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• W4252406720 abstract "Ole Olsen and Peter Gotzsche's full report on www.thelancet.com1Olsen O Gotzsche PC Cochrane review on screening for breast cancer with mammography.http://image.thelancet.com/lancet/extra/fullreport.pdfGoogle Scholar is riddled with misrepresentation, inconsistency in the treatment of the randomised trials, and errors of method and fact, some examples of which follow.They cite inconsistencies of reporting for the Two-County Trial. However, the individual trials and the Swedish overview inevitably differ, since the latter reclassified causes of death and redefined the study groups. This independent review of trial results is exactly the sort called for by Olsen and Gotzsche and Richard Horton in his accompanying Commentary,2Nyström L Larsson LG Breast cancer screening with mammography.Lancet. 1993; 341: 1531-1532Summary Scopus (841) Google Scholar but was overlooked. Other alleged inconsistancies cited by Olsen and Gotzsche are due to the numbers of deaths increasing with longer follow-up; competent metaanalysts would be aware of such change and differences between the primary studies and secondary researchers' reports.3Horton R Screening mammography-an overview revisited.Lancet. 2001; 358: 1284-1285Summary Full Text Full Text PDF PubMed Scopus (70) Google Scholar The Two-County Trial is further misrepresented as two separate trials and as having failed to publish vital information. It was, in fact, one trial. We have made public more material on its design, conduct, and results than any of the other trials.In their attempts to justify the baseline imbalance in palpable nodepositive tumours in the Canadian National Breast Screening Study,4Miller AB To T Baines CJ Wall C The Canadian National Breast Screening Study: update on breast cancer mortality.Monogr Natl Cancer Inst. 1997; 22: 51-53Google Scholar Olsen and Gotzsche note that study group patients were generally treated in centres with more thorough axillarynode dissection, but did not deem this difference a source of bias. However, they wrongly cite this treatment difference as a potential source in the other trials. In the Two-County study, standard treatment according to stage of disease was applied to study and control groups.5Holmberg LH Tabar L Adami HO Bergström R Survival in breast cancer diagnosed between mammographic screening examinations.Lancet. 1986; 2: 27-30Summary PubMed Scopus (70) Google ScholarOlsen and Gotzsche quote a significant excess of excluded previous cancers in the people aged 60–69 years in the study group of the Kopparberg part of the Two-County Trial, but do not seem to have adjusted their singinficance test for the multiple testing that they must have done to search for such chance heterogeneities.The above do not inspire confidence in Olsen and Gotzsche's judgment of study quality or for the notion that allcause mortality is an appropriate endpoint. As if deaths from road-traffic accidents or hip fractures were in some way indicative of the effect of breast-cancer screening. We believe that Olsen and Gotzsche referring readers to a website for details of why they were right all along, is a clever and convenient way of subverting the peer review process and shielding their work from proper scientific scrutiny. The full report is not the official Cochrane review, despite its misleading title. Olsen and Gotzsche's review is of poor quality, and, therefore, unreliable. Given this poor quality, Horton's uncritical commentary is at best ill considered. Nothing in the report or commentary disproves the finding of millions of person-years of experimental research, and dozens of previous expert reviews, that mammographic screening significantly reduces mortality from breast cancer. Ole Olsen and Peter Gotzsche's full report on www.thelancet.com1Olsen O Gotzsche PC Cochrane review on screening for breast cancer with mammography.http://image.thelancet.com/lancet/extra/fullreport.pdfGoogle Scholar is riddled with misrepresentation, inconsistency in the treatment of the randomised trials, and errors of method and fact, some examples of which follow. They cite inconsistencies of reporting for the Two-County Trial. However, the individual trials and the Swedish overview inevitably differ, since the latter reclassified causes of death and redefined the study groups. This independent review of trial results is exactly the sort called for by Olsen and Gotzsche and Richard Horton in his accompanying Commentary,2Nyström L Larsson LG Breast cancer screening with mammography.Lancet. 1993; 341: 1531-1532Summary Scopus (841) Google Scholar but was overlooked. Other alleged inconsistancies cited by Olsen and Gotzsche are due to the numbers of deaths increasing with longer follow-up; competent metaanalysts would be aware of such change and differences between the primary studies and secondary researchers' reports.3Horton R Screening mammography-an overview revisited.Lancet. 2001; 358: 1284-1285Summary Full Text Full Text PDF PubMed Scopus (70) Google Scholar The Two-County Trial is further misrepresented as two separate trials and as having failed to publish vital information. It was, in fact, one trial. We have made public more material on its design, conduct, and results than any of the other trials. In their attempts to justify the baseline imbalance in palpable nodepositive tumours in the Canadian National Breast Screening Study,4Miller AB To T Baines CJ Wall C The Canadian National Breast Screening Study: update on breast cancer mortality.Monogr Natl Cancer Inst. 1997; 22: 51-53Google Scholar Olsen and Gotzsche note that study group patients were generally treated in centres with more thorough axillarynode dissection, but did not deem this difference a source of bias. However, they wrongly cite this treatment difference as a potential source in the other trials. In the Two-County study, standard treatment according to stage of disease was applied to study and control groups.5Holmberg LH Tabar L Adami HO Bergström R Survival in breast cancer diagnosed between mammographic screening examinations.Lancet. 1986; 2: 27-30Summary PubMed Scopus (70) Google Scholar Olsen and Gotzsche quote a significant excess of excluded previous cancers in the people aged 60–69 years in the study group of the Kopparberg part of the Two-County Trial, but do not seem to have adjusted their singinficance test for the multiple testing that they must have done to search for such chance heterogeneities. The above do not inspire confidence in Olsen and Gotzsche's judgment of study quality or for the notion that allcause mortality is an appropriate endpoint. As if deaths from road-traffic accidents or hip fractures were in some way indicative of the effect of breast-cancer screening. We believe that Olsen and Gotzsche referring readers to a website for details of why they were right all along, is a clever and convenient way of subverting the peer review process and shielding their work from proper scientific scrutiny. The full report is not the official Cochrane review, despite its misleading title. Olsen and Gotzsche's review is of poor quality, and, therefore, unreliable. Given this poor quality, Horton's uncritical commentary is at best ill considered. Nothing in the report or commentary disproves the finding of millions of person-years of experimental research, and dozens of previous expert reviews, that mammographic screening significantly reduces mortality from breast cancer. Screening for breast cancer with mammographyAuthor's reply Full-Text PDF" @default.
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• W4252406720 title "Screening for breast cancer with mammography" @default.
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