BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6959.966 (Published 08 October 1994) Cite this as: BMJ 1994;309:966

Women who are infertile and have repeated treatments with clomiphene have an increased risk of ovarian tumours. The latest data showing this relation come from a follow up of 3837 women evaluated for infertility in Seattle (New England Journal of Medicine 1994;331:771-6). The investigators found 11 invasive or borderline malignant ovarian tumours compared with an expected number of 4.4. Nine of the women had taken clomiphene, and the findings suggest that the risk of a tumour rises with the number of treatments given. Treatment for less than a year was not associated with an increased risk.

Adults in northwest Europe are unusual in being able to drink as much milk as they like: in most populations the lactase required to digest the lactose in milk disappears between the ages of 2 and 6. A hypothesis article in “Gut” (1994;35:1487-9) suggests that the high frequency of lactase deficiency is another example of a mutation that gives protection against malaria. By discouraging the drinking of milk the mutation leads to mild riboflavin deficiency, which in turn inhibits the multiplication of malaria parasites.

Controversy continues over whether air pollution is …

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