Abstract
A group of patients with a disease such as cancer of the breast will contain some who would survive five years without any treatment and others who would die within five years despite any treatment. The presence of these has a serious effect on the chance of showing a difference between two methods of treatment. Controlled series in cancer therapy should be carefully chosen, otherwise equivalent results are likely to be obtained and real differences which are present may be obscured. This type of reasoning is applied to McWhirter's proposal that the overall survival rate is the crucial figure in judging methods of treatment for cancer of the breast. If one method of treatment is superior to another for one stage of the disease only, then this difference may be obscured if groups containing all the stages are compared. Yet staging as ordinarily practised is a crude device and tends to give fallacious answers. We suggest co-operation between treatment centres using different types of therapy to obtain detai...
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