 | | | | |  | An antidote to panics based on dodgy statistics and dubious arguments.
Edited by Rob Lyons. |  | | |  |  |
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| | | 12 February 2004 | Smoking sperm
Panic: Smoking damages almost all aspects of sexual, reproductive and child health, according to a new report out from the British Medical Association (BMA). Impotence, sperm damage, infertility, miscarriage, premature birth, low-weight birth and early menopause are all associated with smoking. Vivienne Nathanson, the BMA's head of science and ethics, said: 'The sheer scale of damage that smoking causes to reproductive and child health is shocking. Women are generally aware that they should not smoke while pregnant but the message needs to be far stronger. Men and women who think they might want children one day should bin cigarettes.'
Don't panic: Smoking is bad for your health. Even the most blinkered tobacco lover is aware of this. But a sense of perspective is required. While smoking may increase the likelihood of health problems, this risk is relative; and the vast majority of smokers do not have any more problems having children than anybody else.
The BMA report quotes various studies that suggest that smoking increases the risk of impotence. The BMA report suggests that in the UK 120,000 men between the ages of 20 and 40 - around 11 per cent of male smokers in that age group - are impotent. But this is strictly an estimate, based on a number of assumptions - for example, that research done on veterans of the Vietnam War is applicable to twenty-first century Britain, and that figures for impotency rates for non-smokers are accurate. Moreover, all that such figures can tell us is that there may be a correlation between people who smoke and impotence, not that one causes the other.
The promotion of a link between smoking and sexual health is driven by a desire to bring down smoking rates among younger people who have remained relatively untouched by the campaigns about the impact of lung and heart disease later on in life, and bad breath and smelly clothes in the here and now. By appealing to a concern about male virility in the near future, this smacks of a base attempt to play on sexual confidence in order to promote a public health outcome.
The notion that we might balance small risks against small pleasures is rarely even considered in today's uptight times. These doctors undoubtedly feel they have our best interests at heart, but a busybody is still a busybody, however well qualified he might be.
Read: |  | Smoking and reproductive life | | British Medical Association, February 2004 |
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| | | 23 January 2004 | Abortive arguments
Panic: A group of Labour MPs has announced plans to conduct a survey of doctors and researchers in the UK to try to discover if there is a link between abortion and breast cancer. Claire Curtis-Thomas MP told the BBC that out of 37 studies since the 1950s, 28 had concluded there may be a link. 'The risk as far as we are able to see is approximately double, and there are a huge number of young women choosing abortion in this country', she said. There were 176,000 abortions carried out in England and Wales in 2002, with the highest rates among women aged 16 to 24.
Don't panic: There is no evidence of a causal relationship between abortion and breast cancer. The research quoted by Curtis-Thomas indicates an association between the two, but better and more recent studies suggests no relationship at all. Guidelines produced by the Royal College of Obstetricians and Gynaecologists (RCOG) on advice for women considering abortion state that 'available evidence on an association between induced abortion and breast cancer is inconclusive'. The American College of Obstetricians and Gynecologists concludes: 'More rigorous recent studies argue against a causal relationship between induced abortion and a subsequent increase in breast cancer risk.'
Nonetheless, promoting the idea that there is a link has become a favourite tactic of anti-abortion campaigners. Veteran pro-lifer David Alton recently used a speech to the House of Lords to claim there was a link that might cost the government billions in compensation claims in the future. Interestingly, the MPs behind this new survey quote exactly the same statistics as Alton.
Two arguments are common. One is that abortion causes some kind of hormonal change which makes women more vulnerable to cancer later. But if this were the case, a similar increase in breast cancer would be expected among women who have experienced miscarriage - and research has found no such link. The other claim is that the availability of abortion allows women to put off pregnancy until their thirties. There seems to be evidence that women who are pregnant later in life have a slightly increased risk of breast cancer. But women are choosing to have children later because it suits them to do so - the availability of abortion is simply irrelevant.
If these arguments were taken to their logical conclusion, campaigners would be calling for women to have children when they are teenagers, or not at all, because of the high rate of miscarriage that always exists - both of which sit uncomfortably with contemporary concerns about teenage pregnancy and the falling birth rate. The truth is that anti-abortion campaigners have lost the political and moral argument in the UK, and have taken to propagating health panics in order to further their cause. Women who need an abortion have got quite enough to worry about without unsubstantiated scares about their future health.
| | MPs launch abortion cancer probe, | | BBC News, 22 January 2004 | | The Care of Women Requesting Induced Abortion, | | RCOG | | ACOG Committee Opinion: Induced abortion and breast cancer risk, | | August 2003 | | spiked-issue: Abortion |
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| | | 9 January 2004 | Cancerous Britain?
Panic: Headlines warn: 'cancer cases "at all-time high".' New figures released by Cancer Research UK show 270,425 new cases of cancer diagnosed in 2000 - this is up 3,000 on the year before, and nearly 15,000 on 1995. This rise has been blamed on the cancerous habits of the UK population. Obesity is blamed - as is drinking too much alcohol and sunbathing for too long. Newspapers today suggest that farmed salmon could be a danger - a new study says that Scottish salmon is packed with carcinogenic chemicals, and consumers should only eat a small portion every four months.
Don't panic: Behind the scary headlines there is some good news. One of the main reasons for the rise in cancer cases is that people are living longer - after all, everybody has to die of something eventually.
As David Forman, chairman of the UK Association of Cancer Registries, said: 'Cancer mainly affects older people, and as our population ages we are inevitably seeing more cases.' Another factor is increased detection. More cancers are getting caught earlier, which improves the chances of successful treatment. While the incidence rates have been rising steadily since the 1970s, the death rates have been declining. For example, the main reason for a 25.4 per cent rise in prostrate cancer is a new blood test, which can pick up many new cases - including many which are not life-threatening.
Some of the 23.8 per cent increase in malignant melanoma between 1995 and 2000 may be due to increased sun exposure - although some is because people tend to present earlier to their doctor. Whatever the percentage increase, malignant melanoma remains rare; it makes up only 10 per cent of all skin cancer cases.
And the toxic salmon? The Food Standards Agency reassures that the levels of carcinogens in salmon are well within the safety levels set by the World Health Organisation. There's no need to be put off from the cheaper salmon now hitting the supermarket shelves. It seems that some experts would rather scare us, and lecture us about changing our beer-swilling, sun-soaking lifestyles, than give us the sober facts.
Read: | | Cancer cases 'at all-time high', | | BBC News, 7 January 2004 |
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| | | 5 January 2003 | Falling fertility
Panic: Researchers in Aberdeen, Scotland, have found that men's sperm counts have fallen by almost a third in just over a decade. The findings are based on 16,000 semen samples taken from 7500 men attending the Aberdeen Fertility Centre, and indicate that the average 'normal' sperm count has fallen from 87million sperm per millilitre in 1989 to 62million in 2002 - a drop of 29 percent.
The study has spawned articles across the UK press claiming new fears about men's fertility, and speculating as to the causes and consequences of falling sperm counts. 'Lifestyle' factors, such as drinking, drugs and smoking have been blamed, along with wearing tight trousers, eating seafood high in mercury, and driving for long distances. 'Environmental' factors like pesticides, chemicals and radioactive material are also in the dock, charged with being linked to decreased fertility. As for the consequences - 'We must act while we still have time', argues Dr Richard Sharpe of the Medical Research Council's Human Reproductive Sciences Unit in Edinburgh, raising fears about the 'enormous social and economic consequences' of decreasing male (and perhaps female) fertility.
Don't panic: As most news reports have pointed out, the Aberdeen study looked at men who already required fertility treatment - which makes it difficult to generalise from this small group to the rest of the male population. Indeed, worries about falling sperm counts generally may be sparked by the fact that more men are coming forward for treatment - as treatment for infertility is dramatically improving. A reassuring Q&A in The Times (London) points out that, internationally, while some studies find a falling sperm count, others do not; with some studies showing 'big variations in sperm counts between countries and even within countries'.
The 'lifestyle' factors blamed for low sperm counts are the usual suspects - drinking, smoking, drugs - blamed for any health problem, even though it is difficult to isolate any one factor as causing these problems. The 'environmental' factors fall into a similar category - when is pollution not held responsible for one of the many mysterious ailments that plague modern life? Meanwhile, the most important alleged link - between lowering sperm counts and rising male infertility - is not as straightforward as often presumed. A Guardian report points out 20million sperm per millilitre is regarded as the lower perameter for a 'normal' sperm count (far lower than the 62million found by the Aberdeen study), while The Times explains that 'even men with sperm counts as low as 10million per millilitre...have more than enough sperm to become fathers - it may just take longer'. As a certain band once put it, Relax....
Read: | | Q&A: the mystery over falling sperm counts, The Times (London), 5 January 2004 |
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| | | 22 December 2003 | Binge boozing
Panic: As the party season gets underway, official concern about how much we drink is on the rise. 'Britain counts cost of binge drinking', says ITV News, reporting a Cabinet Office study which claims that alcohol abuse costs Britain £20billion a year. According to government statistics, 6.4million people in the UK are 'moderate-to-heavy' drinkers and 1.8million more are 'heavy drinkers'. The Stroke Association says that binge-drinkers double their risk of having a stroke. The authorities are especially concerned at the rising levels of binge drinking among young women.
Don't panic: The same Cabinet Office report notes that, while drinking levels have been rising since 1945, they are still substantially below consumption levels in 1900. Per capita consumption in the UK is still lower than that in Ireland, France and Germany. In fact, most of the population drinks less than the abstemious levels recommended by the Department of Health, and 4.7million Brits are teetotal.
Binge drinking is defined as drinking twice the recommended daily allowance in one sitting. For men, this means roughly four pints of ordinary-strength beer or one bottle of wine. For women, it means three pints or two-thirds of a bottle of wine. While drinking to excess frequently is certainly a bad idea, these definitions of binge drinking lump together ordinary social drinking with alcoholism. Some people at the Department of Health clearly need to get out more.
The scare stories about strokes are a classic example of confusing relative and absolute risk. The Stroke Association may be correct about the increased relative risks - and stroke is one of the most common causes of death in the UK. But the absolute risk of stroke for anyone who is not old is very low. Government statistics for the period 1994 to 1998 reveal that there were 0.2 cases per 1000 people of stroke in the 0 to 35-year age group each year. Even if a young person's annual risk of stroke doubled, it would still be only 2500-to-1. In 1998, for example, there were just 130 cases of stroke among the millions of people under 35.
What is most striking is the moralistic tone of the discussion, and the contempt for any hint of risky or reckless behaviour among the young, particularly young women. But incapable of laying down a moral standard about alcohol, the government hides behind health campaigns and junk science. The vast majority of young drinkers will suffer no more than a bad hangover and the occasional embarrassing moment. They won't have a stroke - even if they walk and talk like they have.
Read: | | Britain counts cost of binge drinking, | | ITV News, 20 December 2003 | | Alcohol Misuse: Interim Analytical Report, | | Prime Minister's Strategy Unit | | Stroke warning to binge-drinkers, | | BBC News, 16 December 2003 |
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