Breast cancer is found largely in older women; women aged over 65 account for 13% of the female population but for two thirds of all deaths from breast cancer ( Annals of Internal Medicine 2003;139: 835-42). Few studies have looked closely at these figures, but the available evidence shows that screening using mammography every two years would reduce the death rate at an acceptable cost.

Heart failure is common in elderly people, but clinicians may find it difficult to recognise (Age and Ageing 2003;32: 565-9). A test that has an “emerging role” in diagnosis is measurement of the B type of natriureteric peptide (BNP). Concentrations of BNP are raised in heart failure and correlate with left ventricular systolic dysfunction. A bedside test is available; a normal value virtually excludes heart failure.

A review in the New England Journal of Medicine ( 2003;349: 2136-46) of the treatment of irritable bowel syndrome urges a multicomponent approach based on the type (diarrhoea, constipation, pain) and severity of the symptoms. It warns that current pharmacological treatments are likely to be ineffective when ongoing psychosocial problems remain undiscovered or untreated.

A study in Leeds of 627 patients who had had 711 liver transplants found that 26% had developed neurological complications after their operations …