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This Week in the British Medical Journal: Feb 14, 2011

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This week in the British Medical Journal, researchers at the National Cancer Institute teamed up with a group at the University of York in the UK to examine the risks of childhood cancer associated with exposure to diagnostic radiation and ultrasound scans in utero and in early infancy. Through examining 2,690 childhood cancer cases and 4,858 controls, the researchers found that there is no evidence to suggest that exposure to ultrasound in utero increases a child's risk of developing a childhood cancer. There was a slight increase in risk from exposure to x-rays, the researchers add, but it wasn't statistically significant. However, the researchers conclude, clinicians should be cautious about using "imaging procedures to the abdomen/pelvis of the mother during pregnancy and in children at very young ages."

Also in BMJ this week, British physician Kinesh Patel says there is a need for "more rationality around cancer," as sometimes unnecessary anxiety about the disease attracts resources and attention that could be better spent on other serious diseases. At a time when the National Health Service's budget is being tightened, and resources are being carefully managed, panicking about possible cancer isn't helping anyone. "Perhaps it is time for a carefully conducted trial of clinical prioritization of patients to see how this affects outcomes," Patel says. "In the new NHS, resources solely devoted to patients' emotional wellbeing can, sadly, no longer be afforded."

And in a letter in BMJ this week, New College professor Klim McPherson says recent publicity about the NHS' breast cancer screening program is "unfair" because it is based on the program's own review of itself. The program's leaflet inflates the percentages of women saved by mammograms each year, as compared to other surveys, and fails to address the potential harm to women from "overdiagnosis," McPherson says.

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