Abortion and breast cancer.

Hawton and colleagues 1 found that, relative to the general population, NHS female doctors had about twice the expected suicide rate, whereas NHS male doctors had about half the expected suicide rate. They concluded that, " the excess risk of suicide of female doctors in the NHS workforce is an important pattern that should be carefully monitored. This is especially so in the light of increasing numbers of women coming into medicine. " (page 299). In the paper's summary, the same conclusion is stated more boldly: " The excess risk of suicide in female doctors highlights the need to tackle stress and mental health problems in doctors more effectively. The risk requires particular monitoring in the light of the very large increase in the numbers of women entering medicine. " (page 296). This conclusion is misleading. The excess suicide risk of female doctors was relative to the comparable age/gender section of the general population. However, that finding is irrelevant to the question at issue: inter-gender differences in the suicide risk of doctors within the NHS. Comparison of the female and male doc-tors' suicide rates, presented in table 2 of the paper by Hawton and colleagues, shows that the female doctor suicide rate is numerically higher in the 35–39 age group, the same in the 30–34 age group, and lower in the 25–29, 40–49, and 50–59 age groups. The total suicide rate of the female doctors is also lower than that of the male doctors, irrespective of the inclusion or exclusion of the male 60–64 age group. With inclusion of the suicide rates presented in table 3, this makes for seven comparisons. In only one comparison is the female doctors' suicide rate higher than that of the male doctors, in one the rates are the same, and in the remaining five, the male doctors have the higher suicide rate. As female suicide risk is quasi-universally lower than male suicide risk, the conservative conclusion should therefore have been that the female doctors maintained the lower suicide risk of their gender. If it is true that increasing numbers of women are entering medicine, it can be confidently predicted that the suicide rate of the profession is more likely to decrease than to go up. References 1 Hawton K, Clements A, Sakarovitch C, et al. Suicide in doctors: a study of risk according to gender, seniority and specialty in medical Goldacre et al 1 …