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"Our results need further verification and should lead to changes to reduce non-combatant deaths from air strikes."

The estimated 100,000 civilian deaths compare with 1,110 American troop casualties and 140 non-American military casualties in Iraq, around 70 of them British, since the war began last March.

Coalition forces say they try to avoid killing civilians - known as "collateral damage" in military jargon - while carrying out military actions. Arab satellite networks have however claimed that airstrikes in Fallujah have regularly killed 100 or more people each night.

Overall, the risk of death was 2.5 times greater after the invasion, the team reported. The risk was 1.5 times higher if mortality around the hotspot of Fallujah, where two thirds of violent deaths were reported, was excluded.

This lower figure equated to an excess 98,000 deaths directly relating to the conflict, said the researchers. The estimate would be much higher if the Fallujah data were added.Violent deaths were reported in 15 of the 33 neighbourhoods surveyed, and were mainly attributed to the coalition forces.

Dr Richard Horton, editor of the Lancet, said the paper had been "extensively peer-reviewed" by independent experts to check its methodology and accuracy, and fast-tracked to publication.

He said in a strongly-worded commentary: "Democratic imperialism has led to more deaths, not fewer. This political and military failure continues to cause scores of casualties among non-combatants."

He said winning the peace in Iraq now demanded a "thorough reappraisal of strategy and tactics to prevent further unnecessary human casualties".

He added: "For the sake of a country in crisis and for a people under daily threat of violence, the evidence that we publish today musts change heads as well as pierce hearts."

Dr Horton acknowledged that there were shortcomings because of the testing conditions in which the study was carried out.

The number of population clusters chosen for sampling was small, and the margins of uncertainty around the mortality estimates were wide. There was also the potential for "recall bias" among those being interviewed.

Yet the central observation - that civilian mortality had risen due to the effects of weapons - was convincing.

"This result requires an urgent political and military response if the confidence of ordinary Iraqis in the mostly American-British occupation is to be restored," said Dr Horton.

Care International closes its Iraq operations

Care International, the aid agency which employs Margaret Hassan who was kidnapped in Baghdad on October 19, said that it had closed down all its operations in Iraq following demands from her abductors.

CARE International today released a short statement, which said: "Care has closed down all operations in Iraq. Please release Mrs Hassan to her family and friends in Iraq."

A day ago another videotape was broadcast on Arab TV network Al-Jazeera showing a frightened Mrs Hassan calling for the release of all female prisoners in Iraq, for British soldiers to stay away from Baghdad, and for CARE to close its offices in the country.

The 59-year-old was seized on her way to work in western Baghdad as Care's Iraq director of operations. The following day Care said it was temporarily suspending its programmes in Iraq under the "current circumstances", but today it confirmed that all operations have been called off indefinitely.

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