Invitations have been pouring through letterboxes all over the UK to take part in the Biobank.
If you haven’t received one already, let me explain what this particular bank wants from you (thankfully, it doesn’t involve money). The Biobank is a research project, and its aim is no less than to improve the “health of future generations”.
Funded by the Medical Research Council, the Wellcome Trust and the Department of Health, among other bodies, it is recruiting half a million people between 40 and 69 to be surveyed about their health. They will be followed for several decades, in some cases until death. People will be asked about health, lifestyle, work, family history, and have blood and urine samples taken for storage. They will also have tests for blood pressure, bone density and lung function. The researchers may ask for permission to access medical notes, and they may in future examine blood for genetic factors.
Now, the Biobank study has a number of strengths. Diseases that are rare among the general population often get overlooked for research funding. A study with a sample size this large may afford a chance to examine such diseases more effectively. The sheer scale is also very unusual – the famous Framingham Heart Study, for example, which began in Massachusetts in 1948, had only 5,000 participants.
The question, from my position as a GP, is what we will do with all this new information once we have it. So often, all we can offer people at risk of certain diseases is the same rote advice – eat well, exercise, don’t smoke, don’t drink too much. Aggressive use of medication can treat risk factors in some people, for example those with high blood pressure. But more often, patients on medication won’t see great benefit but will have to endure side effects.
I am concerned, too, about the effects of genetic screening in the future. It is conceivable that the information provided could make people more motivated to avoid certain risk factors. But still, there is the possibility that genetic testing may merely offer best guesses and create more worry and stress. However, the study is being conducted by the cream of UK epidemiologists, and something may turn up to change life for the better. Sir Richard Doll discovered, through following a large cohort of doctors, that smoking caused lung cancer. It was an unexpected finding, and it has saved lives. From my side of the desk, poverty, loneliness and social exclusion seem to be the biggest determinants of ill health. In other words, it may not be cholesterol pills and antidepressants that will make our population better.
Margaret McCartney is a GP in Glasgow.
For lively discussion of the latest medical issues go to Margaret McCartney’s blog at blogs.ft.com/mccartney
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