Child Molestation and Pedophilia

To the Editor.—  We congratulate the editors of JAMA on the publication of the fascinating and scholarly review by Dr Fuller1¹ entitled "Child Molestation and Pedophilia: An Overview for the Physician." Though otherwise comprehensive, the review omitted emphasis of one of the most prevalent and traumatic categories of child sexual abuse, ie, incest (intrafamilial child sexual abuse). Dr Fuller mentions incestuous abuse only twice in his review. Our concern is that such omission might serve to perpetuate what some have labeled one of this century's greatest tragedies: the failure of society (and medicine) to acknowledge the presence and devastating impact of the scourge of incest on our children.The brief reference to incest might be taken by the reader to imply that incest is not significant enough to warrant discussion, even in a general review. Such cannot be the case when 10% to 50% of all child sexual abuse is