Cancer, poverty and pay-to-access journals

I had intended to use this evening to read the paper published by the British Journal of Cancer about survival rates from cancer over the past 20 years. This paper has had a lot of media attention. The upshot seems to be that people are living longer after a diagnosis of cancer, but those living in affluent areas (still) do better in terms of survival compared with those living in deprived areas.  I wonder if some of the reported improved mortality in some social groups relates to an increase in over diagnosis resulting from screening for some types of cancers – but cancers which were never going to affect lifespan anyway. For example, this can be true of some prostate or breast cancers (a subject touched on in a feature for this week’s FT Magazine about breast cancer here.)

Meantime, some media commentators have ascribed the differences in survival rates to all kinds of things including the quality of nutrition, smoking, exercise, alcohol, stress, and even the supposed greater ability of the middle classes to ‘nag’ one’s doctor for a diagnosis.

I would have liked to go and read the academic paper in full. However the journal is not part of my Athens subscription (the package offered to GPs in Scotland) until the paper is a year old. The individual parts of this paper cost $32  each. That adds up to quite a lot.

The British Journal of Cancer says that it is planning to allow free access to the journal –  but only for papers published over a year ago. This is good but it is not good enough. On the BJC website it says that “BJC is owned by Cancer Research UK, the world’s leading independent charity dedicated to cancer research”. It also says that “its far-sighted mission was to encourage communication of the very best cancer research from laboratories and clinics in all countries”. I imagine that if the standard subscription package offered by my institution doesn’t cover access then this would also be the case in many other countries too.

I would also have hoped that Cancer Research UK would consider that allowing journalists and other interested people rapid and full access to the complete studies to be an essential part of dissemination of the published research. This would allow for properly informed discussion and debate. Otherwise the information we get about cancer will continue to be as erratic and unhelpful as it currently is.

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