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To the Editor: Dr Terry and colleagues recently demonstrated an association between aspirin use and a reduced incidence of hormone receptor–positive breast cancer.¹ We are concerned about how the implied relative change of risk (a 26% decrease; OR, 0.74; 95% CI, 0.60-0.93) is presented to the public without addressing the absolute risk reduction.

To really understand what this statistic means, readers should know that 26% represents the decrease in the risk of breast cancer present in nonaspirin users. Given the study design (a population-based case-control study), the risk of breast cancer overall can be calculated: it is the total number of incident breast cancer cases (2030 originally identified in the Long Island Breast Cancer Study Project²), divided by the population at risk (1 021 348 women aged 20 years and older in Nassau and Suffolk counties, New York, US Census 1997). Based on the odds ratio and knowing the proportion of . . . [Full Text of this Article]

Steven Woloshin, MD, MS
steven.woloshin@dartmouth.edu

Lisa M. Schwartz, MD, MS
VA Outcomes Group
White River Junction, Vt

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