With the festive season in full swing, Ian Gilmore and Nick Sheron urge the implementation of policies to curb excess drinking to reduce the harms of alcohol in the UK (read more), whereas Christopher Cook and colleagues consider a classical Greek text that makes it obvious that drunkenness has a long tradition in Western civilisation (Classically intoxicated), and A&E doctor Robert J Douglas from Australia recommends CHAMPAGNE as the safer choice for celebrations.


BMJ 21 December 2007;

Organised marathons are not associated with an increased risk of sudden death, despite the media attention they attract. In fact, marathons lower the risk of fatal motor vehicle crashes that might otherwise have taken place if the roads had not been closed

Diet and the risk of cancer

Editorials, BMJ  2007;335:897 (3 November).

The possible influence of diet on the risk of cancer is constantly topical. The subject is important because people can change their diets, and even a moderate effect on risk could prevent several thousand cancers each year in a country the size of the United Kingdom. However, apart from the confirmed adverse effects of alcohol and obesity on the risk for some types of cancer, progress in understanding has been slow and the evidence remains confusing.

There is little evidence that fall prevention programmes used throughout the NHS are effective in cutting the number of fallers or fall related injuries.

BMJ  2007;335:765-768 (13 October), by:

Patrick Petignat, consultant gynaecological oncologist, Michel Roy, professor and gynaecological oncologist.

  • Cervical cancer is the second most common cancer in women worldwide.
  • Cervical cancer is an important cause of early loss of life as it affects relatively young women. 
  • Cervical biopsy is the most important investigation in diagnosing cervical cancer

Surgery or chemoradiotherapy can cure 80-95% of women with early stage disease (stages I and II) and 60% with stage III disease.

Rapid response to Professor Gareth William’s editorial on the use of weight loss aid, orlistat, correctly concludes that it is no substitute for a healthy lifestyle;

by: Howard Marsh MRCP MRCGP
Medical Director
GlaxoSmithKline Consumer Healthcare, 1500 Littleton Rd, Parsipanny, New Jersey 07054, USA

GSK launched a non-prescription version of orlistat (brand name alli) in the US in June this year, the first FDA-approved weight loss medicine to be available over-the-counter (OTC).

The weight loss that can be achieved with OTC orlistat requires commitment to adopt a low-fat, reduced calorie diet.

Indeed all our communication, including television advertising, websites, in-store communications as well as materials provided to pharmacists stresses this requirement. These materials specifically state that “alli is not a magic pill” and provide candid information about the consequences of eating too much fat.

Colorectal cancer

BMJ  2007;335:715-718 (6 October), by: Anne B Ballinger, consultant gastroenterologist.

Colorectal cancer is common, the presenting symptoms are non-specific, and the stage of disease at diagnosis is closely related to survival.

Summary points

  • The lifetime risk of developing colorectal cancer is about 5%
  • Increasing age and a family history of colorectal cancer are the greatest risk factors for the disease
  • Patients presenting with suspicious symptoms and signs should be referred and investigated urgently in a specialised unit
  • Colonoscopy and computed tomographic colonography are of equal sensitivity for detection of colorectal cancer
  • Colonoscopy allows biopsy of suspicious lesions and removal of polyps
  • Population screening by testing for faecal occult blood has begun in the United Kingdom

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