Jeremy Laurance: How to remain optimistic in the face of the worrying facts

Medical Life

Optimism is a valuable commodity in medicine and the NHS Breast screening Service is no different from other organisations in putting the best possible spin on its considerable achievements. "Nearly 2 million women screened in 2007-8," the press release for its annual report announced last week after an extra 100,000 were invited compared with the previous year.

The breast cancer charities hailed its progress. "We are pleased [the programme] is now screening more women than ever before," said Alexis Willett, head of policy at Breakthrough Breast Cancer. "It is extremely encouraging to see a significant increase in the number of women accepting their invitations to breast screening," said Olivia Marks-Woldman, head of policy at Breast Cancer Care.

Good news all round then? Unfortunately, a glance at the figures in the report itself tell a different story. Acceptance rates declined across all age groups from 50 to 71+. The decline was particularly sharp in the over 70s where acceptance rates fell 12.9 per cent, though the number of women in this category is very small. The report says the decline in women newly invited for screening, by 0.5 per cent, is "particularly worrying." It is the second consecutive year this has happened. Are women starting to lose faith in breast screening?

I am all in favour of trying to stay optimistic but when facts are "particularly worrying" they deserve to be debated, not buried.

The total number of women screened last year increased because more women were invited, as screening is being extended to include younger women aged 47 to 50 and older ones aged 70 to 73.

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I know it's the season of goodwill but handing out free alcohol to students in the interests of "science" seems to be taking matters a bit far. What was the first thing you learnt about alcohol? I remember at school earnest discussions about which spirit left least incriminating trace on your breath and, as important, on next morning's hangover. Now researchers have confirmed what teenagers have known for decades – that whisky will give you a thick head while vodka will leave you relatively bright eyed and bushy-tailed next morning and should be the spirit of choice, especially for the novice drinker.

The study was carried out at Brown University in the US where 95 volunteers were given enough alcohol to put them a third over the driving limit in the UK. They concluded it was the "congeners" in the whisky – bourbon in this case – that accounted for its hangover-inducing property. Congeners are present in larger quantities in all dark drinks, which explains why red wine causes worse hangovers than white wine. But did we really need a bunch of addled students to tell us this?

One interesting conclusion did come out of the study. Both the whisky drinkers and the vodka drinkers were equally poor next day at carrying out everyday tasks. So the size of your hangover is not, in fact, a guide to the detriment in your performance. You may feel worse on whisky but you perform just as badly on vodka. Happy New Year!