News round-up (10 November 2023)

Some heartening news this week: 150,000 people with type one diabetes are to be offered an artificial pancreas to monitor insulin levels, while nearly 300,000 women with a high risk of breast cancer will be given the opportunity to take a drug that can prevent the disease. Evidence continues to emerge, however, about the strain on the NHS, with a charity finding that difficulty in accessing dentists may be responsible for an increase in the number of deaths from mouth cancer, and an investigation warning that long waits in A&E may be leading to a rising number of excess deaths.

Dentist shortage leads to rise in mouth cancer deaths, charity says

A lack of access to dentists is leading to some people dying from mouth cancer, according to the Oral Health Foundation, a charity.

In 2021, 3,000 people died from mouth cancer, an increase of 46% in a decade. The charity believes that difficulty in accessing dentists means that signs of the disease are not being picked up. An investigation by BBC News last year found that 90% of UK NHS dental practices were not accepting new adult patients.

Early detection results in a roughly 90% survival rate, compared with 50% following delayed diagnosis.

Eddie Crouch, chair of the British Dental Association, told the BBC: “Every dental check-up doubles as an oral-cancer screening.” He said that the difficulty many people were experiencing in gaining access to a dentist “will inevitably cost lives”.

New breast cancer drug approved for NHS use

The Medicines and Healthcare products Regulatory Agency has licensed use of the drug Anastrozole to prevent breast cancer.

The drug has been used for several years to treat breast cancer, but recent trials show that it can reduce the incidence of breast cancer by almost 50% in post-menopausal women at moderate or high risk of the disease.

An estimated 289,000 women could be eligible for the drug, which means that potentially thousands of lives could be saved.

The drug will be offered to women with a significant family history of the cancer. If only a quarter of these take the drug, NHS England said, it could help prevent 2,000 cases of breast cancer, saving the health service £15m in treatment costs.

NHS to offer artificial pancreas to 150,000 people with type 1 diabetes

Final draft guidance from the National Institute for Health and Care Excellence (NICE) recommends that some people with type 1 diabetes should be offered an artificial pancreas.

More than 150,000 adults and children with type 1 diabetes in England and Wales could be eligible for the device, which uses a hi-tech algorithm to determine the amount of insulin that should be administered and reads blood sugar levels to keep them steady. A trial showed it was more effective at managing diabetes than current devices and required far less input from patients.

The NICE guidance recommends that patients should be offered the artificial pancreas if their diabetes is not adequately controlled by their current pump or glucose monitor.

The first people to be offered the wearable device will be children and young people, women who are pregnant or planning a pregnancy, and people who already have an insulin pump. The artificial pancreas will be rolled out to all those eligible within five years.

Women in Britain top binge-drinking league

British and Danish women engage in binge drinking more than any other women in the developed world, according to research by the Organisation for Economic Co-operation and Development (OECD).

The figures show 26% of women in Britain, and a similar proportion in Denmark, report “heavy episodic drinking” – more than twice the OECD average of 12%. Only 2% of women in Italy, 4% of those in Spain and 12% of those in France engaged in similar levels of drinking, the study found.

The research, which looked at drinking habits in 29 countries, found that men were more likely to engage in binge drinking than women. In the UK, 45% of men admitted to heavy episodic drinking, compared with an OECD average of 27%. The figures were higher in only three countries: Romania, Denmark and Luxembourg.

Dr Katherine Severi, the chief executive of the Institute of Alcohol Studies, said the figures were concerning because alcohol was the “leading risk factor for death and ill-health in people aged 15-49 due to its links with cancers, stroke and cardiovascular disease.”

Scientists developing finger-prick test for brain cancer recurrence

Scientists at Nottingham Trent University and the University of Sheffield are developing the world’s first finger-prick test to detect brain tumours.

More than 300,000 people worldwide are diagnosed with brain cancer each year, and even if treated successfully, there is a risk of recurrence. The unpredictable timing of tumours returning makes them difficult to detect early.

The researchers are designing a lateral flow test to pick up signs of recurrence that patients who have previously had brain cancer could use at home.

The researchers say the new test, which would use a tiny blood sample from a finger-prick, could potentially extend the lives of tens of thousands of people around the world. It would also reduce the burden on health care systems by reducing the need for MRI scans and providing a cost-effective alternative to some clinic appointments.

Excess deaths caused by A&E delays rise by nearly a third in one year

Long waits in accident and emergency departments may have caused approximately 30,000 excess deaths last year, according to an analysis of data by the publication HSJ.

Using Freedom of Information (FoI) requests to a selection of NHS trusts, the HSJ analysis examined data on admitted patients who had waited six hours or more in A&E. Ratios were applied to these figures to produce estimates for associated excess mortality per trust. The methodology was based on a study published in the Emergency Medicine Journal, which found that delays to hospital admission of more than five hours from time of arrival at A&E were associated with an increase in all-cause mortality within 30 days. The data suggests the rate of excess deaths from 2022-23 has so far continued into 2023-24.

The analysis produced an estimate of 29,145 excess deaths related to long accident and emergency delays in 2022-23, up from 22,175 in 2021-22, and 9,783 related deaths in 2020-21. The publication also produced estimates of excess mortality related to long A&E delays for every acute trust. Croydon Health Services Trust topped the table with an estimated 297 excess deaths as a result of delays between April 2022 and July 2023.