In this week's BMJ, a systematic review of observational studies by Loosemore and colleagues assesses the risk of chronic traumatic brain injury with amateur boxing.1 It finds that the quality of evidence is too poor to come to any definite conclusions. So, do we need to worry about the health of modern boxers, amateur or professional?

Concern over injury to fighters has been a persistent theme throughout the history of boxing. Although boxing was popular in early Rome, the practice was banned by Caesar Augustus, supposedly because of the high rates of injury in Roman legionnaires. The sport resurfaced in England during the 17th century in the form of bare knuckle boxing or prize fighting. The most famous of the rules introduced to protect the injured or incapacitated boxer were the 1867 Queensberry rules, which dictated that fights should be “a fair stand-up boxing match.” Each fighter was given a 10 second count if he was knocked down and the length of bouts was time limited. Gloves of a “fair size” were introduced, which changed the nature of the sport, as bouts …