Cancer Stage vs Mortality End Points in Randomized Clinical Trials of Cancer Screening—Reply

In Reply Our study compared the end points of cancer-specific mortality and late-stage cancer in randomized clinical trials of cancer screening. Drs Kim and Gibbs write that the relationship between these could be affected by changes in cancer staging and treatment. We agree that this is true not only for our comparison of end points, but for cancer screening in general. For example, a screening test that is effective at reducing cancer mortality could become ineffective if new treatments decrease differences in survival between stages. For the cancer types in our study, Surveillance, Epidemiology, and End Results data generally show survival improvements over time across all stages.

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Ottobre 2024

Cancer Stage vs Mortality End Points in Randomized Clinical Trials of Cancer Screening

To the Editor A recent study provided a robust analysis of the association between the reduction in stage III to IV cancer diagnoses and overall survival gains in historical cancer screening trials, and the accompanying Editorial added an important epidemiological perspective. However, the relationship between cancer stage at diagnosis and survival is not static. Data from the studies examined, many of which were initiated 30 to 40 years ago, are of questionable relevance in the modern era.

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Ottobre 2024

Evaluating Supplemental Breast Cancer Screening With Simulation Modeling

In 2009, the first state dense breast legislation was passed in Connecticut, requiring that women who undergo mammography receive written notification of breast density. This advocacy-driven policy was intended to raise women’s awareness that dense breasts are a risk factor for breast cancer and can also obscure breast cancer on mammography. Since then, 37 states and the District of Colombia have followed with their own reporting laws, and beginning in September 2024, the US Food and Drug Administration will require breast density notification to be included in mammography reports for all patients and their referring clinicians.

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Ottobre 2024