Breast Cancer League Table

[Mark]

Breast cancer league table, out today, suggests (to some of us) an epicentre of XMRV infection and genetic vulnerability to XMRV:

http://www.dailymail.co.uk/health/a...ate-11th-highest-world.html?ito=feeds-newsxml

1. Belgium
2. Denmark
3. France
4. Netherlands
5. Israel
6. Iceland
7. Ireland
8. Uruguay
9. Switzerland
10. New Zealand
11. UK

The top 4 are particularly suggestive, lying so close together as they do; looking at that from an epidemiological point of view might just be a clue as to either the origin of genetic vulnerability to XMRV or ground zero of XMRV in Europe. Note that Belgium, in particular, is way out in front.

I wouldn't disagree with the factors mentioned in the article as partial explanations for the distribution, but of course as usual it's only the soft factors, lifestyle factors etc that are advanced as explanations - we have to add genetic factors and XMRV infection to that story.

Very few posts on the discussion thread so far, and this will be across all papers today (GoogleNews search on 'breast cancer' stories today should find all the other articles). It's a good opportunity to add comments explaining XMRV and the breast cancer connection.

Some background info, and references regarding the tentative links made between XMRV and breast cancer, would be required. First reference to breast cancer was from John Coffin, Oct 2009 CFSAC - thought at the time to be a slip of the tongue, meaning to say prostate cancer; subsequently when the suggestion of breast cancer/XMRV connection was made public we realised that this slip of the tongue implies that this connection has been known behind the scenes for nearly 18 months now.

I think stories like this are a good opportunity to spread the word about XMRV to a wider audience.

 

[Mark]

Also interesting: the box-out mentions that women with wider circles of friends are more likely to survive breast cancer and less likely to relapse. There's an evidence-based chain that may connect that to ME: a recent study found that amygdala size is related to size of social group, and amygdala has also been linked to ME. Could be that what all those findings are picking up on is the subset of breast cancer that has genetic vulnerability to XMRV underlying their cancer...

 

[alex3619]

Hi Mark, I haven't gone back to confirm it, but didn't Singh find that most prostate cancers have XMRV in the surrounding tissues? We might be thinking about his wrong - XMRV might not cause many cancers, it might cause localized immune suppression or cancer proliferation. If you get cancer, and have XMRV, you cant control the cancer. This might also help explain the aggressiveness of such cancers. Bye, Alex

 

[Mark]

Hi Alex, yes I agree, especially in that saying any one thing specifically is the cause of anything is potentially misleading in this area. If you need a genetic vulnerability, plus a pathogen, plus another event, for a disease to occur, which of these do you say is "the cause"? Anyway it really is too early to say anything much about whether XMRV is a passenger, an enabler, a maintainer, or the root cause, in the cancers where it's being found...there does seem to be an association with aggressiveness, which Singh had some great results on, but another PC researcher found the opposite I think...my money's on Dr Singh, on that one For what it's worth, I think it's very likely that XMRV at least plays a role in encouraging these cancers, but it's too early to say much more than that I think.

 

[Mark]

Still more reports being added to this story...still focusing solely on the same old lifestyle factors to explain the findings...

http://www.nhs.uk/news/2011/01January/Pages/unhealthy-lifestyles-linked-to-UK-cancer-rates.aspx

...but I still think there's more to it than that - and the league table itself is not reporting the link to unhealthy lifestyles; that's a reference back to other work.

I just have this feeling that the league table story is just being used once again to push the public health education agenda, which however accurate it may be in itself, is actually not the story of the news itself, but an interpretation being advanced as an explanation of that news: "Unhealthy lifestyles linked to UK cancer rates" is not what this story is about and I haven't seen any of the news stories that focus on that point - which is to say, all of them - actually citing which old studies they are referring to when they draw those conclusions.

And since Belgium is way out in front, does that mean they have the unhealthiest lifestyle in the world?! Never heard about that - but there's quite a big margin in the published tables between Belgium and 2nd place: what special factors explain that, I wonder?

Anyway, constantly trying to guilt-trip people about their allegedly unhealthy lifestyles, and most importantly, focusing on that message to the exclusion of all other considerations, is getting really tedious in our news reporting. Is there any evidence that banging on about all that actually makes a difference to people's behaviour? And I'd also be interested to explore whether making all the lifestyle changes recommended actually lowers the risk - there may well be loads of good research that shows it does, but if so, I'd like to see it cited: retrospectively proving an association of cancer with all these behaviours isn't the same thing as showing that the association is a direct causal one, or that making the behavioural adjustments suggested will actually make a difference...I imagine that's probably proven, but if so, the stories should cite that evidence, and even then, I still think there are other factors here that aren't being focused on...like the significance of viral infections...