Abstract
Commentary on Keen and Keen 'What is the point: will screening mammography save my life?' BMC Medical Informatics and Decision Making, 2009
Highlights
Why are the authors' modelled results different from the empirically observed results of others? One reason may be the difference between the time frames of the authors' model and the period of observation in the empirical data
From a rather convoluted ecological synthesis of information from different sources, the authors arrive at the finding that 1.8 breast cancer deaths would be prevented by repeatedly screening 1000 women for 15 years
The randomised trials combined yield an estimate of a 20% mortality reduction with invitation to screening [5], whereas the authors posit this as
Summary
Why are the authors' modelled results different from the empirically observed results of others? One reason may be the difference between the time frames of the authors' model and the period of observation in the empirical data. The first is that the paper rather labours the obvious point that in breast cancer screening, as in primary and secondary prevention generally, one has to apply the intervention to large numbers of healthy subjects in order to benefit the few who are unlucky enough to develop the disease. If one is in the business of preventive medicine, one has to accept this as a fact of life.
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