Per-Henrik Zahl, DrMedSci
Potential Conflicts of Interest: None disclosed.
Zahl P.; Overdiagnosis of Invasive Breast Cancer due to Mammography Screening. Ann Intern Med. 2012;157:220-221. doi: 10.7326/0003-4819-157-3-201208070-00024
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Published: Ann Intern Med. 2012;157(3):220-221.
TO THE EDITOR:
Kalager and colleagues (1) reported a 15% to 25% overdiagnosis rate of invasive cancer in the Norwegian Breast Cancer Screening Program. In 2004, my coworkers and I reported (2) that screening led to a 51% increase in breast cancer cases that could not be explained by earlier diagnosis and called this increase overdiagnosis. We updated our study in 2012 (3) and reported the same high level of overdiagnosis. Our updated study had longer follow-up and included 11 631 breast cancer cases diagnosed after screening started, whereas Kalager and colleagues' analysis included only 3862 cases. The difference in estimates of overdiagnosis between our study and theirs, however, is not explained by data per se but by the methods for adjusting for underlying incidence increase and lead time.
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