BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7124.84 (Published 03 January 1998) Cite this as: BMJ 1998;316:84

Americans continue to dispute the value of mammography in women aged 40-49. An analysis in Annals of Internal Medicine (1997;127:955-65) has concluded that “screening is relatively cost ineffective in women aged 40-49…. To prevent one death clinicians would need to screen 2500 women, whereas routine screening of only 270 women aged 50-69 would also prevent one death.”

Hereditary haemochromatosis is a disorder of iron metabolism that affects 1 in 300 people of Northern European descent: the carrier rate is about 10%, and a simple genetic test will identify 90% of the homozygotes (Gut 1997;41:841-4). The disease may be fatal if not treated, but if treatment is started early in life the life expectancy is normal. A chill note in the report warns that before genetic testing is introduced “ethical issues need to be addressed such as how insurance companies will view homozygous people with no signs of iron overload.”

Minerva is a long term fan of the British Kidney Patient Association, which since 1975 has raised funds to improve the quality of lives of patients who have developed renal failure. Its appeal includes an article by Sir Cyril Chantler recalling that when he started recommending transplants for children he was worried about the length of time the grafts would survive. …

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