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Silicone breast implants (SBIs) are frequently discussed in the media. Reporting on this topic is commonly characterised by sensationalism and a lack of nuance. SBIs have been linked to autoimmune disease and the controversial disease entity 'breast implant illness'. However, convincing evidence for this association is lacking because nearly all studies examining this association suffer from methodological weaknesses. Among the well-described long-term adverse effects of SBIs are implant ruptures, capsular contractures and the exceptionally rare breast implant-associated large cell lymphoma of the breast (BIA-ALCL). SBIs contribute significantly to the quality of life of many breast cancer patients and women with cosmetic implants. Any potential adverse effect of SBIs must therefore always be carefully weighed against the benefits of SBI-based procedures. In this consideration, evidence based on sound methodology is of vital importance. Oversimplified reporting based on deficient research leads to undue alarm among women with breast implants.

The Dutch BETER consortium has established a national care infrastructure for Hodgkin lymphoma survivors. 'BETER' [the Dutch word for 'better'] stands for Better care after Hodgkin lymphoma (HL): Evaluation of long-term Treatment Effects and screening Recommendations. The survivorship care focuses on long-term effects of HL treatment. Over 10,000 HL survivors who were treated in the period spanning 1965-2008 have been identified. As part of the survivorship care initiative, specific BETER out-patient clinics have been set up. A dedicated website, www.beternahodgkin.nl, provides HL survivors with relevant information. The stakeholders of the BETER survivorship care programme aim to achieve an improved healthy life expectancy for patients treated for HL.

Objective: To calculate the proportion of cancer cases in the Netherlands in 2010 that were attributable to lifestyle factors by using the most recent data., Design: Secondary analysis., Method: Lifestyle risk factors studied were tobacco smoking, alcohol consumption, overweight, lack of physical exercise, and six elements of diet (consumption of vegetables, fruit, processed meat and red meat, and calcium and fibre intake). The lifestyle factors were organised so that the group with the highest risk (e.g. smokers) could be compared with the groups with the lowest risk (e.g. ex-smokers, non-smokers). Cut-off points were in line with Dutch public health messages. We obtained prevalence data on risk factors from national databases. Relative risks for the relationship between lifestyle and cancer were based on the international literature. Incidence and mortality data for cancer in 2010 were obtained through the Netherlands Cancer Registry. We calculated percentages of new cancer cases and deaths for men and women and for each type of cancer individually; these were then summed., Results: We estimated that of the 98,971 newly-diagnosed cases of cancer among persons aged ≥ 20 years in the Netherlands in 2010, 29,938 (30%) were attributable to the above-mentioned lifestyle factors. Smoking was the most important contributory risk factor (19% of all new cancer cases), followed by sub-optimal dietary habits (10%), overweight (4%), alcohol consumption (3%), and lack of physical activity (2%). Of cancer deaths in 2010, an estimated 38% were attributable to lifestyle factors. Projections for 2020 show that lack of exercise and consumption of alcohol and meat will contribute less to the development of cancer while overweight and a reduction in inadequate dietary fibre intake and inadequate fruit and vegetable consumption will contribute more., Conclusion: Almost one-third of all cases of cancer and almost 40% of deaths from cancer can be attributed to a less healthy lifestyle.

The Dutch Cancer Society developed the 'KWF Kanker Risico Test' (Cancer Risk Test) to improve the information available to the Dutch population regarding cancer risk factors. This Internet test, based under licence on the American 'Your Disease Risk' test, informs users about risk factors for 12 common types of cancer. The test provides an estimate of individual risk of a specific type of cancer and gives specific lifestyle advice that could lower that risk. This paper describes the development of the test, how it works, and its strengths and limitations.

Human tissue remaining after diagnostic procedures is important for use in scientific research. This 'secondary use' of tissue is regulated by the Dutch Medical Treatment Contracts Act and the Code of Conduct for Proper Secondary Use of Human Tissue of the Dutch Federation of Biomedical Scientific Societies. Patients have the right to opt-out of further use of their residual tissue, but the procedures for objection and the provision of information involved are not regulated by statute. Dutch patients have a positive attitude to further use of human tissue for other purposes. They prefer, however, a procedure in which they are informed verbally by their health professional about research with residual tissue. The information can be brief and is best provided early in the treatment. Administrative and technical modifications of the current registration systems are necessary to support the opting-out procedure in practice. By taking the preferences of patients into account, trust in medical practice can be maintained.