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Editor's Correspondence
Mar 12, 2012

Screen Detection Has Both Winners and Losers

Author Affiliations

Author Affiliations: Department of Radiology, Cook County John H. Stroger Jr Hospital, Chicago, Illinois (Dr J. D. Keen); and School of Veterinary Medicine and Biomedical Sciences, University of Nebraska, Lincoln (Dr J. Keen).

Arch Intern Med. 2012;172(5):447. doi:10.1001/archinternmed.2011.1885

Dr Welch is a pioneer in presenting the benefits and harms of screening to both clinicians and the public. However, Keen and Keen1,2 were the first to devise the method to calculate the life-saving proportion (LSP) of screen-detected breast cancers, using matched 15-year periods. The follow-up analysis promoting screening mammography insight used 10-year periods.3 The higher percentage of screen-detected cancers (61%-64% vs 50%-56%) in the article by Welch and Frankel4 makes our estimates higher, while the mixed 20-year/10-year death/diagnosis risk makes our estimates lower.