1436

Hence the publication of International Incidence of ChildhoodCancer.3 As well as the data tables, this text does make useful andinteresting comments, usually for every registry.Three registries in Japan, spanning 1971-80, show cumulative

incidence rates (an estimate of cumulative risk) for neuroblastomaup to age 14 years of 93-121 cases per million. Diagnosis at an earlyage is important in the prognosis of neuroblastoma. Hence the massscreening of children in Japan, which started in 1972 in 3-year-olds,was extended to infants aged 6 months.’ Now such screening withhigh-performance liquid chromatography (HPLC) is reportedfrom Japan,s at$1-5 per sample. HPLC is quick, quantitative,detects more cases than the qualitative spot or dip tests for

vanillylmandelic acid, and has a lower re-test rate. Some registriesfrom all five continents show cumulative incidence rates that aresimilar to or higher than those of children in Japan. Is it only the costof HPLC equipment and staff that prevents mass screening in suchcountries (which include many from the first world)?

WOMEN’S HEALTH CONCERN

Women’s Health Concern,l a charity that provides healthinformation and counselling for 60 000 women every year, haslaunched an appeal for c500 000 to expand its counselling servicesduring the next three years. A new counselling centre is to be set upin London, and a telephone counselling service will be started inCardiff. Both centres will introduce training programmes to swellthe ranks of WHC’s team of nurse counsellors. Last month, MrsEdwina Currie, Parliamentary Under-secretary for Health,announced that WHC’s grant from the Department of Healthwould be increased from 7000 a year to £ 15 000 a year for threeyears.More than half the inquiries received by WHC concern the

menopause, and a quarter relate to gynaecological disorders andhysterectomy. WHC has long been active in promoting the use ofhormone replacement therapy (HRT), especially for the preventionof postmenopausal osteoporosis-an expensive disease that costsBritain c500 million a year in treatment and support. Yet WHCestimates that only 4% of women who could benefit from HRT areusing it.

HEALERS, QUACKS, AND LADY DOCTORS

TOWARDS the end of last century women fought a long hardbattle not for admission but for readmission to the medical

profession. In seventeenth and early eighteenth century Englandfemale surgeons practised under licence and women healers werecommonplace; even educated men endorsed a role for women inmedicine. The industrial revolution changed all that. Prejudicebased on gender crept in and female apothecaries and surgeons werebanned. Women became quacks and moved into market places,where they touted brand-named "physics" and cosmetics forwomen’s complaints and were butts for male humour. Their fight toreturn to respectable medicine was recalled at a symposium at theWellcome Institute for the History of Medicine on Nov 25. WendyAlexander from the Wellcome Unit in Glasgow has investigated 62women graduates who qualified in that city at the turn of the centuryto see how they fared. Contrary to the expectations of the maledoctors of that time (and often of today’s doctors), 89% of thewomen practised their profession for all or most of their workinglives--only 8% stopped work on their marriage. Lamentably,despite the high qualifications of many of Alexander’s sample (14had research MDs and 31% had published books and researcharticles), only 4 became consultants, 3 in gynaecologically relatedspecialties-a situation that has scarcely improved. However poor

3. International Incidence of Childhood Cancer Edited by D M Parkin, C A. Stiller,G J Draper, C. A. Bieber, B Terracini, J. L. Young Lyon: International Agencyfor Research on Cancer, Scientific Publication no 87, 1988 Pp 401. £30 ISBN0-9283211871

4 Sawada T, Hirayama M, Nakata T, et al Mass screening for neuroblastoma in infantsin Japan interim report of a mass screening study group. Lancet 1984, ii: 271-73

5 Sawada T. Laboratory techniques and neuroblastoma screening. Lancet 1988; ii:

1134-35.

1 Women’s Health Concern, PO Box 1629, London W8 6AV (01-602 6669)

Britain’s record, that of the Chinese is not much better. ProfKanwen Ma of Beijing University could find only 20 reports offemale healers in China during the 41 thousand years up to the latenineteenth century. But in China today 60% of practising doctorsare women-is there a message for the western world here?

Postgraduate Education

The full report of the conference mentioned in our columns

(1987; ii: 464) has now been published. Improving Postgraduate andContinuing Education, by Dr K. M. Parry, is published for theUnited Kingdom Conference of Postgraduate Deans by the KingEdward’s Hospital Fund for London. Available from King’s FundPublishing Office, 14 Palace Court, London W2 4HT (01-7270581). /:3.95.

Training Courses for HIV/AIDS Counsellors

The Terrence Higgins Trust has introduced a certificate trainingprogramme in HIV/AIDS counselling. The full course consists offour weekend workshops and is designed to be of interest both tomedical and other professionals and to volunteers with little or noprofessional experience. For further details, course prospectus, andapplication forms, contact Ian Mandleberg, counselling coursecoordinator, Terrence Higgins Trust, 52-54 Gray’s Inn Road,London WC1X 8JU (01-831 0330).

A lecture by Prof R. Williamson on Gene Probes and DifficultDiseases—Cystic Fibrosis and Friedreich’s Ataxia is to be held in theClinical Lecture Theatre, Clinical Research Centre, Northwick Park,Watford Road, Harrow, Middlesex HA1 3UJ, on Thursday, Jan 12 (01-8645311 ext 2026).

A meeting entitled Radiology in AIDS will be held at the British Instituteof Radiology, London, on Thursday, Jan 19: Conference Office, BritishInstitute of Radiology, 36 Portland Place, London WIN 4AT (01-580 4085).

A conference on Manic Depression-The Implications For

Community Care is to take place at Westminster Cathedral ConferenceCentre, Victoria, London, on Wednesday, Jan 25: Emmanuel Andreopoulus,Manic Depressive Fellowship, 51 Sheen Road, Richmond Upon Thames,Surrey TW9 1YQ (01-876 4498).

The Advanced Neurological Life Support course will take place atSunnybreak Medical Centre, 2075 Bayview Avenue, Toronto, Canada M4N3M5, on Jan 26-28: Mrs Lois Kaphalakes (1-416-482 2247).

Correction

Fetal Obstructive Uropathy.-This is the correct title for the letter by Dr S.Degani and colleagues (Dec 10, p 1363).

International Diary

1989

A conference on Lead Research-Implications for EnvironmentalHealth: North Carolina, USA, Jan 9-11 (Janet Riley, AdministrativeOfficer, OD, National Institute of Environmental Health Sciences, PO Box12233, Research Triangle Park, NC 27709).

23rd annual scientific meeting of the European Society for ClinicalInvestigation: Athens, Greece, April 19-22 (Prof S. Rapns, PO Box 14127,Athens 115 10).

A symposium on Vaginismus and Dyspareunia-the Dutch view:Amsterdam, The Netherlands, May 27 (QLT Convention Services/Congrex, Keizersgracht 782, 1017 EC Amsterdam).

2nd European congress of Endocrinology; Ljubljana, Yugoslavia, July1-6 (Secretariat, Kompas Jugoslavia, Congress Department, Prazakova 4,61000 Ljubljana).

Joint convention of the 5th international Child Neuorology congress andthe 3rd Asian and Oceanian congress of Child Neurology; Chiba, Japan,Nov 4-10 (Secretariat of the Joint Convention of the 5th ICNC and 3rdAOCCN, c/o Simul International Inc., Kowa Building No 9, 8-10 Akasaka1-chrome, Minato-ku, Tokyo 107, Japan).