Prostate cancer clue in fingers

30 November 2010 Last updated at 19:01 ET By Fergus Walsh Medical correspondent, BBC News

The length of a man's fingers can provide clues to his risk of prostate cancer, according to new research.

A British Journal of Cancer study found men whose index finger was longer than their ring finger were significantly less likely to develop the disease.

Researchers made the discovery after comparing the hands of 1,500 prostate cancer patients with 3,000 healthy men.

The length of the fingers is fixed before birth and is thought to relate to sex hormone levels in the womb.

Being exposed to less testosterone before birth results in a longer index finger and may protect against prostate cancer later in life, say researchers at the University of Warwick and the Institute of Cancer Research.

One of the report authors, Professor Ros Eeles, said more studies would be needed, but if these confirmed the findings it could be used a simple test for prostate cancer risk.

She said: "This exciting finding means that finger pattern could potentially be used to select at-risk men for ongoing screening, perhaps in combination with other factors such as family history or genetic testing."

The study was funded by the charities Prostate Action and Cancer Research UK.

Emma Halls, chief executive of Prostate Action, said: "This research brings us another step closer to helping determine risk factors for prostate cancer, which is possibly the biggest issue in current thinking about preventing and treating the disease.

"However, we are still a long way from reducing the number of men who die of prostate cancer every year and need more research and education in all areas to achieve this."

Dr Helen Rippon, head of research at The prostate Cancer Charity, said the research added to growing evidence that the balance of hormones we are exposed to before birth influences our health for the rest of our lives.

But she said men with shorter index fingers should not be "unduly worried".

"They share this trait with more than half of all men and it does not mean they will definitely develop prostate cancer in later life."

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Age affects appointment chances

1 December 2010 Last updated at 03:02 ET

Age, sex and wealth all affect how likely your GP is to refer you for a specialist appointment, a study has concluded.

A UK team analysed data for 130,000 patients, reporting their findings in the British Medical Journal.

Older people were less likely to be referred for three common symptoms, with sex and deprivation also influential.

A charity said the study should raise alarm bells across the NHS.

Michelle Mitchell, Charity Director at Age UK, said: "A doctor's decision to refer patients must be based solely on the patient's clinical need, not their age. Age discrimination in health provision will be unlawful from 2012 and it can't come a moment too soon for older people in need of medical care."

The study from the King's Fund and University College London covered decisions on patients with postmenopausal bleeding, hip pain and heartburn from 326 UK practices across a six-year period.

Once everything else that might influence a doctor's decision to refer - such as smoking, weight, alcohol use and pre-existing conditions - was taken into account, the researchers found significant differences in referral rates between old and young, male and female.

As a guide, the older the patient, the less likely a referral was - in postmenopausal bleeding, someone aged 85 or over was 61% less likely to get a specialist appointment, compared with someone aged 55 to 64.

For patients with hip pain, the difference in referral rates was 32%.

Women were 10% less likely to be referred for hip pain than men, while there was some evidence that coming from a poorer background made a specialist appointment for hip pain and heartburn less likely.

The reasons behind the decisions were not revealed by the study - however, the authors suggested that older patients might be less likely to ask for referral, and that GPs choosing to work in deprived areas might be generally less inclined to refer.

However, they said that the differences could lead to "delays in treatment and poorer outcomes" - and might be an even greater concern if similar patterns emerged in referrals for other common symptoms, some of which could be linked to serious illness.

In an accompanying commentary, Professor Moyez Jiwa, from the Curtin Health Innovation Research Institute in Perth, Australia, said it was hard to know how harmful decisions like this could be.

While some patients might be "denied timely access" to experts, she wrote, others who were referred could be harmed by unnecessary testing and treatment.

She added: "The appropriate referral of cases has economic, quality and safety ramifications that resonate across the health sector and the globe."

She said that database analysis like this could not help researchers understand why GPs and their patients behaved in a certain way in the consulting room.

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