For months, media outlets have speculated that tens of thousands of civilians have been killed since the invasion of Iraq. Since the Pentagon declared that it “doesn’t do body counts” for noncombatants, the media estimates have been considered true. Now, a study done by American and Iraqi researchers puts the civilian death toll much higher, more than 100,000. As the researchers write, these findings demand a reconsideration of the methods of U.S. and coalition forces in Iraq.

British officials have said they will examine the findings “with very great care,” especially because they were published by The Lancet, an esteemed medical journal. American officials defended the invasion and did not call for further review. They should.

Researchers interviewed Iraqi households in September to gather information about civilian deaths. They found that the risk of death in the nearly 18 months after the invasion of Iraq was 2.5 times higher than in the 15 months before it. Because two-thirds of the violent deaths occurred in Fallujah, the researchers worried that this skewed their data. Excluding Fallujah, the risk of death was 1.5 times higher after the invasion. In actual numbers, that means 98,000 “extra” deaths occurred outside Fallujah during the post-invasion period, according to the researchers’ finding, rushed to online publication by The Lancet. Based on their Fallujah sample, the researchers found an “extra” 200,000 deaths in that area alone. The deaths are considered “extra” because they exceed the pre-war death rate.

Before the Iraq invasion, the primary causes of death in the country were heart attacks, strokes and chronic diseases. After the invasion, it was violence. Excluding Fallujah, 24 percent of deaths after the invasion were attributable to violence. Including Fallujah, 51 percent of deaths were attributable to violence. The majority of the deaths were caused by helicopter gunships and other aerial attacks. Nearly half of those killed were under the age of 15 and 7 percent were adult women.

“Civility and enlightened self-interest demand re-evaluation of the consequences of weaponry now used by coalition forces in populated areas,” wrote the researchers.

The researchers themselves caution that their numbers are not precise and need further review. However, similar methods were used to calculate civilian deaths in Kosovo in the late 1990s.

Perhaps as important as their findings is the fact that such research was conducted. Their work challenges government officials, inside and outside the military, to consider the consequences of war through a public health lens.

“This survey shows that with modest funds, four weeks and seven Iraqi members willing to risk their lives, a useful measure of civilian deaths could be obtained,” they wrote. “There seems to be little excuse for occupying forces to not be able to provide more precise tallies.”

Except that such tallies might be politically unpalatable.