To the Editor Dr Silber and colleagues1 reported survival differences among black and white women with breast cancer. However, screening overdiagnosis may weaken the results of this and prior studies on the topic.
For example, cases detected through screening mammography are sometimes diagnosed as breast cancer even though they would never be noticed otherwise. These overdiagnoses can lead to unnecessary treatments.2 Recent studies have prompted disagreement about the extent of overdiagnosis.3 Despite this attention, the effect of overdiagnosis on survival disparities is unclear.
Harding CF, Pompei F, Wilson R. Differences in Breast Cancer Survival by Race. JAMA. 2013;310(22):2456–2457. doi:10.1001/jama.2013.281072
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