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Daniel B. Kopans, MD
Massachusetts General Hospital Boston

JAMA. 1994;271(13):982.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—There is a trend on the part of the epidemiologic community to try to find reasons to withdraw support for screening women aged 40 to 49 years for breast cancer and a disturbing lack of balanced scientific analysis. This trend is reflected in the paper by Dr Kerlikowske and colleagues.¹ Their conclusions are biased and certainly more sweeping than the data justify, and the quoted historical data concerning screening are factually incorrect.

The meta-analysis cited by the authors used out-of-date numbers. Fletcher et al² reported that the mortality benefit in five of the eight randomized, controlled trials for women aged 40 to 49 years ranges from 22% in the Edinburgh study³ to 49% in the Malmo trial,⁴ not the 13% to 23% cited by Kerlikowske et al. It is specious to suggest that these results are "nonsignificant" since the trials were not designed . . . [Full Text PDF of this Article]

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