Richard
Don't lump the use of FOBT in Bowel Cancer Screening with some of the
others. It has been shown quite clearly that screening shifts the stage of
cancer at pick up towards the curative end of the spectrum. Admittedly these
people will require some years of surveillance but that will be cheaper than
the radio and chemo therapy for the more advanced cancers. In addition we
showed quite clearly there was a reduction in emergency admissions (more
expensive than electives) for colorectal surgery during the pilot screening
programme.
Not that I am biased of course.
Best wishes
Steve
Steve Smith
Consultant Clinical Biochemist
Midlands and North West Bowel Cancer Screening Hub
-----Original Message-----
From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Mainwaring-Burton
Richard (RGZ)
Sent: 09 January 2008 10:06
To: [log in to unmask]
Subject: Re: ... more diagnostic procedures will be available in GP surger
ies
Likewise other screens : BNP, Troponin, FOB, PSA, etc etc
with best wishes
Richard
Richard Mainwaring-Burton
Consultant Biochemist
Queen Mary's Hospital
Sidcup, Kent
020-8308-3084
-----Original Message-----
From: gordon challand [mailto:[log in to unmask]]
Sent: 08 January 2008 18:58
To: Mainwaring-Burton Richard (RGZ); [log in to unmask]
Subject: Re: ... more diagnostic procedures will be available in GP surger
ies
Dear Richard
I think that a major problem with all this is that there appears to be a
perception in the outside world that somehow introducing pre-symptomatic
screening increases the number of healthy individuals (and hence reduces the
health costs). The opposite is obviously true: any screening programme will
place some subjects previously thought to be healthy into an 'at-risk' or
'sick' category who will then cause health costs (apart from causing
individual concern, people who thought themselves healthy now find
themselves categorised as sick). This belief of health screening as a
'reduction in sick patients' or as an overall 'reduction in costs' has been
around for a long time including the original basis on which the NHS was
founded; I personally became aware of it when 'well-person screening' was
introduced as a DoH initiative in the late 1980s which simply led to a
massive increase in the number of patients found to have a 'high'
cholesterol and then placed on expensive statin treatment (and almost as
expensive continuing laboratory monitoring, none of which was funded).
At times I despair that anyone in the DoH will ever learn any lessons from
what has gone before (and I am unwilling to devise any audit programme for
the new developments suggested by one of the other Gordons!) .
However, with all best wishes for 2008
Gordon Challand
----- Original Message -----
From: "Mainwaring-Burton Richard (RGZ)"
<[log in to unmask]>
To: <[log in to unmask]>
Sent: Tuesday, January 08, 2008 4:31 PM
Subject: Re: ... more diagnostic procedures will be available in GP surger
ies
> That gordon crossed my mind also.
> Perhaps he (GC) will be good enough to devise a QA package for the
> interpretative comments produced by the screening programme introduced by
> GB
>
> with best wishes
> Richard
> Richard Mainwaring-Burton
> Consultant Biochemist
> Queen Mary's Hospital
> Sidcup, Kent
> 020-8308-3084
>
>
> -----Original Message-----
> From: gordon challand [mailto:[log in to unmask]]
> Sent: 07 January 2008 15:35
> To: [log in to unmask]
> Subject: Re: ... more diagnostic procedures will be available in GP
> surgeries
>
> Dear David
> To which Gordon do you refer (there aren't too many of us about)?
> Gordon Challand
> ----- Original Message -----
> From: "David Bullock" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, January 07, 2008 3:18 PM
> Subject: Re: ... more diagnostic procedures will be available in GP
> surgeries
>
>
>>I trust that Gordon will be taking note of best practice when evaluating
>>the
>> effectiveness of this screening programme . . .
>>
>> http://www.hta.ac.uk/execsumm/summ1152.htm
>>
>> Happy New Year
>>
>> David
>>
>>> -----Original Message-----
>>> From: Jonathan Kay [mailto:[log in to unmask]]
>>> Sent: 07 January 2008 10:15
>>>
>>> http://politics.guardian.co.uk/gordonbrown/story/0,,2236473,00.html
>>> <http://politics.guardian.co.uk/gordonbrown/story/0,,2236473,00.html>
>>>
>>> Brown will say that more diagnostic procedures will be available in GP
>>> surgeries, making blood tests, ECGs and, in some cases, ultrasounds
>>> available "when you want and need them".
>>>
>>
>>
>> Dr David Bullock
>> Director, Wolfson EQA Laboratory
>> P O Box 3909, Birmingham B15 2UE, U K
>> FAX: 0121 414 1179 [+44 121 414 1179]
>>
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community working in clinical biochemistry.
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via the internet. Views expressed are those of the individual and
they are responsible for all message content.
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------ACB discussion List Information--------
This is an open discussion list for the academic and clinical
community working in clinical biochemistry.
Please note, archived messages are public and can be viewed
via the internet. Views expressed are those of the individual and
they are responsible for all message content.
ACB Web Site
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