LAST month there was conflicting news on screening for breast screening. Women between 52 to 70 are eligible, but nationally only 76 per cent of women take up the offer to get mammograms done every three years. Treating cancer early is the key to success.

Lifestyle changes such as taking regular exercise, losing weight and cutting alcohol intake reduces the risk by up to 30 per cent.

A recent study from Harvard medical school into 54 years of mammography concluded that mammography reduced the risk of dying from breast cancer by 19 per cent, but also that 36 out of 190 women who got regular mammograms for ten years would be subjected to unnecessary surgery, chemotherapy or radiation.

Self awareness and regular examination is also important.

The five signs to watch out for are a lump, discharge from a nipple, change in skin texture, crusting and change in appearance of the nipple.

A study published in the British Journal of Cancer found that of 847 men with prostate cancer 209 of the 415 who were told their cancer was slow growing were found to have a more aggressive form of the disease, suggesting that current screening techniques may underestimate the severity of the cancer.

The author Greg Shaw called for improvements in biopsy techniques and the quality of the MRI scans used for screening. Prostate cancer can be slow growing and in some men active surveillance is sometimes advised.

Separately, a new study in 46 men found that screening for three new proteins in a blood test was much more sensitive in detecting prostate cancer than the currently used PSA test. This paper was presented at the American Association of Cancer research. There is currently no prostate cancer screening programme in the UK.

Concern over claim culture

AT a spinal conference recently I met another surgeon with 20 years experience and at the peak of his career. I was so surprised when he said that he had stopped doing any complex surgery because he was afraid of being sued.

I can understand why he has made that decision and it is one that should send alarm bells ringing in our society and among policy makers. A lot of medicine involves complex decision making, risks of treatment, dealing with uncertainty and conveying all this to patients accurately. Doctors strive to do their best at all times. It is relatively easy, looking back, for lawyers to pick holes in the treatment offered and to sue doctors.

The fear of this and its implications is beginning to dictate decision-making and is making doctors more wary of treating complex patients.

This is going to impact all of society negatively.

I heard from a colleague recently that there are now television advertisements asking if people had a problem with their treatment and that they could get you compensation.

Doctors face many pressures and need courage to go out to bat for their patients and our creeping compensation culture may benefit the few, but be to the detriment to the many.

Manoj Krishna is a spinal surgeon working at the Nuffield hospital in York. For more information, visit www.spinalsurgeon.com