Medicine and Science from The BMJ

Low carb and cancer screening

Nov 6, 2023

Barry Kramer, an expert in cancer screening, discusses the language and evidence surrounding cancer screening tests. The NHS's plan for a multicancer detection test is examined. The association between carbohydrate intake and long-term weight changes is explored, along with the limitations of self-reporting in determining dietary intake.

33:22

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Episode guests

Barry Kramer

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Episode notes

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Quick takeaways

Cancer screening tests have limited efficacy in reducing all-cause mortality, raising questions about their value in clinical care.

Reducing consumption of starchy vegetables, such as fries, can be associated with less weight gain over time, highlighting the importance of dietary choices in weight management.

Deep dives

The Debate on Cancer Screening Tests

The podcast explores the controversy surrounding cancer screening tests and whether they truly save lives. A research paper published in JAMA Internal Medicine by Michael Breathour and colleagues questions the efficacy of common screening tests by examining higher quality evidence from randomized control trials. The podcast also discusses a pilot program in the NHS for a multi-cancer early detection test called Galerii, which detects abnormal DNA from cancer cells. The discussion emphasizes the need for precision in the language used when discussing screening tests and highlights the challenges in evaluating the effectiveness of these tests.

Introduction

3min

Examining Language and Evidence in Cancer Screening Tests

12min

NHS England's Position and Plan for Pilot Test and Potential Purchase

2min

Changes in Carbohydrate Intake and Long-Term Weight Changes

7min

Limitations of Self-Reporting and Food Frequency Questionnaires

4min

Importance of Balanced Diet and Continuous Glucose Monitoring

6min

Each episode of Talk Evidence we take a dive into an issue or paper which is in the news, with a little help from some knowledgeable guests to help us to understand what it all means for clinical care, policy, or research.

In this episode:

Helen Macdonald take a deep dive into cancer screening tests, prompted by a paper in JAMA which showed most have no effect on all cause mortality, and news that the NHS is evaluating a single test which screens for 50 common cancers - we ask Barry Kramer, former director of the Division of Cancer Prevention, at the U.S. National Cancer Institute to help explain how to hold those two pieces of knowledge.

Juan Franco has been looking into diet and obesity, prompted by new research in The BMJ and a new Cochrane review, looking at the role of low glycemic index foods in weightloss - we ask Khadidja Chekima, nutritional researcher at Taylor’s University in Malaysia, to define low GI foods, and why it’s so hard to research their role in diet and weightloss

Reading list;

JAMA research - Estimated Lifetime Gained With Cancer Screening Tests; A Meta-Analysis of Randomized Clinical Trials

The BMJ news - Clinicians raise concerns over pilot of blood test for multiple cancers

The BMJ research - Association between changes in carbohydrate intake and long term weight changes: prospective cohort study

Cochrane review - Low glycaemic index or low glycaemic load diets for people with overweight or obesity