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© 1986 Oxford University Press

research-article

An Analysis of the Mortality Effect in a Breast Cancer Screening Study

JOAN L ARON* and PHILIP C PROROK{dagger}

* Biostatistics Branch, Landow 8C25, National Cancer Institute Bethesda, MD 20205, USA
{dagger} Biometry Branch, Blair 3A01, National Cancer Institute Bethesda, MD 20205. USA

Present address: Department of Population Dynamics, Johns Hopkins School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.

In order to better understand the effect of breast cancer screening on mortality, we use the theory of competing risks to analyse deaths from the long-term follow-up of the HIP breast cancer screening trial. We conclude that some, but not all, of the breast cancer cases detected early as a result of screening realized a benefit in terms of elimination of the risk of breast cancer mortality. Breast cancer screening appears not to affect the rate of mortality from causes of death other than breast cancer. Methodologically, we demonstrate the importance of analysing mortality separately for the breast cancer as well as for the entire population in a trial.

Revised 1 April 1985


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