Chernobyl, ionising radiation exposure, and cancer risk
The first review in this months TLO reviews the epidemiological evidence linking cancer incidence as a result of the 1986 Chernobyl nuclear explosion in the Ukraine. Most studies have focused on malignant diseases in children, specifically thyroid cancer and leukaemia. Authors of the review argue that there is good evidence to suggest that rates of thyroid cancer in children from the countries that were formally part of the Soviet Union have risen as a consequence of the Chernobyl accident. The findings for childhood leukaemia, they comment, are less conclusive. Among adult populations, there is no strong evidence to suggest that risk of thyroid cancer, leukaemia, or other malignant disease has increased as a result of the Chernobyl accident.

Hormone-replacement therapy (HRT) and breast cancer
HRT has been available for many years, but the important question of its place in development and progression of breast cancer remains controversial. This review summarises current clinical data, which suggest that short-term HRT use does not increase breast-cancer risk, although a small increase in risk is associated with long-term (more than 10 years) HRT use. The review highlights the need for prospective controlled trials in healthy women as well as those at higher risk of breast cancer or with a personal history of the disease.

A case for geriatric oncology
The increase in cancer incidence with increasing age is becoming more obvious and more important as the average age of the population increases. This review assesses the biological and clinical interactions of cancer and ageing and discusses the skills and knowledge necessary for caring for older patients.

A culture of mistrust
This months Leading Edge editorial examines the issues surrounding diet and cancer, especially media reports that often
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Contact: Richard Lane
richard.lane@lancet.com
44-20-7424-4949
Lancet
1-May-2002