Consequences of the provision of laboratory services for the National Health Service by commercial firms: a view from the university sector

Article Abstract:

Laboratory tests for patients being treated in British hospitals or general practices have traditionally been performed by the National Health Service (NHS) or university laboratory departments. This practice has recently come under scrutiny, and the alternative of using the services of private laboratories has been suggested. Some are concerned, however, that this change may have an adverse impact on the NHS and medical schools in Great Britain. As it is now, NHS laboratory services are based in the major health care facilities and are readily available to the patient and the physician. The services of the NHS facilities go beyond routine testing, extending to provision of stat (rush) procedures and also planning and scheduling of radiotherapy, chemotherapy, ultrasonography, drug monitoring and other specifically hospital-based procedures. In those locations where NHS facilities are not readily available or the laboratories are remote from the patient or the physician, commercial facilities may be used, providing that turn-around times and the quality of the test performance are appropriate and the charges are cost-effective. Some of the services which may appropriately be put out into the private sector are non-urgent clinical chemistry, histopathology and virology. Changes in service and test requirements, on the other hand, may not be readily accommodated in the private sector. Also, use of the private sector may impede the educational process mandated by law, in that clinical laboratory medicine programs may suffer. The laboratory services currently provided by the NHS and the university laboratories go even further beyond the testing areas, providing valuable support for clinical and medical research and performing services for new procedures, materials and equipment. The changes to the operation of clinical laboratory services implicit in their privatization should be carefully reviewed at all levels of government and service before implementation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, United Kingdom, Medical laboratories, Biomedical laboratories, Hospital laboratories, Great Britain, Diagnosis, Laboratory, Laboratory diagnosis

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Human papillomavirus in oesophageal squamous cell carcinoma

Article Abstract:

Squamous cell carcinoma (SCC) is the most common malignancy of the esophagus. The incidence of SCC is particularly high among southern Chinese, and it is the fifth leading cause of death from cancer in Hong Kong. Human papillomavirus (HPV) infection is associated with the development of papillomas (benign tumors) in various parts of the body. HPV types 6 and 11 are found most frequently in benign lesions; HPV types 16 and 18 are usually detected in malignant lesions, such as those produced by SCC. A study was performed to determine if HPV is present in esophageal SCC (ESCC). In situ hybridization and DNA slot-blot analysis (techniques used for the detection of small amounts of viral DNA) were used to detect HVP DNA in ESCC samples from 37 patients. HPV genomes (DNA) for types 6, 11, 16 and 18 were not detectable in any of the ESCC samples. This indicates that HPV does not have the same role in ESSC as it does in comparable malignancies of other mucosal tissues. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Squamous cell carcinoma, Esophageal cancer

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Detection of human papillomavirus type 16 DNA in carcinomas of the palatine tonsil

Article Abstract:

Carcinoma of the palatine tonsil is the second most common malignant tumor of the upper respiratory tract, with tobacco and alcohol abuse being the most common contributors. A possible causative role for DNA tumor viruses has been postulated for several carcinomas. In particular, human papillomaviruses (HPV) have been associated with squamous cell carcinomas, such as cervical, anal and laryngeal carcinomas. Epstein-Barr virus (EBV) has been implicated in the pathogenesis of nasopharyngeal carcinoma. Therefore, a study was performed using in situ hybridization to screen 28 human tonsillar carcinomas for the presence of EBV and HPV (types 6, 11 and 16) DNA. In 6 of the 28 tonsillar carcinomas, HPV type 16 DNA was detected. All samples were negative for EBV and HVP, types 6 and 11, DNA. These results indicate a possible role for HVP 16 in the etiology of a few of the tonsillar carcinomas. (Consumer Summary produced by Reliance Medical Information, Inc.)

Head and neck cancer

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