BMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7098.1918 (Published 28 June 1997) Cite this as: BMJ 1997;314:1918

It took two generations–not to mention some financial incentives for general practitioners–before cervical screening became accepted by most women in Britain. So what about screening for colorectal cancer? An editorial in the Scottish Medical Journal (1997;42:67) reports yet another study in which compliance with sigmoidoscopy was below 30%. Should screeners just be patient and wait for attitudes to change? Colorectal cancer kills many more people than cancer of the cervix.

A study in Sweden of twin pairs aged 80 or older found that monozygotic twins continued to show close similarities despite so many years of exposure to the environment (Science 1997;276:1560-3). In these old people the heritability of cognitive ability was 62%–a figure similar to that in adolescent twins. So the balance between environmental and genetic influences on intelligence shows little or no change with age.

The task of producing clinical guidelines must seem pretty thankless to those who do the work. Recent guidelines for the management of low back pain were evaluated in an audit of case notes of 963 patients (JAMA 1997;277:1782-6). The review showed that 13% of the patients had had radiographs of their lumbar spines–but, had the guidelines been followed, the proportion having radiographs would have been 44%.

A supplement in Tropical Doctor …

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