Annals of Surgical Oncology

, Volume 26, Issue 2, pp 698–699 | Cite as

Treatment Intensity Differences According to Participation in a Population Screening Program

  • G. B. MannEmail author
  • C. Nickson
  • K. Elder
Breast Oncology

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...


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Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  1. 1.The Breast Service, Royal Melbourne and Royal Women’s HospitalParkvilleAustralia
  2. 2.Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia

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