Treatment Intensity Differences According to Participation in a Population Screening Program
To the Editors:
We thank Dr. Lannin for his editorial interest1 in our paper ‘Treatment Intensity Differences After Early-Stage Breast Cancer (ESBC) Diagnosis Depending on Participation in a Screening Program’.2 We believe that much of his analysis stems from a misunderstanding of the nature of our study and a number of questionable assumptions.
Our study assesses differences in breast cancer pathology and treatment according to screening status, combining outcomes for screen-detected and interval cancers among recent screening participants. We agree that length of time bias (screening detecting more favorable cancers) arises when screen-detected cancers are compared with all other cancers in the community. This bias is carefully minimized in this study by combining interval cancers and screen-detected cancers in the ‘active screeners’ group, and then excluding likely overdiagnosed screen-detected cancers from our analysis.
Dr. Lannin’s re-analysis of our published figures purports to...
- 3.Australian Institute of Health and Welfare. BreastScreen Australia monitoring report 2014–2015. Cancer series no. 106. Cat. no. CAN 105. Canberra, ACT: AIHW; 2017.Google Scholar