumulative intake of artificially sweetened soft drinks and dementia were no longer significant after additional adjustment for vascular risk factors and diabetes mellitus’ – as the editor also pointed out. So are the conclusions sound? Perhaps not.”

Gavin Partington, director general of the British Soft Drinks Association, said: “Despite their claims, the authors of this observational study admit they found no cause and effect and provide no science-based evidence whatsoever to support their theories.

“In fact, based on the evidence, Public Health England is actively encouraging food and drink companies to use low-calorie sweeteners as an alternative to sugar and help people manage their weight.”

However, Tam Fry, a spokesman for the National Obesity Forum, warned consumers not to see low- or no-sugar drinks as healthy. “Don’t be fooled by the use of the word diet. Diet drinks were dreamed up as a description by an industry wanting to lull you into believing that it was a healthy thirst-quencher. Whether you’re thin or fat and thirsty, and not near a good old-fashioned tap, buy yourself bottled water,” Fry said.

Ad linking alcohol to cancer most effective at curbing drinking, study finds

A graphic Australian advertisement that highlights the link between alcohol and cancer has been nominated by drinkers as the most effective in leading them to reconsider their alcohol intake.

The video advertisement, titled Spread, was developed and funded by the Western Australia government. It shows alcohol being absorbed into the bloodstream, spreading and causing cancerous cell mutations in the liver, bowel and throat.

Researchers led by renowned international behavioural scientist Professor Melanie Wakefield tested 83 English-language alcohol advertisements from around the world on 2,174 Australian adults who regularly consume alcohol.

Study participants ranked each advertisement on a five-point scale, with a score of “one” representing a low motivation to reduce drinking after viewing and “five” representing high motivation to reduce drinking after viewing.

Spread ranked the highest with an average score of 3.77 and was favoured across a range of groups including men, women, young and older adults, and low and high-risk drinkers.

Four out of the top 10 most effective advertisements were from Australia and of those, all were from Western Australia. The least motivating ad, from New Zealand, was titled Add Nothing, and encouraged drinking water instead of beer. The results were published on Thursday in the medical journal BMJ Open.

The McCusker Centre for Action on Alcohol and Youth gave input into the development of the highest-ranked ad. The centre’s executive officer, Julia Stafford, said Spread was successful because experts in the field had been approached for input.

“We are really pleased that the evidence base for these harm-reduction ads is building and that we are learning more about what works in designing and running them,” Stafford said.

“It is important that very careful, research-based approaches are being taken.”

According to the Cancer Council of Australia, more than 3,200 cases of cancer each year could be prevented nationally if people limited their alcohol consumption.

But the CEO of Cancel Council Victoria, Todd Harper, said the carcinogenic properties of alcohol were still widely unknown in the community.

“Our 2015 survey of Victorian men and women found that nearly half of the respondents either believed that alcohol made no difference or were not sure if it had any effect on a person’s risk of cancer,” Harper said.

“It’s worrying because alcohol is a group one carcinogen – the highest classification available. It means that there is strong evidence that alcohol causes cancer at some body sites in humans.”

He said that “every drink” increased the risk of mouth, throat, bowel, liver and female breast cancers.

This risk as well as other alcohol-related harms has prompted some public health experts and health professionals to call for plain packaging on alcohol products that warn people of their risk, similar to that used on tobacco products.

But Alcohol Beverages Australia executive director Fergus Taylor dismissed the Spread ad as “off the mark” and “scaremongering”.

“The industry has long advocated for targeted measures to deal with specific areas of problem consumption and misuse, as opposed to broad-based, population-wide measures like ads that use cynical scare tactics to frighten responsible drinkers,” he said.

“These ads will just be dismissed as scaremongering by the vast majority of Australians who drink responsibly and are well aware that alcohol should be consumed in moderation.”

Taylor accused researchers of “simply demonising a product that has well-established health benefits when consumed at moderate and responsible levels”.

Evidence from the World Cancer Research Fund and American Institute for Cancer Research identifies a causal relationship between alcohol and cancer. While any level of drinking increases cancer risk, this risk increases in line with the level of consumption.

Recorded childhood cancers rise by 13% worldwide, study finds

Childhood cancers have risen across the globe by 13% over 20 years, according to data from the World Health Organization’s cancer section.

Cancer in children is comparatively rare; when it does occur it is more likely to have been triggered by something in the child’s genetic makeup than by anything to do with lifestyle or the environment.

Part of the reason for the rise is thought likely to be better detection. But experts say it is vital to collect better data from all over the world to establish all the causes, which could include infections and environmental pollutants.

The International Agency for Research on Cancer (IARC), which has published its findings in the medical journal Lancet Oncology, says the numbers recorded in cancer registries around the world have gone up since the 1980s. Between 2001-2010, there were 140 children in every million who were diagnosed with cancer under the age of 14, which represents a 13% increase.

IARC for the first time gives numbers for adolescents with cancer. There were 185 adolescents in every million diagnosed with cancer, most commonly lymphomas, which are cancers of the white blood cells.

“Cancer is a significant cause of death in children and adolescents, in spite of its relatively rare occurrence before the age of 20 years,” said IARC’s director, Christopher Wild. “This extensive new set of information on the pattern and incidence of cancer in young people is vital to raise awareness and to better understand and combat this neglected area of health early in life.”

A third of the cases under the age of 15 were of leukaemia, a cancer of the blood that is now successfully treated in Europe and the US.

A second paper, published in the Lancet Haematology journal, looks at the stark variation in survival from acute lymphoblastic leukaemia (or ALL) in childhood around the world between 2005 and 2009. In Germany, 92% of children survived for at least five years but in Colombia the figure was 52%.

Survival rates have improved significantly in all countries. From 1995-99 and 2005-09, five-year survival for the disease ALL, in children, increased from 79% to 89% in the UK, and from 83% to 88% in the US.

Regarding a second form of the disease, acute myeloid leukaemia (AML), five-year survival increased from 59% to 68% in the UK and from 52% to 63% in the US. Survival in China increased substantially over the same period – from 11% to 69% for ALL survival, and 4% to 41% for AML survival.

The IARC study on the global cancer rise has gathered information from cancer registries worldwide. But while the data covers 100% of children in Europe and North America, it accounts for only 5% or a lower percentage in Africa and Asia, where the information is not routinely collected.

In poorer countries, some children’s cancers are never diagnosed and their deaths will not be investigated. Social factors may explain why the cancer numbers for girls and small babies are very low.

In wealthier countries, greater understanding of cancers affecting children and adolescents and the development of better tools will account for much of the rise in numbers.

“It’s likely that this reported rise in children’s cancers is, in part, due to improvements in diagnosis,” said Anna Perman, Cancer Research UK’s senior science information manager. “We now have a better understanding of the symptoms of children’s cancers, which helps doctors to spot those who might have gone undiagnosed before. It’s unlikely environmental factors that children are exposed to either early in life or during development in the womb play a big role in this rise. Although some environmental and lifestyle factors that do play a role in cancer are on the rise, these usually take many years to influence cancer risk and would be unlikely to cause cancer at a young age.”

Pets Help Kids Build Immunity Even Before They’re Born, Study Finds

If you’ve been considering adopting a dog or a cat, this new study might help you make up your mind: According to research published in Microbiome, children born into homes with pets have higher levels of gut microbes that protect against allergies and obesity. Researchers say that indirect exposure to furry friends is especially beneficial to babies in their first three months of life, and even while they’re still in the womb.

This period appears to be a “critical window of time when gut immunity and microbes co-develop,” says lead author Anita Kozyrskyj, PhD, a pediatric epidemiologist at the University of Alberta. Disruptions to this development process—for example, the introduction of foreign bacteria—can change immunity and have implications for long-term health, she adds.

Kozyrskyj’s study compared fecal samples from 746 Canadian infants. Some of the infants were from families with pets (70% of which were dogs), some were from families who had pets during their pregnancy but not once the babies were born, and some had no recent pets.

The researchers found that babies from households with pets had twice the amount of two specific bacteria, Ruminococcus and Oscillospira, that have been linked with reduced risk for childhood allergies (such as dermatitis and asthma) and obesity, respectively.

Even when pets had been given up for adoption before the babies were born, this benefit was still seen. This shows that pet exposure affected the babies’ microbiomes indirectly, with influential bacteria transferring from the animal to the mother to the unborn child.

This bacterial exchange occurred regardless of the type of birth (vaginal versus C-section), regardless of whether the babies were breastfed, and regardless of whether antibiotics were used during birth. This is important, say the authors, as previous research has shown that C-sections, antibiotics, and not breastfeeding can all negatively impact babies’ immunity.

The presence of pets in the house during a woman’s pregnancy was also associated with a reduced likelihood that she would transmit group B strep bacteria—which can colonize in the vagina and cause pneumonia in newborns—to her baby during birth.

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The study builds on decades of research showing that exposure to dirt and bacteria can help children build up immunity, and that kids who grow up with pets have lower rates of asthma and allergies, says Kozyrskyj. (This effect is strongest with dogs but is true with cats, as well.) “Pets have always been our best friends and they appear to be good for our babies too,” she says.

But further studies are needed to provide definitive evidence that a “dog intervention” during pregnancy can actually prevent allergies. “Our next step is to pursue the ‘does it matter’ question, to determine the allergy and obesity outcomes of studied infants at ages 1, 3, and 5,” Kozyrskyj says.

And of course, allergies and obesity aren’t products of the environment alone; genetics also play a role. It also makes sense that kids with pets have natural protection against allergies, since parents with allergies are less likely to have dogs and cats in the first place.

RELATED: 13 Fun Ways to Work Out With Your Dog

But the study’s results were adjusted to account for whether the mothers had asthma or allergies, and still held true. Kozyrskyj says her team’s findings “are independent of these two possible explanations.”

It’s not far-fetched to think that pet exposure during pregnancy could one day be an official recommendation from doctors, Kozyrskyj says. It’s even possible that scientists could develop a “dog in a pill” supplement, she adds, for mothers to take as a preventative measure against allergies and asthma.

More research is needed for these scenarios to actually happen, however. For now, families have have another reason (on top of plenty already!) to snuggle up to their fur babies—and that includes moms-to-be.

Two in five GPs in south-west of England plan to quit, survey finds

About two in five GPs in the south-west of England are planning to quit, exposing a potential doctors’ crisis in the NHS. A survey of more than 2,000 GPs in the region revealed the impending healthcare problems.

Figures published last month showed there had been a drop in the number of GPs working in the NHS despite the government aim of recruiting 5,000 more by 2020.

The survey, carried out by the University of Exeter, also found that seven in 10 GPs intended to change their working patterns in a way that would mean less contact with patients. This included leaving patient care, taking a career break or reducing their hours.

The researchers said the data provided a snapshot of low morale which, if echoed in other regions, could point to a deeper and more imminent crisis than previously anticipated in relation to the worsening shortage of GPs nationwide.

John Campbell, a professor who led the research, which is published in BMJ Open, has called for a move away from “sticking plaster solutions” towards robust, joined-up, action to avert the crisis nationwide.

Campbell, a practising GP, said: “We carried out this survey because of a nationally recognised crisis in the shortage of GPs across the country, and our findings show an even bleaker outlook than expected for GP cover, even in an area which is often considered desirable, and which has many rural communities,.

“If GPs have similar intentions to leave or reduce their hours in other regions, as many are reporting, the country needs to take robust action more swiftly and urgently than previously thought.”

The research team sent surveys to 3,370 GPs across the region and received responses from 2,248, with 54% reporting low morale.

Campbell said: “We know that there’s an ageing workforce in general practice, with 30% of GPs being over 50 years old. Previous research has found that GP morale is low because of workload pressures, and many younger GPs do not want the financial risk and responsibilities of taking on a practice.

“Yet if the GPs we surveyed fulfil their intentions to leave or to cut back their patient contact, and no action is taken to address the issue, the south-west of England will experience a severe shortfall of GPs in the next five years.

“Whilst numerous government-led initiatives are under way to address recruitment, there is a need to address the underlying serious malaise which is behind this data.

“We are in a perilous situation in England, with poor morale of the current GP workforce, and major difficulties with recruitment and retention of GPs reflected in the stark overall reduction in the GP workforce. Reactive, sticking-plaster, approaches are not the answer.”

Campbell said GPs and their teams delivered nine in every 10 patient contacts with the NHS but attracted just seven pence in every pound of NHS spending.

“The government needs to work with the Royal College of General Practitioners, the British Medical Association and universities to obtain evidence on the causes of the problem, to develop and implement relevant strategy, and to effect fundamental change in healthcare resourcing and planning nationwide,” he said.

Recorded childhood cancers rise by 13% worldwide, study finds

Childhood cancers have risen across the globe by 13% over 20 years, according to data from the World Health Organization’s cancer section.

Cancer in children is comparatively rare; when it does occur it is more likely to have been triggered by something in the child’s genetic makeup than by anything to do with lifestyle or the environment.

Part of the reason for the rise is thought likely to be better detection. But experts say it is vital to collect better data from all over the world to establish all the causes, which could include infections and environmental pollutants.

The International Agency for Research on Cancer (IARC), which has published its findings in the medical journal Lancet Oncology, says the numbers recorded in cancer registries around the world have gone up since the 1980s. Between 2001-2010, there were 140 children in every million who were diagnosed with cancer under the age of 14, which represents a 13% increase.

IARC for the first time gives numbers for adolescents with cancer. There were 185 adolescents in every million diagnosed with cancer, most commonly lymphomas, which are cancers of the white blood cells.

“Cancer is a significant cause of death in children and adolescents, in spite of its relatively rare occurrence before the age of 20 years,” said IARC’s director, Christopher Wild. “This extensive new set of information on the pattern and incidence of cancer in young people is vital to raise awareness and to better understand and combat this neglected area of health early in life.”

A third of the cases under the age of 15 were of leukaemia, a cancer of the blood that is now successfully treated in Europe and the US.

A second paper, published in the Lancet Haematology journal, looks at the stark variation in survival from acute lymphoblastic leukaemia (or ALL) in childhood around the world between 2005 and 2009. In Germany, 92% of children survived for at least five years but in Colombia the figure was 52%.

Survival rates have improved significantly in all countries. From 1995-99 and 2005-09, five-year survival for the disease ALL, in children, increased from 79% to 89% in the UK, and from 83% to 88% in the US.

Regarding a second form of the disease, acute myeloid leukaemia (AML), five-year survival increased from 59% to 68% in the UK and from 52% to 63% in the US. Survival in China increased substantially over the same period – from 11% to 69% for ALL survival, and 4% to 41% for AML survival.

The IARC study on the global cancer rise has gathered information from cancer registries worldwide. But while the data covers 100% of children in Europe and North America, it accounts for only 5% or a lower percentage in Africa and Asia, where the information is not routinely collected.

In poorer countries, some children’s cancers are never diagnosed and their deaths will not be investigated. Social factors may explain why the cancer numbers for girls and small babies are very low.

In wealthier countries, greater understanding of cancers affecting children and adolescents and the development of better tools will account for much of the rise in numbers.

“It’s likely that this reported rise in children’s cancers is, in part, due to improvements in diagnosis,” said Anna Perman, Cancer Research UK’s senior science information manager. “We now have a better understanding of the symptoms of children’s cancers, which helps doctors to spot those who might have gone undiagnosed before. It’s unlikely environmental factors that children are exposed to either early in life or during development in the womb play a big role in this rise. Although some environmental and lifestyle factors that do play a role in cancer are on the rise, these usually take many years to influence cancer risk and would be unlikely to cause cancer at a young age.”

Antibiotics overuse could increase bowel cancer risk, study finds

The overuse of antibiotics could increase a person’s risk of developing bowel cancer, the findings of a US study suggest.

Research published in medical journal Gut found extended use of antibiotics significantly increased the chance of polyp formation in the colon, a precursor of bowel cancer.

The findings add weight to emerging evidence that the type and diversity of bacteria in the gut may have a key role in the development of cancer, according to the authors of the study.

An Australian bowel cancer expert, Associate Professor Graham Newstead, the head of the colorectal unit at the Prince of Wales private hospital and director of Bowel Cancer Australia, said the research had “credence”.

“We know already that if you take antibiotics you frequently get diarrhoea,” Newstead said.

This happened because the antibiotic killed some of the normal bacteria, leading to an overgrowth of the abnormal bacteria in the gut.

But Newstead said the study did not look at the effect of antibiotics on the colon and caution must be taken.

US researchers monitored the health of more than 120,000 nurses, aged between 30 and 55, who were part of the the Nurses Health Study launched in 1976.

Between 2004 and 2010, 1,194 abnormal growths in the colon and rectum were diagnosed.

Those who had taken antibiotics for two months or more between the ages of 20 and 39 were 36% more likely to be diagnosed with an adenoma, or polyp, compared with those who had not taken antibiotics for any extended period in their 20s and 30s.

Similarly, women who had taken antibiotics for two months or more during their 40s and 50s were 69% more likely to be diagnosed with an adenoma.

And those who had taken these drugs for 15 days or more between the ages of 20 and 39, and between the ages of 40 and 59, were 73% more likely to be diagnosed with an adenoma.

“It does seem to indicate that people who have too many antibiotics might be at more risk of of getting polyps than people who have less of them,” Newstead said.

“And, remembering that not all polyps turn to cancer but the cancer comes from the polyps. If you have more polyps or tendency to get polyps then maybe you are slightly more at risk of getting cancer.”

The message to be taken from the study was not to use antibiotics for a “tickle” in the throat or a cold, Newstead said.

Cancer patients have 55% greater risk of suicide, study finds

Cancer patients have a 55% greater risk of suicide than people without the potentially deadly disease, according to preliminary research findings.

Previous research has found suicide rates to be higher than in the general population but a paper being presented at this week’s European Congress of Psychiatry in Florence, Italy is an attempt to quantify the size of the increased risk.

Co-author Dr Raffaella Calati from the department of emergency psychiatry and post-acute care at Lapeyronie hospital, Montpellier, described the results, derived by pooling data from 15 studies, as “extremely preliminary” but nevertheless significant.

“The key message that remains is that in the majority of the studies there is an increased risk,” she said. “We are quite sure the risk would be higher, although I cannot say the exact number.”

The analysis, which also looked at suicide attempts and suicidal thoughts, included studies published between 1983 and 2015 from Australia, Canada, China, Norway, South Korea, Sweden, the UK and the US.

Patients with cancer were found to have a 55% higher suicide rate compared with people without the disease. But the analysis revealed no increased risk of suicide attempts ( 8,147,762 participants) or suicidal thoughts (42,700 participants) in patients with cancer.

The authors are currently seeking to add more studies into the mix and, in their initial analysis, did not seek to rule out other external factors that might influence the results, hence their emphasis on it being preliminary.

They say: “The assessment of suicide risk in patients with cancer is crucial. We suggest there is a need in cancer patients to be screened and cared not only for anxiety and depression, but also specifically for those people with suicidal thoughts and a lifetime history of suicide attempts, in particular during the period immediately subsequent to the diagnosis of cancer.”

A 2014 study by Cancer Research UK and the Scottish government found that three-quarters of cancer patients who also have clinical depression were not receiving any treatment for depression.

As the analysis is ongoing, it has not yet been submitted to a medical journal for publication but to be accepted for the European Congress of Psychiatry it had to undergo a peer review process set out by the European Psychiatric Association.

  • In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Doctor was ‘dishonest’ in screening nurse who had Ebola, tribunal finds

A doctor acted dishonestly when she lied to investigators about the dangerously high temperature of a nurse who went on to develop Ebola, a tribunal has found.

Dr Hannah Ryan, who had been working in Sierra Leone during the west Africa Ebola outbreak of 2014, was one of the medics who assessed Pauline Cafferkey following the Scottish nurse’s return to the UK in December 2014.

Ryan did not raise the alarm when a colleague wrote down Cafferkey’s temperature as 1C lower than it actually was during a “chaotic” screening process at Heathrow airport on 28 December 2014, a medical practitioners tribunal found on Monday.

A raised temperature can be the first sign of Ebola, which can kill within five days. Cafferkey, who twice nearly died from the virus, went on to develop one of the worst cases on record for people treated in the west.

During screening at Heathrow, Cafferkey insisted she was feeling fine and was eventually allowed to catch her connecting flight to Glasgow. The following day, she developed further Ebola symptoms and was admitted to hospital for urgent treatment.

The tribunal found that Ryan had acted in a “misleading” manner when she agreed that the form recording the lower, wrong temperature be submitted to screening staff from Public Health England (PHE) at the airport.

But Ryan, who had only just graduated from medical school, did not intend to conceal Cafferkey’s real temperature at the airport, knowing it to be at least 38.2C – higher than the 37.5 considered normal – the panel found.

However, the tribunal decided that the doctor had later been “dishonest” when she concealed her role in taking Cafferkey’s temperature during a conversation with Dr Nick Gent on 2 January 2015. Gent, deputy head of the emergency response department at PHE, had phoned her during PHE’s investigation into when Cafferkey’s symptoms first emerged.

Ryan did not tell him she had taken Cafferkey’s temperature and told him words to the effect that the nurse’s temperature was “normal”, the panel found.

The tribunal heard that Ryan and Cafferkey were one group among many British medics who put their own lives at risk by volunteering their medical skills and going to west Africa to help fight the outbreak.

Deployed on 22 November 2014, they were based at an 80-bed treatment centre in Kerry Town, a village in Sierra Leone, working “tirelessly in dangerous and highly pressurised conditions” during which they “formed a strong bond of friendship”, according to Fraser Coxhill, representing the General Medical Council.

The medical practitioners tribunal, which is independent of the GMC, will decide later this week whether Ryan’s fitness to practice as a doctor was impaired due to her actions and whether to impose sanctions.